Citation Nr: 20032702 Decision Date: 05/11/20 Archive Date: 05/11/20 DOCKET NO. 19-12 801 DATE: May 11, 2020 ORDER Entitlement to service connection for a left ankle disorder, to include a left heel spur, is denied. FINDING OF FACT The preponderance of the evidence does not show that the Veteran’s left ankle disorder, to include left heel spur, is etiologically related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for a left ankle disorder, to include a left heel spur, have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from September 1959 to September 1963. The Veteran was afforded a hearing before the undersigned in October 2019. A copy of the transcript is of record. 1. Entitlement to service connection for a left ankle disorder, to include a left heel spur. Service connection will be granted for disability resulting from a disease or injury incurred in or aggravated by military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection requires competent evidence showing, (1) the existence of a present disability; (2) 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 determining whether service connection is warranted for a disability, VA must determine 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 the claimant. The Veteran asserts that in 1961 while in service he fell and injured his left ankle and left heel. He further testified that this injury was not recorded in his service treatment records because he worked at a smaller base and was seen by a civilian doctor who no longer has his treatment records. Service treatment records dated December 1959 reflect the Veteran was seen for dropping a fire extinguisher on his foot, and the treatment note further states that there were no significant abnormalities noted on the left foot. A July 1960 treatment note details the Veteran was treated for a sprained ankle without follow up treatment or diagnosis. His service discharge examination is silent for any left ankle or foot abnormality. The Veteran did list a private physician that treated him while in service but did not list why or for what reason he was treated. Post-service medical treatment records reflect the Veteran is currently treated for left foot pain and has a diagnosis of left calcaneal spur. The records do not contain an etiologic opinion. A September 2016 statement from the Veteran’s treating physician Dr. K.M. noted that the Veteran reported he injured his left foot and ankle while in service, was operated on in Indianapolis for his left foot and ankle injury in 1963, and has left foot and ankle pain that is growing in severity. Dr. K.M. noted a scar on the Veteran’s left medial malleolus and a post-operative scar on the left achilles. He opined that “the patients’ history and examination is consistent with his injury as he stated”; however, this statement fails to provide a clear etiologic opinion supported by any rationale for the claimed left ankle disorder. A January 2019 VA examination report found that the Veteran did not have a diagnosis of any ankle sprain residuals or any left ankle joint diagnosis. The examiner did diagnose bilateral calcaneal spur. The Veteran reported left foot pain, numbness, and heel pain that radiated to the ankle joint. The examiner opined that it was less likely than not that the Veteran’s claimed left ankle disorder was related to service. As rationale, the examiner stated that there is no diagnosis of left ankle sprain residuals, the Veteran was discharged for over three years before showing any ankle or foot symptoms, and service treatment records failed to show left ankle residuals while in active service. The examiner further stated that while the Veteran reported to Dr. K.M. he had left ankle surgery in 1963, the Veteran reported to the examiner that he had left ankle surgery between 1965 and 1967 post-service. The examiner also opined that it was less likely than not that the Veteran’s current bilateral heel spurs were related to his active service. As rationale, he stated there was no evidence during active service of any heel spurs, the x-ray taken in service of the left foot did not reflect heel spurs, and current x-rays reflect bilateral calcaneal spur instead of unilateral spur. After review of all the lay and medical evidence of record, the Board finds that the weight of the evidence is against finding that any current left ankle disorder, to include left heel spur, was manifested during service or related to any service in any way. The Board concedes that the Veteran currently suffers from the claimed disabilities of left ankle pain and left heel spur. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). The Board concludes, however, that the greater weight of the evidence is against the claim. Here, the Veteran’s service treatment records do not indicate that he was treated for chronic left ankle pain, left ankle sprain residuals, or treated or diagnosed for left heel spur. Further, records of the Veteran’s post-service treatment records reflect that he was not diagnosed or even treated for these disabilities until years after his separation from service. Moreover, the Board finds persuasive the absence of medical evidence to support a finding of a nexus between the Veteran’s service and any current left ankle disorder, to include left heel spur. Absent a medical opinion in the record of a relationship to military service, the Veteran’s claims for service connection for a left ankle disorder must be denied. There is simply no medical evidence in the record supporting a finding of an etiological relationship between the Veteran’s service and his currently claimed disabilities. The Veteran’s lay statements of record are competent insofar as they report symptomatology which is capable of lay observation. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). However, to the extent that the Veteran asserts a nexus between his claimed left ankle disorder, to include heel spur, and his active duty, the Board finds them to be less probative, as the Veteran is not shown to possess expert knowledge which would enable him to render such a nexus opinion. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). As such, his lay statements concerning a nexus between his claimed disabilities and active service do not constitute competent medical evidence and lack probative value. The Board gives greater probative weight to the January 2019 VA examiner’s opinion as it is both well-reasoned and thorough, having considered the entire record, including the Veteran’s medical history and contentions, and provides specific medical evidence for the opinions rendered. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). There is no competent and probative evidence of record to contradict the examiner’s conclusions. Further, to the extent that the Veteran asserted in his October 2019 testimony that the January 2019 VA examiner provided an inadequate examination regarding his claimed left ankle disorder, the Board finds the examination is fully adequate. The Veteran has also not provided any basis for the assertion that the examination was inadequate other than his statements that the examiner focused incorrectly on the length of time between the Veteran’s claimed injury and treatment and that the examiner made definitive statements concerning subjective subjects. The Board finds the January 2019 VA examination included an interview with the Veteran, a review of the record, and a full examination. As the opinion rendered at this time included clear conclusions with supporting rationale, the Board finds the January 2019 VA examination to be adequate in order to evaluate the diagnosis, or lack thereof, of the Veteran’s claimed left ankle disorder. Nieves-Rodriguez, 22 Vet. App. 295; see also Cox v. Nicholson, 20 Vet. App. 563, 569 (2007) (“[T]he Board is entitled to assume the competence of a VA examiner.”) Thus, new VA examinations are not warranted. Based on the foregoing, the Board finds that the preponderance of the evidence establishes that the claimed left ankle disorder, to include left heel spur, is not etiologically related to the Veteran’s military service. The benefit of the doubt doctrine is not applicable, and the claim must be denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. 49. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Peden 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.