Citation Nr: 21063047 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 10-47 063A DATE: October 12, 2021 ORDER Service connection for bilateral heel spurs is denied. FINDINGS OF FACT 1. The Veteran had active service from December 1972 to October 1974; he has been rated at 100 percent disabled based on unemployability since August 2018. 2. Bilateral heel spurs were not shown in service and are not causally or etiologically related to service. CONCLUSION OF LAW Bilateral heel spurs were not incurred in service. 38 U.S.C. §§ 1101, 1110, 1112, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.309 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSION As a procedural matter, in September 2018, the Board denied a request to reopen the Veteran's claim of service connection for heel spurs, finding that new and material evidence was not submitted. He appealed to the Veterans Claims Court and in September 2019, the Court Clerk granted a Joint Motion for Partial Remand (JMPR), which vacated the Board's decision and remanded the case for further development consistent with the JMPR. In April 2020, the Board reopened and remanded the Veteran's claim for development consistent with the JMPR. Subsequently in March 2021, the Board again remanded the Veteran's service connection claim for additional development. The case has now been returned to the Board for further appellate action. Additionally, in connection with his appeal, the Veteran testified at a December 2011 hearing before a Decision Review Officer (DRO) and a July 2013 hearing before the undersigned Veterans Law Judge. Copies of the transcripts have been associated with the claims file. Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Turning to the evidence, the Veteran was diagnosed with small bilateral calcaneal spurs in November 2015 based on X-rays. Similarly, a November 2020 VA examiner diagnosed bilateral calcaneal spurs. As such, a current disorder has been shown and the first element of service connection has been met. As to in-service incurrence, the service treatment records (STRs), to include the October 1974 separation examination, found that the Veteran's lower extremities and feet were clinically normal. Further, he asserted in an October 1974 Report of Medical History that he did not then-presently or previously have foot trouble. However, the Veteran reported in February 2010 and May 2010 treatment notes that he had a past medical history of an old stress fracture in his right heel that he incurred while in service. Additionally, in December 2011 testimony before a DRO and a December 2012 lay statement, he opined that his heel spurs stemmed from an in-service frostbite injury, as well as the use of improper footwear while on active duty. He is competent to report in-service symptoms and experiences capable of lay observation; accordingly, resolving reasonable doubt in his favor, the second element of direct service connection has been met to the extent that he experienced foot pain in service. Turning to nexus, the Veteran asserted in December 2011 testimony before a DRO and additional lay statements that his heel spurs were the product of in-service frostbite, as well as the use of improper footwear in service. He additionally reported a prior medical history of an in-service stress fracture in his right heel. However, November 2020 and June 2021 examiners opined that it was less likely than not that heel spurs were the product of in-service frostbite and use of improper footwear, respectively. The November 2020 examiner explained that, while the Veteran described bilateral foot pain following in-service frostbite injury, the STRs did not contain in-service foot complaints and medical literature did not document a correlation between bilateral heel spurs and frostbite. The June 2021 examiner reported that inflammation of the plantar fascia of the Achilles tendon was a cause of heel spurs and noted that X-rays of the Veteran's feet revealed a diagnosis of bilateral achilles spurs. The medical evidence does not otherwise establish a relationship between the Veteran's heel spurs and active duty, to include a reported old stress fracture, frostbite injury, and use of improper footwear. Rather, the evidence of record first documents a one-month history of heel spur-type pain in his right foot in a May 1998 treatment note, more than 20 years after discharge. This evidence suggests an onset of symptoms in 1998. Similarly, a subsequent March 2003 evaluation observed that the Veteran had heel spurs in both feet in 1998. This is consistent with the contemporaneous medical records dated in 1998. Based on the above, the medical evidence does not support service connection for bilateral heel spurs. In this regard, while the Veteran contends that he experienced a stress fracture and frostbite injury and was required to wear improper footwear in service, the STRs do not support his recollections. Further, no medical professional has determined that the symptoms of his current bilateral heel spurs stemmed directly from his in-service complaints. As such, the medical evidence does not support service connection. The Board has considered the Veteran's lay statements and testimony regarding the etiology of bilateral heel spurs. He is competent to report symptoms because this requires personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of any current disorder due to the medical complexity of the matters involved. Further, his statements are contradicted in May 1998 medical findings that noted a one-month history of heel pain, which was confirmed in March 2003. Such competent evidence has been provided by the medical personnel who have examined the Veteran during his current appeal and by STRs and clinical records obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to the lay statements. Based on the above, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Spigelman, 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.