Citation Nr: 21062266 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 18-51 738 DATE: October 6, 2021 REMANDED Entitlement to service connection for bilateral foot disability, to include gout, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1974 to May 1977. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2015 rating decision. In December 2019, October 2020, and April 2021, the Board remanded this matter for additional development. Unfortunately, additional remand is warranted. The Board notes that the Veteran has claims for service connection for right knee and lumbar spine disabilities that he appealed and that were remanded by the Board in November 2020. It appears the Regional Office is still developing these claims in accordance with the remand directives. A supplemental statement of the case has not been issued and the claims have not been recertified to the Board; therefore, these issues are not yet again before the Board. 1. Entitlement to service connection for bilateral foot disability, to include gout, is remanded. In April 2021, the Board remanded this matter for additional VA medical opinion. The Board explained that the January 2021 VA contract opinion was inadequate because it failed to address the Veteran's gout, failed to provide an adequate rationale for the other foot disabilities, and concluded that the Veteran's calluses likely started before service without providing any evidentiary basis for such a conclusion. The Board remanded for the Regional Office to obtain adequate VA medical opinion regarding whether the Veteran's foot disabilities are related to service. In August 2021, a VA examiner opined that the Veteran's gout is less likely than not incurred in service or related to service. The VA examiner explained that the Veteran's service treatment records do not show complaints or symptoms associated with the development of gout during service. The VA examiner explained that the Veteran's daily long walks through the woods during service are not a nexus for gout, which is caused by too much uric acid in the body. However, the August 2021 VA examiner failed to address whether the Veteran's other foot disabilities are related to service, including hammer toes, hallux valgus, bone spurs, and healed navicular chip fracture. Accordingly, remand is warranted to obtain additional VA medical opinion. See Stegall v. West, 11 Vet. App. 268 (1998). The August 2021 VA examiner also did not address the Veteran's lay statements of symptoms since service. See Miller v. Wilkie, 32 Vet. App. 249 (2020) (holding when an examiner fails to address the Veteran's lay evidence, and the Board does not find the Veteran not credible or not competent to offer that lay evidence, a new exam is needed). In that regard, the Veteran has indicated he has had foot pain since service, but recently indicated his "foot problems" started in 2009. The examiner should elicit and clarify the Veteran's reported history of symptoms / problems and consider them in rendering any opinion. To the extent the examiner finds the Veteran's reported history of symptoms inconsistent or not plausible, any such finding should similarly be explained. In addition, remand of the claim is appropriate to obtain outstanding treatment records. VA treatment records show that potentially relevant private treatment records were scanned into the Veteran's VA medical file. See, e.g., January 2021, April 2021, and July 2021 VA Treatment Records (noting treatment records scanned into system). However, it does not appear that such records are in the Veteran's claims file. While this matter is on remand, any additional outstanding VA treatment records should be obtained, including VA treatment records from September 2021 to the present. The matters are REMANDED for the following action: 1. Obtain any additional VA treatment records, to include any VA treatment records from September 2021 to the present. Associate with the claims file all potentially relevant documents scanned into Vista Imaging or CPRS but not associated with the Veteran's claims file. 2. After obtaining any outstanding records, ask the appropriate examiner to review the Veteran's file. The necessity of an in-person examination is left to the discretion of the examiner. The examiner should identify any right and left foot disability present at any time during the claims period, even if resolved, including hammer toes, hallux valgus, bone spurs, and healed navicular chip fracture. For each such disability, the examiner should opine whether it is at least as likely as not that the disability had an onset in service or is otherwise related to service. The examiner should consider all medical and lay evidence of record. The examiner should specifically comment on the Veteran's contention that his foot problems are due to daily 15-mile long walks through the woods during service, his reports of foot pain during service especially after walking, his service treatment records regarding foot problems, and his March 1977 report of foot trouble at separation from service. If the Veteran's reports are discounted, the examiner should provide a rationale for doing so (e.g., whether there is any medical reason to accept or reject his contentions). In this regard, the Board notes the Veteran's lay statements that on the one hand indicates symptoms since service, but on the other hand notes "foot problems" beginning in 2009. The examiner should clarify the Veteran's history of symptoms and indicate whether any such reports are discounted. In short, the examiner is asked to explain the reasons behind any opinions expressed. 3. After the above development, and any other development deemed necessary, readjudicate the claim. SHEREEN M. MARCUS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Purcell, Amy 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.