Citation Nr: 18136348 Decision Date: 09/18/18 Archive Date: 09/18/18 DOCKET NO. 15-42 969 DATE: September 18, 2018 ORDER A rating of 30 percent, is granted, but no higher, for service-connected bilateral pes planus with plantar fasciitis and calcaneal spur syndrome, prior to January 15, 2016, subject to the laws and regulations governing payment of monetary benefits. Entitlement to an increased rating for bilateral pes planus with plantar fasciitis and calcaneal spur syndrome, rated 50 percent disabling since January 15, 2016 is denied. Entitlement to an initial compensable rating for left foot hammertoe associated with bilateral pes planus with plantar fasciitis and calcaneal spur syndrome is denied. Entitlement to an initial compensable rating for right foot hammertoe associated with hallux valgus and hallux rigidus of the right foot is denied. Entitlement to an initial rating in excess of 10 percent for hallux valgus with hallux rigidus of the right foot is denied. Entitlement to an initial rating in excess of 10 percent for hallux valgus of the left foot is denied. Entitlement to an initial rating in excess of 10 percent for bilateral metatarsalgia associated with bilateral pes planus with plantar fasciitis and calcaneal spur syndrome is denied. Entitlement to an initial rating in excess of 10 percent for scar status post right metatarsal head resection with complications associated with hallux valgus with hallux rigidus of the right foot is denied. REMAND Entitlement to concurrent receipt of military retired pay and VA service-connected disability compensation is remanded. Entitlement to an extraschedular rating for bilateral pes planus with plantar fasciitis and calcaneal spur syndrome is remanded. FINDINGS OF FACT 1. Prior to January 15, 2016, the Veteran’s bilateral pes planus with plantar fasciitis and calcaneal spur syndrome more nearly approximated severe flatfoot with objective evidence of pain on manipulation and use accentuated, and indication of swelling on use. 2. Since January 15, 2016, the Veteran has been awarded the maximum 50 percent rating for bilateral foot disability rated based on pes planus. 3. The Veteran has never been shown to have hammertoes of all toes of either foot or functional impairment associated with hammer toes. 4. The Veteran has been awarded the maximum 10 percent rating for unilateral foot disability rated based on right foot hallux rigidus and hallux valgus. 5. The Veteran has been awarded the maximum 10 percent rating for unilateral foot disability rated based on left foot hallux valgus. 6. The Veteran has been awarded the maximum 10 percent rating for bilateral foot disability rated based on metatarsalgia. 7. The residual scarring from right metatarsal resection is shown to be well healed without evidence of tenderness, ulceration or skin breakdown, limitation of function, underlying soft tissue loss, or other abnormality. CONCLUSIONS OF LAW 1. The criteria are met for a schedular 30 percent rating for bilateral pes planus with plantar fasciitis and calcaneal spur syndrome prior to January 15, 2016. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71 a, Diagnostic Code 5276. 2. The criteria are not met for a schedular rating higher than 50 percent for bilateral pes planus with plantar fasciitis and calcaneal spur syndrome since January 15, 2016. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71 a, Diagnostic Code 5276. 3. The criteria for a compensable rating for hammertoe of the right second, third, and fourth toes of the left foot are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71 a, Diagnostic Code 5282. 4. The criteria for a compensable rating for hammertoe of the left second, third, and fourth toes of the right foot are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71 a, Diagnostic Code 5282. 5. The criteria for a disability rating in excess of 10 percent for right foot hallux valgus with hallux rigidus are not met. 38 U.S.C. 1155, 5107; 38 C.F.R. § 4.71a, Diagnostic Codes 5280, 5281. 6. The criteria for a disability rating in excess of 10 percent for left foot hallux valgus are not met. 38 U.S.C. 1155, 5107; 38 C.F.R. 4.71a, Diagnostic Code 5280. 7. The criteria for a disability rating in excess of 10 percent for bilateral metatarsalgia are not met. 38 U.S.C. 1155, 5107; 38 C.F.R. 4.71a, Diagnostic Code 52790. 8. The criteria for a disability evaluation in excess of 10 percent for residual scarring from metatarsal resection have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.7a, including Diagnostic Code 7804. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from September 1979 to September 1999. