Citation Nr: 21064037 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 14-13 814 DATE: October 18, 2021 ORDER Entitlement to a 10 percent rating for right foot plantar fasciitis for the appeal period prior to June 18, 2014 is granted. FINDING OF FACT For the appeal period prior to June 18, 2014, the Veteran's right foot plantar fasciitis manifested in pain that was, at worst, moderate in nature without marked deformity, pain on manipulation and use accentuated, indication of swelling on use or characteristic callosities. CONCLUSION OF LAW The criteria for a 10 percent rating for right foot plantar fasciitis for the appeal period prior to June 18, 2014 have been met. 38 U.S.C. §§ 1151, 5107; 38 C.F.R. §§ 4.14.14, 4.59, 4.71a, Diagnostic Codes 5276, 5284. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from April 1984 to April 2004. These matters come to the Board of Veterans' Appeals (Board) on appeal from a June 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) Augusta, Maine. Jurisdiction of this appeal is currently with the RO in San Diego, California. In August 2020, the Board issued a decision denying a compensable rating prior to June 18, 2014 for right foot plantar fasciitis. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). The Veteran did not appeal the Board's grant of entitlement to a 20 percent rating for the appeal period beginning on June 18, 2014 for right foot plantar fasciitis. In a June 2021 Order, the Court granted a Joint Motion for Partial Remand of the parties and remanded the case to the Board for action consistent with the Joint Motion. Increased Rating Right Foot Plantar Fasciitis Prior to June 18, 2014 The Veteran seeks a higher rating for his right foot plantar fasciitis for the appeal period prior to June 18, 2014. Specifically, he asserts that his right foot pain warrants a compensable rating. See generally, VA Form 9, April 2, 2014. Disability evaluations are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing his symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.10. Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Reasonable doubt as to the degree of disability will be resolved in the Veteran's favor. 38 C.F.R. § 4.3. It is permissible to switch diagnostic codes to reflect more accurately a claimant's current symptoms. See Read v. Shinseki, 651 F.3d 1296, 1302 (Fed. Cir. 2011). Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. Although a rating specialist is directed to review the recorded history of a disability in order to make a more accurate evaluation, see 38 C.F.R. § 4.2, the regulations do not give past medical reports precedence over current findings. Francisco v. Brown, 7 Vet. App. 55 (1994). Pertinent regulations do not require that all cases show all findings specified by the Rating Schedule, but that findings sufficiently characteristic to identify the disease and the resulting disability and above all, coordination of rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21. Therefore, the Board has considered the potential application of various other provisions of the regulations governing VA benefits, whether or not they were raised by the Veteran, as well as the entire history of the veteran's disability in reaching its decision. Schafrath v. Derwinski, 1 Vet. App. 589, 595 (1991). In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25. Pyramiding, the evaluation of the same disability, or the same manifestation of a disability, under different diagnostic codes, is to be avoided when rating a veteran's service-connected disability. 38 C.F.R. § 4.14. It is possible for a veteran to have separate and distinct manifestations from the same injury which would permit rating under several diagnostic codes, however, the critical element in permitting the assignment of several ratings under various diagnostic codes is that none of the symptomatology for any one of the conditions is duplicative or overlapping with the symptomatology of the other condition. See Esteban v. Brown, 6 Vet. App. 259, 261-62 (1994). Separate ratings can be assigned for separate periods based on the facts found - a practice known as "staged" ratings. Francisco v. Brown, 7 Vet. App. 55, 58 (1994); Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id. The basis of disability evaluation is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10. The Veteran is competent to report symptoms and experiences observable by his senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). The Veteran's right foot plantar fasciitis is rated as noncompensable prior to June 18, 2014, under Diagnostic Code 5284-5276. Hyphenated diagnostic codes are used when a rating under one diagnostic code requires the use of an additional diagnostic code to identify the basis for the rating assigned; the additional code is shown after the hyphen. 38 C.F.R. § 4.27. Under Diagnostic Code 5284, a 10 percent rating is warranted for moderate other foot injuries. 