Citation Nr: 20002292 Decision Date: 01/10/20 Archive Date: 01/10/20 DOCKET NO. 14-11 469 DATE: January 10, 2020 REMANDED Entitlement to service connection for right and left foot numbness is remanded. REASONS FOR REMAND The Veteran served on active duty from April 2007 to August 2011. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a June 2012 rating decision of a Department of Veteran Affairs (VA) Regional Office (RO). In October 2015, the Board remanded the bilateral foot claim for further development. Entitlement to service connection for bilateral foot numbness is remanded. The October 2015 Board decision remanded the claim for a VA examination to determine the etiology of the Veteran’s bilateral foot numbness. The Board decision highlighted contradictory information in an April 2012 VA examination report regarding whether or not the Veteran had a diagnosis for a peripheral nerve condition. Although the VA examiner recorded no diagnosis, the examination report stated that symptoms were present that were attributable to a peripheral nerve condition. The Veteran was afforded another VA examination in December 2015. The VA examiner determined the Veteran did not have a peripheral nerve condition or peripheral neuropathy following an electromyography (EMG) study, which showed normal results. The Board finds the examination report is incomplete in light of the federal court ruling in Saunders v. Wilkie, 886 F.3d 1356, 1367-68 (Fed. Cir. 2018) issued after the 2015 examination. The Saunders decision found that pain alone can constitute a “disability” under § 1110, because pain can cause functional impairment. The Board finds the December 2015 VA examination report did not address all the issues found in the medical evidence of record that are probative to determine whether or not pain could cause functional impairment for the Veteran. Although, the Board notes the December 2015 VA examiner recorded the undiagnosed bilateral foot condition did not impact the Veteran’s ability to work. The Veteran has asserted that his feet become numb and he cannot stand for prolonged periods of time. The cause of his foot numbness is related to running while on active duty and landings after parachuting from planes during his active military service. The Veteran’s DD Form 214 shows his Military Occupational Specialty (MOS) during service was an infantryman. Moreover, his DD Form 214 also indicates he was awarded a parachutist badge. The October 2015 VA examination report did not address the Veteran’s MOS or the potential impact of parachuting on his feet. Further, the Board notes the December 2015 VA examination report did not address contemporaneous VA medical records. The Board notes that the dates of the records are approximately the same time as the December 2015 VA examination; as such, the records may not have been available at the time of the examination. Nevertheless, VA treatment records in December 2015, reveal the Veteran experienced bilateral foot numbness for approximately four years. The symptoms covered both feet entirely. Moreover, his symptoms were aggravated by standing or running, with the right foot more symptomatic than the left. Notably, the treatment record stated the Veteran denied weakness or pain related to his feet. However, these records were not discussed by the VA examiner regarding the Veteran’s medical history. Thus, the December 2015 examination report medical history was incomplete. Additionally, in June 2014, the Veteran’s accredited representative provided a statement asserting that the Veteran’s service-connected lumbosacral strain could be the proximate cause of the bilateral foot numbness due to pressure being placed on the nerve root. This particular contention was also not addressed in the December 2015 examination report. The Board finds a medical opinion to address this contention would be useful to adjudicate these appellate matters. Based on the above, the Board finds that remand is warranted for an addendum opinion for the December 2015 VA examination report. Upon remand, updated VA treatment records should be associated with the record on remand. See Sullivan v. McDonald, 815 F.3d 786, 792 (Fed. Cir. 2016) (finding that because § 3.159(c)(3) expanded the VA’s duty to assist to include obtaining VA medical records without consideration of their relevance.) The matter is REMANDED for the following actions: 1. Update/Obtain VA treatment records from July 2016 to the present. Document all requests for information as well as responses in the claims file. 2. After completion of step #1, schedule the Veteran for an appropriate VA examination to determine the nature and etiology of his bilateral foot numbness. The examiner is to review the entire claims file and must note such review in the examination report. The examiner is to note/address the following: (a.) The Veteran’s DD Form 214 showing he served in the infantry and he was awarded the parachutist badge during his active military service. See July 8, 2011, Certificate of Release or Discharge From Active Duty (e.g. DD 214, NOAA 56-16, PHS 1867). (b.) VA treatment records from December 7, 2015, which show a four-year history of bilateral foot numbness. See 07/21/2016 CAPRI, at 11. (c.) The Veteran’s Accredited Representative Statement submitted August 6, 2014, asserting that the bilateral foot numbness was proximately caused by the Veteran’s service-connected lumbosacral strain. See June 6, 2014, VA 646 Statement of Accredited Representative in Appealed Case. (d.) Whether it is at least likely as not the Veteran’s current bilateral foot numbness is related to an in-service injury, event or disease. (e.) If the Veteran does not have a diagnosed bilateral foot condition; is there pain associated with the bilateral foot condition that causes functional impairment that reduces the Veteran’s ability to work. Please complete the functional impact section of the appropriate worksheet. (f.) If no, is it at least as likely as not (50 percent or greater probability) that the Veteran’s disability was either 1) proximately due to OR 2) aggravated by any service-connected disability, to include his service-connected lumbosacral strain. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinions. A comprehensive rationale for all opinions is to be provided. All pertinent evidence, including both lay and medical evidence, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.M. Williams, 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.