Citation Nr: 20002218 Decision Date: 01/10/20 Archive Date: 01/09/20 DOCKET NO. 17-27 198 DATE: January 10, 2020 ORDER Entitlement to service connection for bone spurs, left foot, is denied. Entitlement to service connection for bone spurs, right foot, is denied. Entitlement to service connection for vasectomy residuals, to include chronic epididymitis with erectile dysfunction, is granted. FINDINGS OF FACT 1. The Veteran has no diagnosis of left or right foot bone spurs during the appeal period. 2. The Veteran’s testicular pain is etiologically related to his in-service vasectomy. CONCLUSIONS OF LAW 1. The criteria to establish service connection for left foot bone spurs disability are not met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). 2. The criteria to establish service connection for right foot bone spurs disability are not met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). 3. The criteria for service connection for residuals of a vasectomy have been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 2007 to May 2016. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2017 rating decision by the Department of Veterans Affairs (VA). Service Connection Service connection will be granted if the Veteran has a disability resulting from personal injury or disease incurred in the line of duty, or for aggravation of a preexisting injury or disease incurred in the line of duty during active service. 38 U.S.C. § 1110 (2012); 38 C.F.R. § 3.303 (2018). To establish service connection, the evidence must show (1) a present disability, (2) an in-service incurrence or aggravation of a disease or injury, and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). In the absence of a current diagnosed disability, service connection cannot be granted for such disability. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The requirement that a current disability be present is satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or at any time during the pendency of that claim. See McClain v. Nicholson, 21 Vet. App. 319 (2007). When there is an approximate balance of positive and negative evidence regarding the merits of an issue, the benefit of the doubt shall be given to the Veteran. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. If the preponderance of the evidence is against the claim, the claim is to be denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). 1. Entitlement to service connection for left and right foot bone spurs. The Veteran filed an August 2016 claim for bone spurs in both heels of his feet. The Regional Office (RO) combined the Veteran’s claim for bone spurs with his claim for bilateral plantar fasciitis. However, the RO later reviewed that decision and granted bilateral plantar fascitis with metatarsalgia, status post metatarsal fracture of the right foot in an April 2018 rating decision. The issues of left and right foot bone spurs remain denied and are properly before the Board for review of the RO’s decision. The Veteran’s service treatment records reflect complaints of chronic foot pain related to an in-service right foot broken during airborne operations. See e.g. May 2011 and May 2015 Service Treatment Records. The Veteran’s service treatment records, entrance and separation exams are silent regarding any in service complaints, diagnoses or treatment for bone spurs located in the Veteran’s feet or heels. At the outset, the Board notes that, as above, service connection is in effect for bilateral plantar fasciitis with metatarsalgia and fibromyalgia which has been rated as 50 percent disabling based on findings of extreme pain on the plantar surfaces, and pain on manipulation and use of the feet. Therefore, to the extent that pain with functional impairment can be considered a disability under Suanders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018), in the absence of actual pathology, this is inapplicable in the present case as foot pain is already being compensated under the service connected bilateral plantar fasciitis. Therefore, the crucial question in this case is whether there is a separate and distinct diagnosis of bilateral foot bone spurs. In this regard, the Veteran was afforded a VA examination in November 2016. The November 2016 examiner determined that the Veteran did not have bone spurs in his feet and noted that the Veteran’s bones were normal. The Veteran’s private podiatrist stated that the Veteran suffers from a painful foot and ankle on his right side. The podiatrist diagnosed the Veteran with plantar fascitis, post traumatic DJD of the ankle joint and post-traumatic DJD of LisFranc’s joint, but did not provide any diagnoses of bones spurs. See May 2017 Private Medical Record. The Veteran was afforded a second February 2018 VA Examination. The VA examiner reviewed x-rays and noted no fracture or other significant bone, joint or tissue abnormality in either foot. See VA Examination dated February 2018. To date, the Veteran has failed to provide or allege any documentation supporting a diagnosis of a bilateral bone spurs. Moreover, the competent medical evidence of record fails to show a diagnosis of bilateral foot bone spurs at any time during the appeal period. As there is no showing of a current disability, service connection is not warranted. 2. Entitlement to service connection for residuals of a vasectomy to include, chronic epididymitis with erectile dysfunction. The Veteran attributes has right testicular pain, erectile dysfunction and chronic epididymitis to the vasectomy he underwent in service. See November 2016 VA Examination. After a review of the evidence of record, the Board finds that service connection is warranted for residuals of a vasectomy. The Veteran’s service treatment records show a vasectomy was performed in 2014 and an elective surgery waiver dated and signed May 2013. After the surgery, the Veteran complained and sought treatment related to right testicular pain. The treating military physician opined that the right testicular pain is likely a residual of the vasectomy. However, any further attempts to correct the pain would likely result in more pain. See October 2015 Service Treatment Records. The Veteran was afforded a VA examination in November 2016. The November 2016 examiner diagnosed the Veteran with erectile dysfunction but stated that the cause was unknown. The Veteran was afforded a second VA examination in June 2018. The June 2018 VA examiner reported that the Veteran had a vasectomy in 2014 and has experienced right testicular pain since that event in-service. The examiner opined that the Veteran’s testicular pain is as likely as not due to the vasectomy. In December 2018, an addendum examiner stated that residuals from a vasectomy such as erectile dysfunction and chronic pain are not uncommon, and that chronic epididymitis occurs in one to two percent of all men after having a vasectomy. As the June 2018 examiner physically examined the Veteran and provided a medically reasoned opinion, the Board finds the opinion probative especially in light of the corroborative December 2018 VA addendum opinion. The Board also notes that there are no contradictory medical opinions of record. Therefore, the Board determines that service connection for residuals of a vasectomy is warranted. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael Lederman, Associate 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.