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). Duty to Assist and Notify There is no indication in this record of a failure to notify or assist the Veteran to include examination and obtaining medical records. See Scott v. McDonald, 789 F.3rd 1375 (Fed. Cir. 2015); see also Sullivan v. McDonald, 815 F.3d 786, 793 (Fed. Cir. 2016) (citing 38 C.F.R. 3.159 (c)(3)). The Board notes that since the issuance of the February 2017 supplemental statement of the case, VA outpatient records have been added to the record; specifically, showing foot complaints in April 2018. The Veteran complained of painful bunionette on the left foot. The Veteran declined any therapy. As this information is duplicative of evidence already of record, the Board will not remand for the issuance of a supplemental statement of the case. Furthermore, the Board notes that the RO, in the July 2012 rating action, assigned 2 separate rating for scars; a noncompensable evaluation for all service connected scars associated with hallux valgus and hallux rigidus of the right foot as well as a 10 percent rating for residual scarring from the metatarsal resection. On review of the medical evidence there is only one scar, the residual scarring from the metatarsal resection. Therefore, the Board will only review the issue regarding a rating higher than 10 percent assigned for the residual scarring from the metatarsal resection. Medical and Procedural History The Veteran argues that higher ratings are warranted for his bilateral foot disabilities. Service connection was granted for pes planus with hallux valgus deformity via rating action in January 2000. A noncompensable evaluation was assigned. In September 2008, the RO granted a 10 percent rating for pes planus effective in September 2007. In January 2010, the Veteran underwent distal L osteotomy of the right 1st metatarsal and Akin osteotomy, and proximal phalanx of the right great toe right metatarsal head resection. The Veteran filed his current claim in September 2011. VA examination was conducted in October 2011. The diagnoses included bilateral pes planus, recurrent plantar fasciitis, bilateral calcaneal syndrome, and bilateral degenerative arthritis. In reporting the Veteran’s medical history, it was noted that he had congenital pes planus. As a result of this condition, plantar fasciitis developed in 2005. Since then he has pain in the plantar aspect of the feet that recurs every three weeks. This is triggered by prolonged standing, walking, and changes in the weather. On examination, there was extreme tenderness of the plantar surfaces. There was decreased longitudinal arch height on weight-bearing. The weight-bearing line fell over or medial to the great toe. There was hallux valgus and right hallux rigidus as result of the right metatarsal head resection performed in January 2010. The Veteran used a stiff sole orthopedic shoe for the right foot, orthotic arch inserts in both shoes, and toe separator between the left hallux and second toe. It was noted that he had developed complications from his right foot surgery. There were hammer toes on second toe of each foot. The symptoms of hallux valgus of the left foot were described as mild or moderate. Whereas, on the right, hallux valgus and hallux rigidus were considered severe with function equivalent to amputation of the great toe. It was further noted that the Veteran was scheduled for the removal of the surgical hardware the next month. The examination report included a postsurgical X ray dated in May 2011, which noted diagnoses of calcaneal spurring and degenerative change, hallux valgus, and bunion deformity of the left foot. On the right foot, there was calcaneal spurring and degenerative changes with bony remodeling with evidence of a partial resection with postsurgical screw in the first metatarsal. In July 2012, the RO granted service connection for bilateral metatarsalgia and assigned a 10 percent rating; hallux valgus with hallux rigidus of the right foot, rated as 10 percent disabling; hallux valgus of the left foot, rated as 10 percent disabling; scar status post right metatarsal head resection, rated as 10 percent disabling; left foot hammertoe, rated as 0 percent disabling; right foot hammertoe, rated as 0 percent disabling; and, (all service connected scars associated with hallux valgus and hallux rigidus of the right foot rated as 0 percent disabling). The RO recharacterized bilateral pes planus to include plantar fasciitis and calcaneal spur syndrome, continuing the 10 percent rating. At VA examination in January 2016, the Veteran reported that he developed increased numbness around the right great toe and left foot bunion. He described it as a sharp stabbing type pain at a 6/10 intensity. He had elevated pain in the morning. He takes Naprosyn for pain control. He is unable to walk or stand for prolonged periods. He is limited to walking a quarter mile without assistance. He had pain that was accentuated on use of both feet. On examination, there was extreme tenderness of plantar surfaces of both feet. This was noted, not improved by his orthopedic shoe. There was decreased longitudinal arch height on both feet on weight-bearing. There was marked deformity on the right foot. There was marked pronation on the right that was not improved by orthopedic shows. There were hammertoes on the second, third and fourth toes of each foot. There was mild to moderate hallux valgus affecting each foot. There was mild to moderate hallux rigidus affecting the right foot. There was pain on movement and weight bearing. Pain