Citation Nr: 21001532 Decision Date: 01/08/21 Archive Date: 01/08/21 DOCKET NO. 13-34 755 DATE: January 8, 2021 ORDER Entitlement to a separate compensable rating for bilateral heel spurs as related to service-connected bilateral pes planus is denied. FINDING OF FACT There are no symptoms attributable to the Veteran’s bilateral heel disability. CONCLUSION OF LAW The criteria for entitlement to a separate compensable rating for bilateral heel spurs as related to service-connected bilateral pes planus have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.10, 4.40, 4.45, 4.59,4.14, 4.71a, DC 5276, 5284. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active military service from July 1979 to March 2001. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2012 and April 2012 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO). In April 2015, the Veteran testified at a Board videoconference hearing. The transcript of the April 2015 hearing is associated with the claims file and has been reviewed by a Veterans Law Judge (VLJ) that is no longer with the Board. This case was previously before the Board in February 2019, at which time the issue currently on appeal was remanded for additional development. The case has now been returned to the Board for further appellate action. Increased Ratings-Bilateral Heel Spurs The Veteran asserts that he should have a compensable rating for his bilateral heel spurs as his symptoms are worse than those contemplated by the currently assigned ratings. As a preliminary matter, service connection is also in effect for the Veteran’s bilateral pes planus, which is rated as 50 percent disabling. In increasing the evaluation of the disability to 50 in a February 2019 decision, the Board found that the disability was manifested by extreme foot pain. As such, those symptoms related to that condition will not be discussed herein. A December 2015 podiatry consult note indicated that the Veteran complained his bilateral feet, toes and plantar surface hurts. The Veteran presented with bilateral foot and arch pain and he was awaiting custom-made insoles. Moreover, the consult note reflects x-rays taken on June 11, 2015 which showed a plantar and posterior calcaneal spur on both feet. In April 2016, the Veteran presented for followup of previously noted bilateral plantar foot and arch pain. The Veteran was able to perform the single limb heel raise exercise on both sides. Pin prick sensation is was diminished to both feet. During the pendency of the appeal, the Board notes that several VA examinations were performed that only spoke to the Veteran’s service-connected disability, pes planus, and therefore not relevant to the analysis herein. The January 2012, September 2015, May 2016, June 2016, April 2017, and January 2020 VA examinations clearly reported the symptoms related to the Veteran’s pes planus disability versus his diagnosed bilateral heel spurs. However, the August 2020 addendum medical opinion addressed the issues regarding the Veteran’s bilateral heel spurs. The August 2020 physician reported that the Veteran described the generalized pain over the plantar aspect of the feet with the majority of the discomfort in the mid foot. The physician opined that the pain attributable to the heel spurs would be in the heel. Therefore, at this time there does not appear to be any specific symptoms attributable to the heel spurs, thus disassociating any foot pain as due to heel spurs. See Mittleider v. West, 11 Vet. App. 181, 182 (1998); see also Langdorn v. Wilkie, 32 Vet. App. 291 (2020). The Board finds that the medical report is consistent with the VA treatment records. The service treatment records show that the Veteran complained about his feet, toes, and plantar surface hurting. Further, the records show that he presented in follow up visits with bilateral foot and arch pain and subsequently performed the heel raise test. There were no symptoms related to the diagnosed heel spurs reflected in the treatment records. Moreover, the Board notes that a review of the medical records do not reveal any complaints or treatments specific to the Veteran’s bilateral heel spur. In this regard, the Board also notes the Veteran’s lay statements to include in his substantive appeal (VA 9), was silent concerning any bilateral heel spur symptoms. Further, the bilateral heel spurs do not have an etiology or symptoms that are separate and distinct from the etiology and symptoms of the Veteran’s service-connected pes planus disability. 38 C.F.R. § 4.14. Diagnostic Code 5284 rates other foot injuries, such as foot spurs. Under DC 5284, a 10 percent disability rating is assigned for moderate symptoms. A 20 percent disability rating is assigned for moderately severe symptoms and a 30 percent disability rating is assigned for severe symptoms. The rating criteria direct that a 40 percent disability rating should be assigned for actual loss of use of the foot. 38 C.F.R. § 4.71a, DC 5284, Note. The Board notes that for the Veteran to warrant a compensable rating he must have moderate symptoms as a result of his heel spurs. The preponderance of the evidence, however, shows that the Veteran has any symptoms and there is no evidence of a functional impairment as a result of the Veteran’s heel spurs alone, as explicitly shown in the VA examination. The lay statements were silent as well. The Board finds the evidence is insufficient to establish that the Veteran’s heel spurs are productive of disability of “moderate” severity. As such, the preponderance of evidence remains against the finding for a compensable rating under the Diagnostic Code 5284. The Board has considered whether other rating codes are applicable to the Veteran’s bilateral heel spurs; however, none would result in a compensable rating. 38 C.F.R. § 4.71a, DC 5276 to 5284. Consequently, the Board finds that there are no specific symptoms attributable to the Veteran’s heels spurs. The record does not show any functional loss or limitation of ambulation. In reaching this conclusion, the Board observes that the United States Court of Appeals for the Federal Circuit (Federal Circuit) has held that “pain in the absence of a presently-diagnosed condition can cause functional impairment,” which may qualify as a “disability” for VA compensation purposes. Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). The Board emphasizes, however, that Federal Circuit in Saunders, cautioned against the notion that “a veteran could demonstrate service connection simply by asserting subjective pain” because, to establish that a disability is present, the veteran “will need to show that... pain reaches the level of a functional impairment of earning capacity.” Id. at 1367-68. “Functional impairment,” the Federal Circuit noted, is defined as the inability of the body or a constituent part of it “‘to function under the ordinary conditions of daily life including employment.’“ Id. at 1363 (quoting 38 C.F.R. § 4.10); see also Wait v. Wilkie, 33 Vet. App. 8, 17 (2020) (A veteran must “show that his manifestations are of sufficient severity, duration, and frequency that they effect his ability to function under the ordinary conditions of daily life). In light of the Federal Circuit’s decision Saunders and the decision of the United States Court of Appeals for Veterans Claims (Court) in Wait, the Board finds that the preponderance of the evidence shows that the Veteran’s condition is not disabling, and by extension, cannot be considered “moderate” in severity, as required for a compensable rating under the assigned DC. In light of the foregoing, because the preponderance of evidence is against the claim, the Veteran’s claim for a compensable rating for bilateral heel spurs must be denied. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Ivan Franklin 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.