Citation Nr: 21063381 Decision Date: 10/14/21 Archive Date: 10/14/21 DOCKET NO. 17-14 164 DATE: October 14, 2021 ORDER Service connection for chronic left ankle instability is granted. Service connection for chronic right ankle instability is granted. FINDINGS OF FACT 1. The Veteran has a current disability of chronic left ankle instability. 2. The Veteran suffered recurrent left ankle instability during service. 3. The current left ankle instability is causally connected to the recurrent left ankle instability during service. 4. The Veteran has a current disability of chronic right ankle instability. 5. The Veteran suffered recurrent right ankle instability during service. 6. The current right ankle instability is causally connected to the recurrent right ankle instability during service. CONCLUSIONS OF LAW 1. Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for left ankle instability have been met. 38 U.S.C. §§ 1110, 1154, 5103, 5013A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. 2. Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for right ankle instability have been met. 38 U.S.C. §§ 1110, 1154, 5103, 5013A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the Navy during the Gulf War Era from August 2003 to July 2010. The basis of the current appeal is an April 2015 Rating Decision denying service connection for right and left ankle condition. The issue appeared before the Board in February 2021, where it was remanded for the VA to obtain a medical examination and nexus opinion. 1. Service connection for chronic left ankle instability 2. Service connection for chronic right ankle instability Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. The Veteran contends that the chronic instability in both ankles was caused by periodically rolling of the ankles during training and marches during service. See e.g., July 2019 Board Hearing Transcript. The evidence shows that the Veteran has a current disability of bilateral chronic ankle instability. A private physician in May 2021 diagnosed bilateral chronic ankle instability, indicating it was characterized by excessive laxity of lateral aspect of both ankles. A private physician in August 2019 similarly diagnosed instability of joints of both ankles. A VA examination in March 2021 diagnosed a recurrent LCL sprain, tendonitis, and instability of the left ankle (but found the right ankle to be normal). The Board finds that the evidence is at least in equipoise on the question of whether there was chronic instability of both ankles during service. Service treatment records show that on the March 2010 service separation examination the Veteran reported that he had a history of pain in the wrist and ankles, reporting that the ankles give out sometimes. A May 2004 record shows that during service the Veteran being treated for left ankle pain after running and rolling the left ankle. Over the duration of this appeal, both for treatment purposes and for compensation purposes, the Veteran reported a history of ankle problems during service and that he had persistent ankle pain in service and since service. The VA treatment records from May and June 2014 show the Veteran being treated for persistent ankle pain, which the Veteran reported as originating during basic training. During treatment, the Veteran reported a history of repeated ankle injuries. The Veteran reported that during service he experienced multiple ankle injuries during runs, marches, and carrying medical equipment as a Corpsman. The Veteran reported that frequently other Corpsman would tend to his ankles, rather than the base clinics. See March 2019 Veteran's Statements. This is confirmed by a statement tendered by another veteran, who reports that he treated the Veteran for the ankles in non-clinical settings. The fellow Corpsman offered his street and email addresses, and his phone number, for follow up contact by VA. After weighing all the evidence, lay and medical, the Board finds that the bilateral chronic ankle instability is causally connected to service, namely, to the in-service ankle instability. The Veteran submitted a private medical opinion in May 2021, in which the private physician opined that the current bilateral chronic ankle instability relates back to the recurrent rolling of ankles while in service. The private examiner based the opinion on the Veteran's subjective reports as well as on objective findings of the ankles. The physician noted that instability develops following an ankle sprain, and worsens periodically following recurrent sprains. The private examiner noted that this pattern is matched by the 2004 in-service treatment for the left ankle sprain, followed by the Veteran and other Corpsman's reports of ongoing ankle sprains after that point, resulting in the current bilateral instability. Weighing against a nexus between the current chronic ankle instability and service is a March 2021 VA opinion (and near-identical May 2021 opinion). The VA examiner opined that the bilateral ankle instability was less likely than not caused by service, reasoning that there are no objective findings in the record of continuous ankle sprains and instability in service. This opinion is inadequate, and thus has no probative value, as it rests upon a faulty factual basis. First, the opinion appears to ignore the in-service treatment in 2004 of a left ankle sprain in service. Second, the opinion ignores the Veteran's claims of persistent ankle sprains in service. Accordingly, the negative March 2021 VA opinion is outweighed by the positive May 2021 private opinion, and the Board finds that there is a nexus between the current left and right ankle instability and service. (Continued on the next page) Resolving reasonable doubt in the Veteran's favor, the Board finds that the criteria for direct service connection for left and right ankle instability have been met. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. As direct service connection is being granted, there is no need to discuss entitlement to service connection on a presumptive or any other basis, as other theories of service connection have been rendered moot, leaving no question of law or fact to decide. See 38 U.S.C. § 7104. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Charles Plambeck 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.