limited movement of the right foot. Pain caused disturbance of locomotion and interfered with standing. The left second toe overlapped the great toe with the first metatarsal phalangeal joint angled laterally by 30 degrees. The right great toe dorsiflexes by 30 degrees at the first metatarsal phalangeal joint. There was early formation of bunionettes on both feet. There was bilateral heel pain to palpation. There was bilateral metatarsalgia of both feet. There was inward bowing of the Achilles tendon of the right foot. There was a hypopigmented scar on the right great toe and first metatarsal phalangeal joints that measured 5 x .25 centimeters. The Veteran used a cane. The physician assistant noted that the Veteran would be unable to work a job that would require prolonged standing and walking. In February 2017, the RO increased the rating for pes planus to 50 percent, effective January 15, 2016. Disability Ratings Disability evaluations are determined by comparing a Veteran’s symptoms with criteria set forth in VA’s Schedule for Rating Disabilities, which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. When a question arises as to which of two ratings apply under a particular diagnostic code, the higher of the two evaluations is assigned if the disability more closely approximates the criteria for the higher rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. The Veteran’s entire history is reviewed when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where, as here, the question for consideration is the propriety of the initial evaluation assigned, consideration of the medical evidence since the effective date of the award of service connection and consideration of the appropriateness of a staged rating are required. See Fenderson v. West, 12 Vet. App. 119, 125-26 (1999). VA adjudicators must consider whether to “stage” the ratings, meaning assign different ratings at different times during the rating period to compensate him for times when the disability may have been more severe than at others. The Court has held that consideration of the appropriateness of a staged rating is required for an increased rating claim. See Hart v. Mansfield, 21 Vet. App. 505, 509-10 (2007). The United States Court of Appeals for Veterans Claims (Court) has held that where a condition is listed in the schedule, rating by analogy is not appropriate. Copeland v. v McDonald, 27 Vet. App. 333, 336 (2015). In other words, “[a]n analogous rating... may be assigned only where the service-connected condition is ‘unlisted.’ “Suttman v. Brown, 5 Vet. App. 127, 134 (1993) (emphasis added). Lay reports of symptoms and history associated with the bilateral foot disabilities have been considered together with the probative medical evidence clinically evaluating the severity of the pertinent disability symptoms. However, the clinical evidence offering detailed, specific, objective determinations pertinent to the rating criteria and manifestations associated with the bilateral foot condition is found to be the most probative and credible evidence with regard to evaluating the pertinent symptoms for the bilateral foot disabilities on appeal. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the appellant or obtained on his behalf be discussed in detail. Rather, the Board’s analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the e-file shows, or fails to show, with respect to the claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-30 (2000). The record contains VA outpatient records that date between 2010 and 2018, as well as, reports of VA examinations that were conducted in October 2011 and January 2016. Bilateral Pes Planus with Plantar Fasciitis and Calcaneal Spur Syndrome The Veteran is rated under Diagnostic Code 5276. A 10 percent rating is warranted when there is moderate bilateral or unilateral pes planus with weight-bearing line over or medial to great toe, inward bowing of the tendo Achilles, and pain on manipulation and use of the feet. See 38 C.F.R. § 4.71a, Diagnostic Code 5276. A rating of 30 percent is warranted when there is severe flatfoot including objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, and characteristic callosities. Id. A rating of 50 percent is warranted for pronounced flatfeet including marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo-Achillis on manipulation, not improved by orthopedic shoes or appliances. Id. For the Period Prior to January 15, 2016 Prior to January 15, 2016, the Veteran’s bilateral pes planus is rated as 10 percent disabling, under 38 C.F.R. § 4.71a, Diagnostic Code 5276. As noted, on examination in 2011 there was extreme tenderness of plantar surfaces. There was decreased longitudinal arch height on weight-bearing. The weight-bearing line fell over or medial to the great toe. There was hallux valgus and right hallux rigidus. The Veteran used a stiff sole orthopedic shoe for the right foot, orthotic arch inserts in both shoes, and toe separator between the left hallux and second toe. There were hammer toes on second toe of each foot. The symptoms of hallux valgus of the left foot