Citation Nr: 20009965 Decision Date: 02/07/20 Archive Date: 02/05/20 DOCKET NO. 10-37 517 DATE: February 7, 2020 REMANDED Entitlement to an initial rating in excess of 10 percent for bilateral plantar fasciitis with degenerative arthritis associated with bilateral pes cavus prior to June 17, 2019, and in excess of 30 percent thereafter, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Coast Guard from October 1963 to August 1967. This matter before the Board of Veterans’ Appeals (Board) arises from an October 2009 rating decision. In a September 2016 decision, the Board denied the Veteran’s increased rating claim for a bilateral foot disability, which was then characterized as bilateral pes cavus. The Veteran appealed the decision to the Court. In a February 2018 Memorandum Decision, the Court vacated and remanded the Board’s September 2016 decision for readjudication. In August 2018, the Board remanded the matter for further evidentiary development. While in remand status, the Regional Office (RO) issued a September 2019 rating decision increasing the Veteran’s rating for bilateral plantar fasciitis with degenerative arthritis to 30 percent effective June 17, 2019. The Veteran continues to appeal for a higher rating. AB v. Brown, 6 Vet. App. 35 (1993) (a claimant is presumed to be seeking the maximum rating allowed by law). Unfortunately, as explained below, the Board is not satisfied that there was substantial compliance with its prior remand; therefore, the appeal must once again be remanded. See Stegall v. West, 11 Vet. App. 268, 271 (1998); D’Aries v. Peake, 22 Vet. App. 97, 105 (2008). Entitlement to an initial rating in excess of 10 percent for bilateral plantar fasciitis with degenerative arthritis associated with bilateral pes cavus prior to June 17, 2019, and in excess of 30 percent thereafter, is remanded. In its August 2018 remand, the Board determined that additional development was necessary in order to fully comply with the Court’s directives in the February 2018 Memorandum Decision. As such, the Board directed the RO to schedule the Veteran for a VA examination to ascertain the current severity and manifestations of his bilateral foot disability. In its remand directives, the Board specifically directed the VA examiner to determine whether the Veteran suffers from any left ankle functional impairment, including limitation of motion, due to plantar fasciitis with degenerative arthritis associated with bilateral pes cavus. The Veteran underwent a VA foot conditions examination in June 2019. Although the VA examiner, who is noted to be a Nurse Practitioner, assessed the Veteran’s plantar fasciitis, she did not address the Veteran’s left ankle complaints or respond to the Board directives to determine whether his left ankle exhibits any functional impacts due to plantar fasciitis and/or degenerative arthritis. In light of the above, the Board finds that the Veteran’s claim must be remanded once again because the RO did not comply with the Board’s prior remand directive to obtain an adequate medical examination on the Veteran’s behalf. See Stegall, 11 Vet. App. at 268. On remand, the Veteran must be afforded a new VA examination that is adequate for the Board to make an informed decision on the Veteran’s claim. In this regard, the RO must ensure that the Veteran undergoes an examination with a qualified medical professional – if possible, a VA doctor (M.D.) who specializes in podiatry and/or orthopedics – who fully assesses the Veteran’s current foot and ankle conditions, as outlined in the directives below. See Barr v. Nicholson, 21 Vet. App. 303, 311-12 (2007); Douglas v. Shinseki, 23 Vet. App. 19, 26 (2009). Accordingly, the matter is REMANDED for the following action: Schedule the Veteran for a VA examination with a VA physician (M.D.) of appropriate expertise (i.e. podiatry and/or orthopedics) to fully assess the current severity and manifestations of his bilateral plantar fasciitis with degenerative arthritis associated with bilateral pes cavus. The examiner must review the claims file in its entirety, to include a copy of this (and the prior) REMAND, and that review must be noted in the report. A complete history of symptoms must be elicited from the Veteran. The examiner is asked to complete both a VA foot conditions disability benefits questionnaire (DBQ) and a VA ankle conditions DBQ in connection with the examination. After examining the Veteran and conducting any studies and/or tests deemed necessary, the examiner should fully describe all symptomatology and functional deficits associated with the Veteran’s bilateral plantar fasciitis with degenerative arthritis associated with bilateral pes cavus, including whether he has any limitation in range of motion or other functional impairment of the left ankle that is associated with his service-connected foot disabilities. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during periods of flare-up. The examiner must also specifically comment on whether the Veteran’s disability involves any functional limitation of the left ankle, as well as an opinion as to how long these symptoms have manifested. Range of motion testing should be conducted on the left ankle. To the extent possible, the examiner should identify any symptoms and functional impairments due to bilateral plantar fasciitis with degenerative arthritis alone and discuss the effect of the Veteran’s disability on his occupational functioning and activities of daily living. A full and complete explanatory rationale must accompany any opinion offered. If it is not possible to provide a specific measurement, or an opinion with regard to flare-ups, symptoms, or functional impairment without resorting to speculation, the examiner must state whether this inability is due to lack of knowledge among the medical community or based on the lack of procurable information. The Board reminds the examiner that failure to comply with the examination directives outlined herein will render the opinion inadequate and will result in further remand of the Veteran’s claim. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Melissa Barbee, 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.