38 C.F.R. § 4.71a. A 20 percent rating is warranted for moderately severe other foot injuries. Id. A 30 percent rating is warranted for severe other foot injuries. Id. With actual loss of use of the foot, the disability should be rated at the maximum 40 percent. Id. Words such as "severe," "moderately severe," and "moderate," are not defined in the Rating Schedule. Rather than applying a mechanical formula, VA must evaluate all evidence, to the end that decisions will be equitable and just. 38 C.F.R. § 4.6. Although the use of similar terminology by medical professionals should be considered, it is not dispositive of an issue. Instead, all evidence must be evaluated in arriving at a decision regarding a request for a higher disability rating. 38 U.S.C. § 7104; 38 C.F.R. §§ 4.2, 4.6. "Moderate" is defined as tending toward the mean or average amount of dimension, having average or less than average quality. "Severe" is defined as harsh or of great degree. Merriam-Webster's Collegiate Dictionary (2003). Under Diagnostic Code 5276, for acquired flatfoot, a 10 percent rating is assigned for weight-bearing line over or medial to great toe, inward bowing of the tendo-Achilles, pain on manipulation and use of the feet. A 30 percent rating is assigned for bilateral severe; objective evidence of marked deformity, pain on manipulation and use accentuated, indication of swelling on use, characteristic callosities. A 50 percent rating is assigned for bilateral pronounced acquired disabilities of the feet with marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo-Achilles on manipulation, not improved by orthopedic shoes or appliances. 38 C.F.R. § 4.71a, Diagnostic Code 5276. This is the maximum schedular rating for under this diagnostic code. The Board notes that effective February 7, 2021, the criteria for schedule of ratings for the musculoskeletal system was revised. See 86 Fed. Reg. 8142 (Feb. 4, 2021) (codified at 38 C.F.R. pt. 4). However, there were no amendments made to Diagnostic Code 5284 or Diagnostic Code 5276. Additionally, in the instant case, the Veteran's appeal concerns only the period prior to June 18, 2014. Therefore, the February 2021 musculoskeletal criteria do not apply to the Veteran's claim on appeal; and the appropriate criteria is discussed below. When there is an approximate balance of positive and negative evidence as to any issue material to the determination of a matter, VA will resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Although the Board has an obligation to provide reasons and bases supporting its decision, there is no obligation to discuss, in detail, the extensive evidence of record. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that the Board must review the entire record but does not have to discuss each piece of evidence). Therefore, the Board will summarize the relevant evidence where appropriate, and the Board's analysis will focus specifically on what the evidence shows, or fails to show, as it relates to the Veteran's claims. Turning to the evidence, the Veteran was afforded a VA examination in December 2012. At that time, the Veteran reported having right foot pain that began during active service. The examiner diagnosed right foot plantar fasciitis. The Veteran endorsed the regular use of inserts as an assistive device as a normal mode of locomotion to treat his plantar fasciitis. Functioning was not so diminished that the Veteran was equally well served by amputation with prosthesis. There were no abnormal findings shown on X-ray. The examiner noted that the Veteran's right foot plantar fasciitis would impact his ability to work due to interference with prolonged standing. In his Notice of Disagreement, the Veteran asserted that his right foot pain began during active service and had continued since. See Notice of Disagreement, July 8, 2013. The Veteran stated he believed the foot pain would interfere with his ability to find work due to its severity. Id. Similarly, in his substantive appeal (VA Form 9), the Veteran reported his foot pain was so severe that he could "hardly put my heel on the groun[d]," and was told that insoles would not help. VA Form 9, April 2, 2014. Further review of the record shows that the Veteran receives VA treatment and from private treatment providers for various disabilities, to include his right foot plantar fasciitis. However, there is no indication from the treatment notes of record that the Veteran has reported right foot symptoms that are worse than those noted in the various VA examination reports of record. Based on the foregoing, the Board finds that the Veteran is entitled an initial compensable rating, but not higher than 10 percent, for his right foot plantar fasciitis prior to June 18, 2014. In this regard, the evidence shows that the Veteran's right foot plantar fasciitis manifested in significant pain, with interference with prolonged walking, and required insoles. The Board finds these symptoms most closely approximate "moderate" impairment. However, the Board finds that the Veteran is not entitled to a rating higher than 10 percent for his right foot plantar fasciitis prior to June 18, 2014. In this regard, there is simply no evidence of record to suggest