were described as mild or moderate. On the right, hallux valgus and hallux rigidus were considered severe with function equivalent to amputation of the great toe. As stated previously, under Diagnostic Code 5276, a rating of 30 percent is warranted when there is severe flatfoot including objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, and characteristic callosities. See 38 C.F.R. § 4.71a, Diagnostic Code 5276. Here, resolving all doubt in favor of the Veteran, the evidence of record establishes that the Veteran is entitled to a rating of 30 percent, but no higher, prior to January 15, 2016. Since there is no evidence of pronounced flatfeet including marked pronation, marked inward displacement and severe spasm of the tendo Achillis on manipulation, not improved by orthopedic shoes or appliances, a 50 percent is not warranted, for this period. For the Period Following January 15, 2016 From January 2016, the Veteran’s bilateral pes planus is rated as 50 percent disabling under 38 C.F.R. § 4.71a, Diagnostic Code 5276. The Veteran has been assigned the maximum rating for pes planus under Diagnostic Code 5276. As such, an increased schedular rating based on pes planus cannot be assigned as a matter of law. 38 C.F.R. 4.71a. The Board has considered 38 C.F.R. 4.59 (2017) regarding the Veteran’s reported foot pain, which could be construed as a type of painful motion. Under 38 C.F.R. 4.59, actually painful joints are entitled to at least the minimum compensable rating. See also Petitti v. McDonald, 27 Vet. App. 415, 425 (2015) (“Under 38 C.F.R. 4.59, the trigger for a minimum disability rating is an ‘actually painful, unstable, or malaligned joint []. “). In this case, however, the Veteran has already been assigned the maximum rating for his pes planus, and the rating criteria for pes planus under Diagnostic Code 5276 specifically includes pain on manipulation and use. Therefore, the Veteran’s reports of pain have been considered and they are adequately compensated. See also Johnston v. Brown, 10 Vet. App. 80, 85 (1997) (implicitly holding that once a particular joint is evaluated at the maximum level in terms of limitation of motion, there can be no additional disability due to pain) Hammertoes The Veteran’s hammertoe of the second, third, and fourth toes is rated under Diagnostic Code 5282. Pursuant to this code, a non-compensable (0 percent) rating is assignable for hammertoe of single toes. A 10 percent rating is assignable for hammertoe of all toes, unilateral, without claw foot. 38 C.F.R. 5282. On review of the evidence, the Board finds that an initial compensable rating is not warranted for residuals of hammertoe of the second, third, and fourth toes of each foot because the Veteran does not have hammertoes on all toes as required under Diagnostic Code 5282. Therefore, the criteria for a 10 percent rating are not met for hammertoe of either the right or left foot. Bilateral Hallux Valgus and Right Foot Hallux Rigidus As noted the Veteran has been diagnosed with bilateral hallux valgus as well as hallux rigidus of the right foot. Hallux rigidus is a painful flexion deformity of the great toe in which there is limitation of motion at the metatarsophalangeal joint. Dorland’s Illustrated Medical Dictionary at 811 (30th ed. 2003). Hallux valgus is defined as an “angulation of the great toe away from the midline of the body (toward the other toes) [that] can be caused by bunions.” Verdon v. Brown, 8 Vet. App. 529, 530 (1996) (citing Dorland’s Illustrated Medical Dictionary 244, 729 (27th ed.1988)). A bunion is an abnormal prominence of the inner aspect of the first metatarsal head, accompanied by bursal formation and resulting in a lateral or valgus displacement of the great toe. See Dorland’s Illustrated Medical Dictionary 261 (30th ed. 2003). Diagnostic Code 5281 directs that hallux rigidus, unilateral, severe, be rated as hallux valgus, severe, under Diagnostic Code 5280. Under Diagnostic Code 5280, a 10 percent evaluation is authorized for severe unilateral hallux valgus if equivalent to amputation of the great toe or if operated upon with resection of the metatarsal head. The maximum rating assignable is 10 percent and this recognizes a severe condition that is the equivalent to amputation of the great toe as indicated under Diagnostic Code 5280. In this case, the Veteran’s great toes have not been amputated; however, he did have surgery. As such, consideration of hallux valgus and hallux rigidus to be severe is clearly appropriate and thus, the maximum rating available under the Rating Schedule has been properly assigned for these disabilities. Therefore, higher ratings for the right and left foot are not met Bilateral Metatarsalgia Metatarsalgia is defined as pain and tenderness in the metatarsal region. Dorland’s Illustrated Medical Dictionary 1138 (30th ed. 2003). Under Diagnostic Code 5279, metatarsalgia, anterior (Morton’s Disease), unilateral or bilateral, warrants a maximum 10 percent evaluation. As indicated above, the Veteran is currently in receipt of a 10 percent rating for bilateral metatarsalgia. This 10 percent rating