Citation Nr: 20004501 Decision Date: 01/21/20 Archive Date: 01/21/20 DOCKET NO. 17-00 700 DATE: January 21, 2020 ORDER Entitlement to service connection for a bilateral heel disability is granted. Entitlement to service connection for a bilateral foot disability is granted. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran’s favor, his bilateral heel disability is at least as likely as not related to active service. 2. Resolving reasonable doubt in the Veteran’s favor, his bilateral foot disability is at least as likely as not related to active service. CONCLUSIONS OF LAW 1. The criteria for service connection for a bilateral heel disability have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a bilateral foot disability have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from November 1979 to November 1999. These matters come before the Board of Veterans' Appeals (Board) on appeal from a September 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In January 2019, the Board remanded these issues for additional development. Service Connection 1. Entitlement to service connection for a bilateral heel disability 2. Entitlement to service connection for a bilateral foot disability The Veteran contends that his current bilateral foot pain and plantar fasciitis are related to active service. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (2017). Establishing service connection generally requires evidence of: (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (nexus) between the claimed in-service disease or injury and the present disability. See, e.g., Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the claimant. As to the first element, a current disability, the Board notes that the Veteran’s private treatment records and the contemporaneous VA examinations show diagnoses of bilateral pes cava, bilateral plantar fasciitis, and bilateral heel spurs. Accordingly, the Board finds that the Veteran has a current disability. As to an in-service incurrence, the Veteran contends that over his 20-year military career the wear and tear from marching, working, long standing, hours of formation, climbing up and down in a host of aircrafts, walking the tarmac, and walking the flight deck caused his current claimed bilateral foot and heel conditions. A review of the Veteran’s service treatment records (STRs) show complaints and treatment for left ankle pain in October 1994; which the Veteran contends is also related to his current bilateral foot and heel conditions. Here, the Board also notes that the Veteran’s MOS during his military career was a Maintenance Man and Maintenance Technician. Resolving all doubt in favor of the Veteran, the Board finds the Veteran’s contentions to be consistent with the nature and circumstances of his service. Thus, the second element is also met. As to the third element, a causal relationship, the Board finds that the evidence is in relative equipoise. The Veteran submitted an October 2014 treatment record from Dr. J. B., his private physician. Dr. J. B. opined that that the Veteran’s conditions most likely initiated while in service due to mechanics of the feet and the use of ladders. Dr. J. B. noted that that due to the size of the Veteran’s heel spurs, the fascial strains have been present for several years, and he further noted that fasciitis can come and go. Evidence weighing against the Veteran’s claim is a VA examination conducted in June 2019. The examiner opined that the Veteran’s bilateral foot conditions were not related to service. As rationale, he stated that although the Veteran did not have a foot condition prior to enlistment and ill-fitting military boots issued during 20 years of service can cause an altered stance and gait due to pain, there is no objective evidence during service which indicates complaints, treatment, or diagnoses of the feet. The examiner added that despite the prior medical record relating the Veteran’s foot conditions to service, there is insufficient objective evidence during service to support the claim. Here, the Board finds that both medical opinions of record are both competent and credible. To that extent, both opinions ar based on thorough examination of the Veteran, are based on a review of his medical history, and contain clear conclusions supported by sound rationale. Thus, both opinions are afforded equal probative value. In view of the foregoing, and in consideration of the credible medical evidence, the Board finds that the evidence is at least in equipoise as to whether the Veteran's bilateral foot and heel disabilities are the result of military service. In cases where the evidence is in relative equipoise, the claimant prevails. See Gilbert v. Derwinski, 1 Vet. App. 49, 53-54 (1990). Accordingly, service connection is warranted. James A. DeFrank Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Marsh II, 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.