Citation Nr: 21001817 Decision Date: 01/11/21 Archive Date: 01/11/21 DOCKET NO. 13-35 844 DATE: January 11, 2021 REMANDED Entitlement to service connection for tinea pedis of the right foot is remanded. Entitlement to service connection for a heart disability is remanded. Entitlement to service connection for a respiratory disability is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1976 to March 1996. These matters come before the Board of Veterans’ Appeals (Board) on appeal from January 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). These matters were previously remanded, most recently in November 2018. 1. Entitlement to service connection for tinea pedis of the right foot is remanded. The claims were previously remanded by the Board in December 2018, so that additional treatment records could be associated with the record and addendum medical opinions could be obtained. While the medical opinions already of record all similarly conclude that the Veteran’s service-connected plantar fasciitis would not cause his tinea pedis of the right foot, the examiners have not adequately addressed whether aggravation at least as likely as not occurred. Thus, on remand, an addendum opinion should be obtained, that more specifically discusses whether the Veteran’s now service-connected plantar fasciitis has aggravated the Veteran’s tinea pedis of the right foot. 2. Entitlement to service connection for a heart disability is remanded. The Board finds that an additional medical opinion is needed to resolve the claim for service connection for a heart disability. According to the prior July 2015 Board remand, it was noted that the November 20210 VA examination was inadequate in part because the examiner did not consider the Veteran’s reports of continued heart problems since service. The addendum July 2017 and November 2019 VA addendum opinions also state that the Veteran’s aortic stenosis and aortic insufficiency is less likely than not caused by or a result of or incurred in service because service treatment records are silent for these conditions and they were not diagnosed within one year of separation from service. Although it was noted that stenosis is a process of aging, the examiners did not consider the Veteran’s reports of continued heart problems since service as requested in the July 2015 Board remand. As a rationale was not provided as requested, remand for an addendum opinion is required. Stegall v. West, 11 Vet. App. 268, 271 (1998) 3. Entitlement to service connection for a respiratory disability is remanded. Finally, because a decision on the heart disability claim could significantly impact a decision on the respiratory disability claim, the issues are inextricably intertwined. VA examination reports refelct that the Veteran’s dyspnea on exertion is at least as likely as not caused by his aortic stenosis. Thus, a remand of the claim for service connection for a respiratory disability is required. The matters are REMANDED for the following actions: 1. Obtain an addendum medical opinion addressing whether the Veteran’s service-connected plantar fasciitis has aggravated his tinea pedis of the right foot. The claims file should be sent to and reviewed by the examiner. Upon review of the record, the clinician should respond to the following question: Is it at least as likely as not (50 percent or greater probability) that the Veteran’s tinea pedis of the right foot was aggravated by his service-connected plantar fasciitis? A complete rationale for the opinion must be provided. In rendering the requested opinion, the examiner should consider and discuss all pertinent medical and lay evidence of record. 2. Obtain an addendum medical opinion addressing the Veteran’s claimed heart disability. The claims file should be sent to and reviewed by the examiner. Upon review of the record, the clinician should respond to the following question: Is it at least as likely as not (50 percent or greater probability) that the Veteran’s that the Veteran’s heart disability, diagnosed as aortic stenosis and aortic insufficiency, was incurred during or is otherwise related to his active service? A complete rationale for the opinion must be provided. In rendering the requested opinions, the VA physician must specifically consider and discuss all pertinent medical evidence, to include the service and post-service treatment records.   The examiner must also consider and address the Veteran’s statements that he continued to experience heart and respiratory problems after service, which are deemed competent lay evidence of such. Cynthia M. Bruce Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Williams, 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.