is the highest possible ratings under Diagnostic Code 5279. Therefore, an increased rating under this code is inapplicable. Residual Surgical Scar Diagnostic Code 7801 provides ratings for scars, other than the head, face, or neck that are deep and nonlinear. Scars that are deep or that cause limited motion in an area or areas exceeding six square inches (39 sq. cm.), but less than 12 square inches (77 sq. cm.), are rated 10 percent disabling. Scars in an area or areas exceeding 12 square inches (77 sq. cm.), but less than 72 square inches (465 sq. cm.), are rated 20 percent disabling. Note (1) to Diagnostic Code 7802 provides that a deep scar is one associated with underlying soft tissue damage. Note (2) provides that scars in widely separated areas, as on two or more extremities or on anterior and posterior surfaces of extremities or trunk, will be separately rated and combined in accordance with 38 C.F.R. § 4.25. 38 C.F.R. § 4.118. Diagnostic Code 7802 provides ratings for scars, other than the head, face, or neck that are superficial and nonlinear. Superficial scars that consist of an area or areas of 144 square inches (929 sq. cm.) or greater are rated 10 percent disabling. Note (1) to Diagnostic Code 7802 provides that a superficial scar is one not associated with underlying soft tissue damage. Note (2) provides that scars in widely separated areas, as on two or more extremities or on anterior and posterior surfaces of extremities or trunk, will be separately rated and combined in accordance with 38 C.F.R. § 4.25. 38 C.F.R. § 4.118. Diagnostic Code 7804 provides a 10 percent rating for one or two superficial scars that are painful or unstable on examination. Three or four superficial scars that are painful or unstable are rated as 20 percent disabling. Five or more scars that are unstable or painful are rated as 30 percent disabling. Note (1) to Diagnostic Code 7804 provides that an unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. Note (2) provides that if one or more scars are both unstable and painful, add 10 percent to the evaluation that is based on the total number of unstable or painful scars. Note (3) provides that scars evaluated under Diagnostic Codes 7800, 7801, 7802, or 7805 may also receive an evaluation under this Diagnostic Code, if applicable. 38 C.F.R. § 4.118. Under Diagnostic Code 7805, which rates scars and other effects of scars evaluated under Diagnostic Codes 7800, 7801, 7802, and 7804, disabling effects not considered in a rating provided under the aforementioned diagnostic codes are to be evaluated under an appropriate diagnostic code. 38 C.F.R. § 4.118. The Veteran had residual scarring form his metatarsal resection. At the October 2011 VA examination. There was a 5 centimeter linear scar over the dorsal aspect of the first metacarpophalangeal (MPJ). He reported moderate to severe intermittent throbbing pain. The scar was not unstable. A VA scar examination was conducted in January 2016. The Veteran reported numbness and diminished around the scar. There was 5 x.25 centimeter (approximately 1.25 centimeter square) scar over the dorsal right great toe. The examiner reported that he had bunionectomy with residual nontender scar. On examination the scar was not considered unstable or painful. The examiner indicated that there was no function impact caused by the scarring. Considering Diagnostic Code 7804 which contemplates a 10 percent rating for unstable or painful scars. A 10 percent rating is warranted for one or two scars that are unstable or painful. A 20 percent rating would be warranted if the Veteran had three or four scars that are unstable or painful. There is no indication that a rating higher than 10 percent was warranted. In fact, as noted above, there is no evidence that he had 2 or more painful scars. Furthermore, there were no disabling effects noted with this scarring. There was no adherence to underlying tissue, no instability, no elevation or depression, no inflammation, edema, or keloid formation, no areas of induration, and no limitation of motion. There was normal skin texture and the scar was superficial. In sum, the evidence does not support a rating higher than 10 percent. REASONS FOR REMAND Extraschedular rating for pes planus As noted above, the Veteran is in receipt of the maximum disability rating available for his service-connected pes planus. See 38 C.F.R. 4.71a, Diagnostic Code 5276. The Veteran’s representative maintains that an extraschedular rating is warranted for his pea planus. The Veteran’s complaints and examination results indicate he is entitled to consideration of referral for the assignment of an extraschedular rating for this disability. Concurrent receipt of military retired pay and VA service-connected disability compensation The Veteran also maintains that he is entitled to additional retroactive compensation benefits beginning March 2010. By way of background, in a July 2012 rating decision, the RO granted several claims, resulting in the Veteran receiving a 40 percent combined schedular rating effective March 1, 2010. VA notified the Veteran that it