Citation Nr: 20022469 Decision Date: 04/01/20 Archive Date: 04/01/20 DOCKET NO. 14-15 180 DATE: April 1, 2020 REMANDED Entitlement to service connection for bilateral pes planus with hallux rigidus of the 1st metatarsal phalangeal joints is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1979 to December 1979. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a June 2010 rating decision by the Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran presented testimony at a Board hearing in August 2017. A transcript of the hearing is associated with the claims folder. This case was previously before the Board in April 2018 and February 2019, on which occasions the claim was remanded. Entitlement to service connection for bilateral pes planus with hallux rigidus of the 1st metatarsal phalangeal joints is remanded. The Veteran asserts that his bilateral pes planus, which preexisted service, was aggravated during his period of active duty service. His entrance examination shows a diagnosis of “pes planus, mild, asymptomatic.” (8/26/2015, STR - Medical - Photocopy, p. 25). He denied experiencing “foot trouble” during the examination. (8/26/2015, STR - Medical - Photocopy, p. 27). During his December 1979 separation examination, the Veteran was once again diagnosed with “pes planus mild.” (8/26/2015, STR - Medical - Photocopy, p. 21). During the separation examination, he endorsed “foot trouble.” (8/26/2015, STR - Medical - Photocopy, p. 23-24). Moreover, during an August 2017 Board hearing, he denied having foot pain prior to going into the military, and indicated that he began experiencing pain during basic training. (8/2/2017, Hearing Transcript, p. 4). In April 2010 the Veteran underwent a VA examination for pes planus, during which a VA examiner opined that the disability was less likely than not caused by active military service. In rendering his opinion, the examiner noted the Veteran had flat feet prior to entering service and indicated that the disability “may have been temporarily aggravated during his service.” (4/20/2010, VA Examination, p. 6). The Board finds that his opinion is inadequate for evaluation purposes, as the examiner failed to provide supporting rationale for his conclusion that pes planus was temporarily aggravated. Subsequently, in July 2018 the Veteran was afforded a second VA examination for pes planus. The VA examiner opined the disability clearly and unmistakably existed prior to service and was not aggravated beyond its natural progression during service. (8/1/2018, VA Examination, p. 12). In rendering her opinion, the examiner noted that the Veteran was diagnosed with bilateral pes planus during his entrance examination and during his separation examination. The examiner suggested that the separation examination also indicated that the Veteran did not have bilateral foot symptoms. Contrary to the examiner’s findings, the Board finds that the Veteran complained of foot trouble related to being flat footed at his separation examination. (8/26/2015, STR - Medical - Photocopy, p. 23-24). Moreover, as previously noted, the Veteran testified that he started experiencing foot pain during basic training. (8/2/2017, Hearing Transcript, p. 4). As the examiner’s opinion seems to be based on an inaccurate factual premise, the Board finds that the opinion is inadequate for evaluation purposes. See Reonal v. Brown, 5 Vet. App. 458, 460-61 (1993). In the Board’s February 2019 remand, further medical development was ordered. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives. In this regard, in an October 2019 VA opinion, a VA examiner failed to opine on whether pes planus was aggravated by service. Hence, another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. The AOJ should obtain copies of VA treatment records for the Veteran’s disabilities from December 2019 to the present. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of bilateral pes planus with hallux rigidus of the 1st metatarsal phalangeal joints. The examiner must opine whether bilateral pes planus with hallux rigidus of the 1st metatarsal phalangeal joints was at least as likely as not aggravated by service and, if so, whether any increase in severity was clearly and unmistakably (undebatable) due to its natural progress. In rendering an opinion, the examiner must specifically address the following evidence: (a.) The Veteran’s December 1979 report of “foot trouble.” (Continued on the next page)   (b.) The Veteran’s August 2017 Board Hearing testimony that he began experiencing foot pain during basic training. Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Glenn, 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.