Citation Nr: 20037585 Decision Date: 06/02/20 Archive Date: 06/02/20 DOCKET NO. 18-54 851 DATE: June 2, 2020 REMANDED Entitlement to service connection for a left foot disability is remanded. Entitlement to service connection for a right foot disability is remanded. REASONS FOR REMAND The Veteran had active military service in the United States Marine Corps from June 2001 to June 2006. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an August 2017 rating decision issued by the VA Regional Office (RO). The Board finds that additional development is required before the appeal is decided. The Veteran has contended that his left and right foot disabilities are related to his active service. Service treatment records (STRs) documented that the Veteran complained of left foot pain twice in May 2005 that began while running. He was diagnosed with an overuse injury and peroneal strain. At his April 2006 separation examination, the Veteran reported foot trouble, high arches, ankle pain, and chronic sprains. A review of post-service VA medical center (VAMC) records show that the Veteran was experiencing intermittent blisters/rash on his bilateral feet in May 2009. In July 2013, he complained of left foot pain and was diagnosed with bilateral plantar fasciitis. In July 2017, the Veteran was afforded a VA examination. He denied any foot problems during his active service in 2006. Instead, he reported that he first complained of lipomas on his forefeet in 2015. Additionally, he stated that the running required to keep his status in the Army Reserves had caused his pes cavus, forefeet pain and lipomas, and burning in the soles of his feet. Further, he admitted that he had been a prison guard for many years. The examiner diagnosed acquired pes cavus. He opined that the Veteran’s bilateral foot disability was less likely than not related to the Veteran’s active service. In support of this opinion, the examiner noted the Veteran’s high arches and left foot peroneal strain documented in his STRs. Additionally, he found no mention of the Veteran’s feet until 2015. He explained that running was not a cause of pes cavus which was characterized by high arch of the foot that did not flatten with weight bearing. Instead, he stated that pain with running was a complication of pes cavus. Whereas pes cavus was a common finding, he noted it could be a sign of an underlying neurologic disorder. He added that deformities associated with pes cavus included clawing of the toes, posterior hindfoot deformity, contracture of the plantar fascia, and cockup deformity of the great toe, which could cause increased weight bearing for the metatarsal heads and associated metatarsalgia and calluses. Possible causes of pes cavus in eighty percent of cases included malunion of calcaneal or talar fractures, burns, sequelae resulting from compartment syndrome, residual clubfoot, and neuromuscular disease. The remaining twenty percent of cases were idiopathic and nonprogressive. The Board finds that the July 2017 VA examination is inadequate for adjudication purposes. In this regard, the examiner’s medical opinion is based on an inaccurate factual premise insofar as it found no post-service evidence regarding the Veteran’s feet until 2015. Additionally, the examiner did not address the Veteran’s bilateral plantar fasciitis. In July 2018, a VAMC podiatrist opined that it was at least as likely as not that the Veteran’s foot pain was caused by his active service. However, the Board notes that she did not provide a rationale. Therefore, the Board finds that the Veteran should be provided a new VA examination to determine the nature and etiology of any currently present left and right foot disabilities. Furthermore, the Board notes that the Veteran reported additional service in the Army Reserves. There is no indication that the RO has made any attempts to obtain those service personnel records. As such, any outstanding service records must be obtained and associated with the claims file. Finally, current treatment records should be identified and obtained before a decision is made with regard to the appeal. The matters are REMANDED for the following action: 1. Identify and obtain any outstanding service records, to include records pertaining to service in the Reserves. 2. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 3. Then, schedule the Veteran for a VA examination to determine the nature and etiology of any currently present left and/or right foot disabilities. The claims file must be made available to, and reviewed by the examiner. Any indicated studies should be performed. Based on the examination results and the review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that any currently present left and/or right foot disability is etiologically related to the Veteran’s active service. The rationale for all opinions expressed must be provided. 4. Confirm that all development conducted complies with this remand and undertake any additional development determined to be warranted. 5. Then, readjudicate the appeal. If the decision remains adverse to the Veteran, issue a supplemental statement of the case and allow the appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Ware, 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.