would be withholding a portion of his disability compensation beginning March 2010 in order to prevent overpayment of VA benefits and his military retirement pay. A November 2013 rating action granted a higher rating for a left shoulder disability assigning a 20 percent rating which bought his combined total rating to 50 percent, effective August 27, 2013. A Statement of the Case was issued in October 2015, the RO merely stated in its discussion that the Appellant could not be paid both military retirement pay and VA disability compensation pay beginning in March 2010 because at the time of the July 2012 rating action, the Veteran combined rating was 40 percent. While the decision provided conclusions, it did not include the laws and regulations that are pertinent to this claim. It did not discuss why the Appellant could not receive some measure of concurrent payments for both his retirement military pay and his disability pay in accordance with the Combat-Related Specialty Compensation (CRSC) and Concurrent Retirement and Disability Payment (CRDP) programs. The CRSC program was established by the National Defense Authorization Act (NDAA) for Fiscal Year 2003, Pub.L. 107- 314, § 636, in December 2002. The purpose of the legislation was to allow receipt of partial or full military retired pay and VA disability compensation to eligible military retirees with combat-related disabilities. There is nothing in the record that shows an actual determination being made as to which of the appellant’s many service-connected disorders are directly attributable to combat or combat-related injuries. In general, CRDP is a program that is available to military retirees who served a minimum of 20 years creditable service, including service in the National Guard and Reserves. CRDP restores some or all of the military retired pay that was deducted due to receipt of VA service-connected disability compensation. Retirees must be rated 50 percent or more disabled by VA and, unlike CRSC, the disabilities do not have to be combat-related. Retirees are not required to apply for this benefit; enrollment is automatic. Qualified retirees with a 100 percent VA disability rating were subject to a phase-in period for payments only from January 1, 2004, to December 31, 2004. After December 31, 2004, such individuals are generally eligible for full payment of their military retired pay and VA disability compensation, with some limitations. See 10 U.S.C. §§ 1413a, 1414. The SOC did not discuss which program was applicable to the Appellant’s claim. In fact, it did not discuss either program. Furthermore, the Veteran’s contends that he was already in receipt of a 10 percent rating therefore the additional 40 percent rating equals a 50 percent rating. There is no explanation as to how VA determined his combine ratings. Without these discussions, the Board in unable to explain the actions of the RO and whether they were correct. Finally, the current information in the file makes it impossible to determine whether he has received the full amount of compensation due. In this regard, the Veteran is entitled to a full and clear explanation for all benefits due and paid, including the amounts and reasons for any payments withheld. The Board finds that a complete audit of the Veteran’s compensation account is deemed necessary in order to ascertain with certainty what VA and retirement benefits were due and paid beginning March 2010 until the grant of the 20 percent rating for the left shoulder disability, effective in August 2013. The matter is remanded for the following action: 1. Refer the claim of entitlement to extraschedular consideration for the Veteran’s service-connected bilateral pes planus to the Chief Benefits Director of VA’s Compensation and Pension Service for consideration of an extraschedular evaluation under the provisions of 38 C.F.R. 3.321 (b)(1). 2. The AOJ should obtain an audit of the Veteran’s compensation account reflecting all due and paid amounts of VA compensation RO’s Finance Activity for the period from March 2010 to August 2013. The RO should also obtain written input from the DFAS as to the amounts of military retired pay due and paid the Veteran for the same period. This accounting should include direct deposit confirmations or an award processing sheet of the CRDP that was paid and any adjustments done by the VA or DFAS. The accounting should be presented using the same month by month format, including the first day of the month, and definitions of terms. Copies of all deposit stubs or other accounting for payments and their components and deductions should be provided. 3. After taking any additional development warranted, readjudicate the Veteran’s claims. Then issue a supplemental statement of the claim that inform the Veteran of the laws and regulations that pertain to a claim for entitlement to concurrent receipt of military retired pay and VA service-connected disability compensation under 10 U.S.C. §§ 1413a, 1414; 38 U.S.C. §§ 5304 (a)(1), 5305; 38 C.F.R. § 3.750. M. TENNER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. D. Jackson, Counsel