Citation Nr: 18115054 Decision Date: 06/29/18 Archive Date: 06/28/18 DOCKET NO. 14-25 618 DATE: June 29, 2018 ISSUES DECIDED: ISSUES REMANDED: 10 REMANDED Service connection for fracture, proximal fourth and fifth metatarsals, left foot is remanded. Service connection for a skin disorder is remanded. Entitlement to an evaluation in excess of 40 percent for lumbar spine is remanded. Entitlement to a compensable evaluation for patellofemoral syndrome, left knee is remanded. Entitlement to an evaluation in excess of 10 percent for patellofemoral syndrome, right knee is remanded. Entitlement to compensable evaluation for metatarsus adductus, left foot is remanded. Entitlement to compensable evaluation for metatarsus adductus, right foot is remanded. Entitlement to an evaluation higher than 20 percent for radiculopathy, left lower extremity is remanded. Entitlement to an evaluation higher than 20 percent for radiculopathy, right lower extremity is remanded. Entitlement to an effective date earlier than January 28, 2010 for the award of service connection for posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1982 to February 1983, from January 1988 to January 1992, and January 1992 to April 1993. His discharge from this last period of service has been characterized as dishonorable for VA purposes. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In February 2016, the Veteran testified at a Travel Board hearing before the undersigned Veterans Law Judge. A transcript of this hearing has been added to the record. The Veteran is seeking an effective date prior to January 28, 2010, for the award of service connection for PTSD. At his February 2016 Travel Board hearing, the Veteran argued that service connection for PTSD should be granted back to the time of his original claim of service connection filed on April 26, 1993. Although the record contains an opinion from Dr. Bash, a radiologist, that the Veteran has had PTSD since 1993, the opinion does not include adequate rationale and the Board notes the Veteran’s treatment records dating from 1993 do not reflect a diagnosis of PTSD until February 2010. The Board finds a retrospective opinion by a VA psychiatrist or psychologist is needed. With respect to the claim for service connection for a left foot fracture, the Veteran contends that he has had ongoing foot pain since his military service, where he served as airborne infantry. The competent evidence of record does not adequately address whether the Veteran’s fracture residuals of the proximal fourth and fifth metatarsal, left foot, is related to service or his service-connected metatarsus adductus disability. Accordingly, a new examination and opinion is needed. With respect to the skin claim, the Board finds that an additional examination and opinion are needed, as VA treatment records from 1993 showing treatment for a skin condition have been added to the record after the 2012 examiner’s opinion was provided. The Veteran’s most recent VA examinations of the spine, knees, and feet were performed in July 2012. The Veteran contends that these conditions have increased in severity since these examinations. Accordingly, new VA examinations are warranted. Relevant ongoing medical records should also be requested. 38 U.S.C. § 5103A(c) (2012); see also Bell v. Derwinski, 2 Vet. App. 611 (1992) (VA medical records are in constructive possession of the agency, and must be obtained if the material could be determinative of the claim). Accordingly, the case is REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have treated him for his feet, back, knees, lower extremity radiculopathy, and skin disorders. After securing any necessary releases, request any relevant records identified. Updated VA treatment records should also be obtained. If any requested records are unavailable, the Veteran should be notified of such. 2. Thereafter, schedule the Veteran for a VA foot examination to determine the current severity of his service-connected bilateral foot metatarsus adductus and to obtain an opinion concerning his claimed fracture of the left foot. The claims file must be reviewed by the examiner in conjunction with the examination. All symptomatology associated with the bilateral foot metatarsus adductus should be reported. After review of the claims file and examination of the Veteran, the examiner should respond to the following: a. Provide an opinion as to whether the Veteran’s old fracture of the left proximal fourth and fifth metatarsal noted on x-ray, is at least as likely as not (50 percent probability or greater) etiologically related to his active service prior to January 13, 1992, to include his in-service duties in the airborne infantry. The examiner must explain the reasons for the conclusion reached. The examiner is advised that the Veteran’s service from January 13, 1992 to April 16, 1993 is dishonorable for VA purposes and cannot be considered for compensation purposes. b. If not related to the Veteran’s military service, the examiner should address whether it is at least as likely as not the left foot fracture was caused by or has been worsened beyond normal progression (aggravated) by his service-connected disabilities. The examiner must explain why or why not. 3. Schedule the Veteran for VA thoracolumbar spine examination to address his lumbar spine and lower extremity radiculopathy disabilities and a VA knee examination to address his bilateral patellofemoral syndrome. The electronic claims file must be reviewed by the examiner. All indicated tests should be conducted and the results reported. 4. Schedule the Veteran for a skin examination to determine the current nature of his claimed skin disability and to obtain an opinion as to whether the Veteran has a skin disability that is related to service. The claims file should be reviewed by the examiner in conjunction with the examination. All necessary tests should be conducted and the results reported. Following review of the claims file and examination of the Veteran, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any current skin disability arose during active service prior to January 13, 1992 or is otherwise related to service prior to that date. The examiner should explain why or why not. The examiner is advised that the Veteran’s service from January 13, 1992 to April 16, 1993 is dishonorable for VA purposes and cannot be considered for compensation purposes. 5. Send the claim file to a VA psychiatrist or psychologist to obtain a retrospective opinion on the claim for an earlier effective date for service connection for PTSD. If an examination is deemed necessary to respond to the question presented, one should be scheduled. Following review of the claims file, the examiner should provide an opinion as to when the Veteran first met the diagnostic criteria for PTSD. A rationale for the opinion must be provided. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD W. Yates, Counsel