that the Veteran's symptoms were "moderately severe," as to warrant a 20 percent rating. Specifically, the Veteran was not shown to have objective evidence of pain on physical examination, nor was pain noted at the December 2012 VA examination. Rather, his reports of pain are subjective, to include the reports of significant pain that prevents putting his heel on the ground. Additionally, X-ray results were normal, and functioning was not so diminished that he would be equally well served by amputation with prosthesis. Moreover, the examiner noted that the Veteran's right foot plantar fasciitis would impact his ability to work due to some interference with prolonged standing, but such activity was not prevented by the severity of his condition. Moreover, the evidence does not demonstrate, and the Veteran has not alleged, objective evidence of marked deformity, pain on manipulation and use accentuated, indication of swelling on use or characteristic callosities. Accordingly, the Board finds that the Veteran's right foot plantar fasciitis manifested, at most, in pain that was moderate such that a 10 percent rating, but not higher, is warranted prior to June 18, 2014. The Veteran's belief that he is entitled to a higher rating for his right foot plantar fasciitis is outweighed by the objective medical findings of record. That is, the Board assigns greater probative value to the pertinent objective findings on the VA examination reports and treatment records that were recorded following physical examinations of the Veteran, than to the Veteran's general belief that he is entitled to higher ratings. Moreover, to the extent that the Veteran alleges that he is entitled to a higher rating due to pain and other symptoms reported, the Board notes that such symptoms are contemplated under the current rating assigned. The Board acknowledges the Veteran's statements that his right foot plantar fasciitis symptoms are more severe than evaluated, to include his reports that he can barely put his heel on the floor. See VA Form 9, April 2, 2014. The Veteran is competent to report his symptoms and has presented credible statements in this regard. See, e.g., Layno v. Brown, 6 Vet. App. 465, 469 (1994) and Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). The Board finds, however, that neither the Veteran's statement nor medical evidence demonstrates that the criteria for an initial rating in excess of 10 percent have been met, for the appeal period prior to June 18, 2014. The Board also acknowledges that the Veteran's VA treatment records note complaints of and treatment for his right foot plantar fasciitis. However, these records do not address the specific rating criteria necessary to substantiate a higher rating. In determining the actual degree of disability, the examination findings are more probative of the degree of impairment. The criteria needed to support higher ratings as the required medical findings that are within the province of trained medical professionals. See Jones v. Brown, 7 Vet. App. 134, 137-138 (1994). As such, the lay assertions are not considered more persuasive than the objective medical findings which, as indicated above, do not support assignment of any higher rating pursuant to any applicable criteria at any point pertinent to this appeal. Nevertheless, the Board acknowledges the Veteran's assertions that his right foot plantar fasciitis results in pain, and also feelings that he cannot place his heel on the ground. However, again, the Board notes that such symptoms are contemplated under the current rating assigned. This argument is therefore without merit. The Board has also considered whether a staged rating under Hart, supra, is appropriate for the Veteran's service-connected right foot plantar fasciitis. However, the Board finds that his symptomatology has been stable throughout the period on appeal. Therefore, assigning a staged rating for such disorders is not warranted. Further, the Veteran and his representative have not raised any other issues, nor have any other issues been reasonably raised by the record, with regard to such claim. Doucette v. Shulkin, 28 Vet. App. 366 (2017). Finally, the Board notes the ruling of the Court in Rice v. Shinseki, 22 Vet. App. 447 (2009). In Rice, the Court held that a claim for a total rating based on unemployability due to service-connected disability (TDIU), either expressly raised by the Veteran or reasonably raised by the record, involves an attempt to obtain an appropriate rating for a disability and is part of the claim for an increased rating. In this case, the Veteran's employment status is unknown. As such, Rice is inapplicable in this case. Accordingly, the Board finds that a preponderance of the evidence is for the assignment of an initial 10 percent rating for right foot plantar fasciitis prior to June 18, 2014, and to that extent only the claim is granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. KRISTY L. ZADORA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mariah N. Sim, 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.