Citation Nr: 21063192 Decision Date: 10/13/21 Archive Date: 10/13/21 DOCKET NO. 15-05 740 DATE: October 13, 2021 ORDER Entitlement to service connection for a bilateral foot disability, claimed as tinea pedis of the feet, is granted. FINDING OF FACT The Veteran's bilateral foot disability was at least as likely as not incurred during service. CONCLUSION OF LAW The criteria for service connection for a bilateral foot disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran has active service in the U.S. Army from April 2003 to August 2003, March 2004 through May 2005, and September 2005 to December 2005. The Veteran also has periods of inactive and active duty for training in the Louisiana Army National Guard until January 2009. This matter comes to the Board of Veterans' Appeals (Board) on appeal from an April 2012 rating decision issued by the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). This matter was previously before the Board in June 2018, June 2020, and June 2021, at which point the claim was remanded for additional development. The most recent VA examination was performed in July 2021. While the Board finds that this opinion is inadequate, remand is not warranted in light of the grant of service connection. See Stegall v. West, 11 Vet. App. 268 (1998). Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (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 or aggravated during service-the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 38 F.3d 1163, 1167 (Fed. Cir. 2004)). The absence of any one element will result in denial of service connection. Service connection may also be granted for any disease initially diagnosed after service when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection must be considered on the basis of the places, types, and circumstances of his service as shown by his service records, the official history of each organization in which he or she served, his or her medical records, and all pertinent medical and lay evidence. See 38 C.F.R. § 3.303 (a); see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) and Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006). 1. Entitlement to service connection for a bilateral foot disability The Veteran maintains that his bilateral foot disability manifested during service and that his symptoms have continued since discharge. The Board finds that the elements of entitlement to service connection have been met. With respect to current disability, a February 2021 VA examiner provided a diagnosis of tinea pedia and pruritis of the bilateral feet. Accordingly, the first element of service connection has been established. With respect to an in-service incurrence, the Veteran reported in September 2011 that the skin condition began in early August 2004. In October 2011, he further reported that the condition started with occasional blisters and itching during deployment because he was not supplied boots for the field and went for days without a shower. The Board notes that the Veteran is competent to report symptoms and observable events within the realm of his personal knowledge. Layno v. Brown, 6 Vet. App. 465, 470-471 (1994); Jandreau, 492 F.3d at 1377. Furthermore, the Board finds no reason to doubt the credibility of these statements, as they are consistent with those he made during the course of treatment. For example, the Veteran complained of left foot pain during a treating visit in August 2006 that began several months prior, and his doctor diagnosed him with tinea pedis. In October 2006, the Veteran also complained of recurring blisters and sores on the sole of his left foot and indicated that they had been present for the past 18 months. Then, in July 2009, a treating doctor noted that the Veteran's tinea pedis had been present for five years. It is noteworthy that the reports of onset in these visits fall within the time the Veteran was serving active duty. Accordingly, the Board finds that the Veteran's competent and credible lay statements sufficiently establish the in-service incurrence element of this claim. The remaining question is whether there is a nexus between the Veteran's in-service incurrence and his current bilateral foot disability. The record contains two negative opinions addressing this question. In February 2021, a VA examiner concluded that the claimed condition was less likely as not incurred in or caused by service because the medical records did not document any treatment or complaints for a skin condition of the feet during service, immediately thereafter, or even in the years following service. However, the Board concluded in June 2021 that this opinion was inadequate because private treatment records document a diagnosis of tinea pedis of the feet as early as August 2006, which less than one after the Veteran's last tour of active duty. The claim was remanded for a new VA examination and another VA examiner offered a negative nexus opinion in July 2021. This VA examiner reasoned that there was no evidence of tinea pedis occurring during service. The examiner elaborated that there is no evidence of chronicity or indication that the condition occurred in service merely because it was found one to two years after service. However, as noted, the Veteran was treated for tinea pedis less than one year following his last tour of active duty. Furthermore, treating records from August 2009 specifically note that the Veteran's condition is chronic and that it had been present for five years. Additionally, as noted, the Veteran reported during treating visits in 2006 that his symptoms had been present for months. The Board notes that the Veteran is competent to report the onset and continuity of his symptoms and there is no reason to doubt the credibility of these statements. 38 C.F.R. § 3.303(a); see also Jandreau, 492 F.3d at 1377. Because the examiner did not consider this evidence, the Board finds that her opinion is inadequate. See Reonal v. Brown, 5 Vet. App. 548 (1993). Given that there is no adequate negative opinion, the competent and credible statements made by the Veteran are highly probative in establishing a nexus. See 38 C.F.R. § 3.303(a) (service connection must be considered on the basis of the places, types, and circumstances of his service as shown by his service records, the official history of each organization in which he served, his medical records, and all pertinent medical and lay evidence); see also Buchanan, 451 F.3d at 1335 ("[N]othing in the regulatory or statutory provisions [relating to evidence to be considered] require both medical and competent lay evidence; rather, they make clear that competent lay evidence can be sufficient in and of itself"). In sum, the weight of the evidence supports finding that the Veteran's bilateral foot disability was incurred during his active service, and service connection is granted. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102; 3.303(a), (d). GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Beech, 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.