Citation Nr: 21000404 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 15-02 696 DATE: January 5, 2021 ORDER Entitlement to service connection for a bilateral foot condition, to include plantar fasciitis, is denied. Entitlement to service connection for Meniere’s syndrome, to include as secondary to service-connected tinnitus, is denied. FINDINGS OF FACT 1. The competent and probative evidence of record fails to link the Veteran’s bilateral foot condition, to include plantar fasciitis, to his active service. 2. The competent and probative evidence of record fails to link the Veteran’s Meniere’s syndrome to his active service or to a service-connected disability. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a bilateral foot condition, to include plantar fasciitis, have not been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for entitlement to service connection for Meniere’s syndrome, to include as secondary to service-connected tinnitus, have not been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1987 to January 1992. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from March 2014 and August 2015 rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned during a hearing in May 2018. A transcript is of record. This matter was previously before the Board in July 2018 and last before the Board in August 2020, when it was remanded for further development. Service Connection Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. 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 nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted on a secondary basis for a disability which is proximately due to or the result of a service-connected disease or injury. Where a service-connected disability aggravates a nonservice-connected condition, a Veteran may be compensated for the degree of disability (but only that degree) over and above the degree of disability existing prior to the aggravation. The Board must consider all the evidence of record and make appropriate determinations of competence, credibility, and weight. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). VA shall give the benefit of the doubt to the claimant when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 1. Entitlement to service connection for a bilateral foot condition, to include plantar fasciitis. The Veteran seeks service connection for a bilateral foot condition, to include plantar fasciitis. He stated that while in service, he was standing 90 percent of the time in jungle boots on hard cement. He noted that this caused foot pain, especially when running, playing sports, and hiking. In this case, the Veteran’s post-service medical records from August 2013 show a diagnosis of plantar fasciitis after the Veteran reported experiencing bilateral foot pain in the plantar part of his feet since December 2012. Thus, the Veteran has a current disability. In regard to the second element for service connection, the Veteran’s service-treatment records (STRs) do not contain any complaints of, treatment for, or diagnosis of any foot-related condition, including plantar fasciitis. The earliest record of a foot-related issue is several decades after the Veteran’s separation from service in August 2013, as noted above. Moreover, the Veteran neither contends nor does the evidence show that his disability manifested within one year of separation from active duty. In regard to nexus, the October 2020 examiner opined that the Veteran’s bilateral plantar fasciitis was less likely than not due to his active service. In support of this conclusion, the examiner stated that the Veteran’s STRs did not note any foot-related complaints or injuries. In addition, the examiner stated that the Veteran was diagnosed with a bilateral foot condition, plantar fasciitis, in August 2013, decades after service, as confirmed by the record. Furthermore, the examiner considered the Veteran’s lay statements regarding his condition being due to the rigors of service; however, the examiner found the statements inconsistent with the record, as the Veteran himself stated that the onset of his foot condition was in December 2012, about two decades after his time in service. The Board finds that the Veteran’s lay statements are outweighed by the persuasive rationale provided in the October 2020 opinion. While the Veteran is shown to be competent to opine on symptoms experienced in service and matters of personal observation, respectively, the Board finds that the opinion of the VA examiner is of greater probative weight than the lay statements of record. The Veteran has not been shown to have the training or credentials to provide a competent medical opinion on the etiology of his plantar fasciitis, as that requires medical expertise. The October 2020 examiner has training, knowledge, and expertise upon which he relied to reach the above determinations, and the opinion reflects a comprehensive, accurate, and reasoned review of the entire evidentiary record, as well as the Veteran’s lay statements. Thus, the examiner’s opinion outweighs the lay statements of record. Ultimately, the preponderance of evidence is against a finding the Veteran’s bilateral foot condition was related to his active service. The Board finds that the October 2020 VA opinion is the most probative evidence with respect to the claim. The rationale provided in the October 2020 VA opinion simply outweighs the other evidence of record, as it is based upon a claims file review and presented by a medical professional with training and credentials. As such, the benefit-of-the-doubt doctrine does not apply in this case, and service connection for a bilateral foot condition, to include plantar fasciitis, must be denied. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 2. Entitlement to service connection for Meniere's syndrome, to include as secondary to service-connected tinnitus. The Veteran asserts that his Meniere’s syndrome had its onset in service or is otherwise related on a secondary basis to his service-connected tinnitus. In this case, the Veteran’s post-service medical records show he reported vertigo and was diagnosed with mild Meniere’s syndrome in July 2015. Thus, the Veteran has a current disability. In regard to the second element for service connection, the Veteran’s STRs do not contain any complaints of, treatment for, or diagnosis Meniere’s syndrome, or any symptoms related to the condition. A STR from March 1991 shows that the Veteran denied experiencing vertigo and was directed to follow up should he experience vertigo, which he did not. As noted above, the earliest record of Meniere’s syndrome symptoms is decades after the Veteran’s separation from service in July 2015. In regard to nexus, the October 2020 examiner opined that the Veteran’s Meniere’s syndrome was less likely than not due to his active service. In support of this conclusion, the examiner stated that the Veteran’s STRs did not note any symptoms of Meniere’s syndrome, particularly vertigo, which was noted as a “hallmark of Meniere’s disease.” The examiner also noted that the evidence did not show a diagnosis or signs of Meniere’s disease prior to his diagnosis in July 2015. Moreover, the examiner took the Veteran’s lay statements into consideration when formulating the opinion provided. The October 2020 examiner also provided an opinion regarding secondary service connection and found that the Veteran’s Meniere’s disease was not proximately due to or caused by his service-connected tinnitus. The examiner explained that tinnitus does not cause Meniere’s syndrome, as they are distinct conditions, and Meniere’s syndrome is due to an excessive accumulation of endolymphatic fluid. Regarding aggravation, since Meniere’s disease is caused by an excessive accumulation of endolymphatic fluid, tinnitus would not aggravate Meniere’s syndrome as tinnitus does not lead to a further accumulation of endolymphatic fluid. As such, a nexus based on causation or aggravation beyond natural progression was not found. See 38 C.F.R. § 3.310. The Board finds that the Veteran’s lay statements are outweighed by the persuasive rationale provided in the October 2020 opinion. To the extent that the Veteran has been shown to be competent to opine on symptoms experienced in service and matters of personal observation, respectively, the Board finds that the opinion of the VA examiner is of greater probative weight than the lay statements of record, and the Veteran is not shown to have the training or credentials to provide a competent medical opinion on the etiology of his Meniere’s syndrome, as that requires medical expertise. The October 2020 examiner has training, knowledge, and expertise upon which he relied to reach the above determinations, and the opinion reflects a comprehensive, accurate, and reasoned review of the entire evidentiary record. Thus, the examiner’s opinion outweighs the lay statements of record. Ultimately, the preponderance of evidence is against a finding that the Veteran’s Meniere’s syndrome is related to his active service on a direct or secondary service connection basis. The Board finds that the October 2020 VA opinion is the most probative evidence with respect to the claim, given the examiner’s training and credentials and the claims file review incorporated. As such, the benefit-of-the-doubt doctrine does not apply in this case, and service connection for Meniere’s syndrome must be denied. See Gilbert v. Derwinski, supra. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Ariasaif, 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.