Citation Nr: 20002125 Decision Date: 01/09/20 Archive Date: 01/09/20 DOCKET NO. 12-31 763 DATE: January 9, 2020 REMANDED Entitlement to service connection for a left foot disorder. REASONS FOR REMAND In July 2018, the Board denied service connection for a left foot disorder. The Veteran appealed to the Veterans Claims Court. In June 2019, the Court Clerk granted a Joint Motion for Partial Remand (JMR) and returned the appeal to the Board for further consideration. The July 2018 Board decision denied the appeal on the basis that the Veteran did not have a current disability except pain, observing that evidence did not demonstrate a functional impairment of earning capacity such that the pain was equivalent to a disability. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). An April 2017 VA examination had found a normal left foot with pain that did not result in functional loss. Since the case was returned to the Board by the Court, the Veteran submitted a September 2019 opinion by Dr. AA, who associated the left foot disorder with service-connected left knee and left ankle disabilities; however, the only disorder of the left foot noted was pain. While the opinion extensively discussed the history of symptoms and impairment in the left knee and left ankle, Dr. AA did not describe any functional impairment in the left foot. An October 2019 statement by the Veteran described the impact of his left foot pain on his ability to function. Nevertheless, the Court in Saunders cautioned that a veteran cannot demonstrate service connection simply by asserting subjective pain. Rather, to establish the presence of a disability, the veteran will need to show that pain reaches the level of functional impairment of earning capacity. Moreover, a review of treatment notes added to the claims file in added to the claims file in December 2019 reflected no complaint, treatment, or diagnosis for the left foot. Therefore, the Board remands the appeal for an examination to assess the current nature and etiology of a left foot disorder. The matter is REMANDED for the following actions: 1. Undertake appropriate development to obtain any outstanding records pertinent to the Veteran’s claim, including providing Dr. AA an opportunity to supplement his statement regarding any left foot diagnosis. 2. Schedule the Veteran for an examination to assess the current nature and etiology of a left foot disorder. All pertinent evidence of record must be made available to and reviewed by the examiner. For any functional impairment of the left foot found, the examiner should state a medical opinion as to whether it is at least as likely as not (i.e., whether there is a 50 percent or better probability) that the disorder was caused by service-connected disabilities, to include any changes in body mechanics that are due to these disabilities? The examiner should then state an opinion as to whether it is at least as likely as not (i.e., whether there is a 50 percent or better probability) that the disorder was aggravated beyond normal progression by service-connected disabilities, to include any changes in body mechanics that are due to these disabilities? The rationale for any opinion expressed must also be provided. The examiner is advised that the questions of causation and aggravation are distinct, and the rationales provided should also be distinct. If the examiner is unable to provide the required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. 3. Then, readjudicate the issue on appeal. If any benefits sought on appeal are not granted to the Veteran’s satisfaction, a supplemental statement of the case should be issued and the Veteran and his attorney should be afforded the requisite opportunity to respond. Thereafter, the case should be returned to the Board for further appellate action. L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. M. Schaefer, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.