Citation Nr: 21064700 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 17-40 513 DATE: October 21, 2021 ORDER Entitlement to a compensable rating for left hallux valgus with a history of hallux rigidus is denied. Entitlement to a compensable rating for right hallux valgus with a history of hallux rigidus is denied. FINDING OF FACT The symptoms of the Veteran's left and right hallux valgus are not severe to be equivalent to amputation of great toe; the Veteran has not received surgical treatment for, or resection of, the metatarsal head of either foot. CONCLUSIONS OF LAW 1. The criteria for a compensable rating for the service-connected left hallux valgus with a history of hallux rigidus have not been met. 38 U.S.C. § 1155, 5107(b); 38 C.F.R. § 4.71a, Diagnostic Code 5280. 2. The criteria for a compensable rating for the service-connected right hallux valgus with a history of hallux rigidus have not been met. 38 U.S.C. § 1155, 5107(b); 38 C.F.R. § 4.71a, Diagnostic Code 5280. REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veteran served on active duty in the U.S. Army from April 2000 to October 2000, and from November 2003 to February 2014. This appeal to the Board of Veteran's Appeals (Board) arose from a September 2015 rating decision by the Department of Veteran Affairs (VA) Regional Office (RO). In November 2019, the Board remanded these compensable rating claims for further evidentiary development. At that time, the Board also determined that the claim for service connection for bilateral pes planus was raised by the record and directed the Agency of Original Jurisdiction (AOJ) to consider whether service connection was warranted for this disability. In October 2020, the AOJ granted service connection for bilateral pes planus. As the Veteran has not yet filed a NOD contesting either the effective date or the level of compensation assigned following this grant, an issue pertaining to the now service-connected bilateral pes planus is not part of the current appeal. Grantham v. Brown, 111 F.3d 1156 (Fed. Cir. 1997). Entitlement to a compensable rating for the service-connected left hallux valgus with a history of hallux rigidus Entitlement to a compensable rating for the service-connected right hallux valgus with a history of hallux rigidus The Veteran seeks compensable ratings for the hallux valgus of each foot. These disabilities are rated under Diagnostic Code 5280. According to this Diagnostic Code, unilateral hallux valgus, if severe (and thus equivalent to amputation of great toe), is rated 10 percent disabling. Unilateral hallux valgus that has been operated upon with resection of metatarsal head is rated 10 percent disabling. The Board acknowledges that the Veteran is currently service-connected for multiple foot conditions, including bilateral metatarsalgia with degenerative joint disease, bilateral pes planus, as well as second, third, and fourth hammertoes of each foot. Turning now to the relevant evidence of the record, the Board notes that, on the September 2015 VA Examination, the Veteran reported experiencing extremely bad pain in his foot. He stated that he could not walk around the house without supportive footwear. He described that both the tops and bottoms of his feet hurt. The Veteran reported experiencing flare-ups described as feeling like he is walking on needles and cramping, which occurred often. Specific to the Veteran's hallux valgus condition, the severity was noted as mild to moderate symptoms. He did not have surgery for his hallux valgus. Pain was noted on weight-bearing. The functional impact was characterized as the inability to walk or stand for prolonged periods without the opportunity to rest. On the February 2020 VA Examination, the Veteran reported experiencing sharp pain in his feet. Flare-ups were reported and were described as difficulty in prolonged standing for more than 20 minutes, difficulties with running and prolonged walking (not more than 1.5 blocks). His hallux valgus was described as mild or moderate, with no surgery. He experienced pain and weakness during flare-ups or repetitive use. Pain with weight-bearing was noted as it pertained to the difficulty in prolonged standing. There was no pain noted with non-weightbearing. The examiner explained that the range of motion testing was not applicable here. After a thorough consideration of the evidence of the record, the Board finds that the Veteran's hallux valgus of each foot is adequately contemplated by the noncompensable rating assigned. Therefore, a compensable rating (10 percent) is not warranted under Diagnostic Code 5280. The evidence does not show that his hallux valgus of either foot reaches the severity equivalent to amputation of great toe. Further, this condition has not required surgery. Regarding the Veteran's noted history of hallux rigidus, although not present on the examinations, Diagnostic Code 5281 instructs to rate hallux rigidus as severe hallux valgus. The evidence does not show that the Veteran has hallux rigidus, or as previously explained, exhibits severe hallux valgus of his feet. As stated previously herein, service connection has been granted for other foot conditions not subject to this appeal. The main symptom the Veteran endorses during this current appeal is extreme pain when walking, running, or standing. His service-connected metatarsalgia is rated at 10 percent disabling. Diagnostic Code 5279 provides a 10 percent disability rating for anterior metatarsalgia (Morton's disease), whether unilateral or bilateral. "Metatarsalgia is a cramping burning pain below and between the MTP bones where they join the toe bones." Nix v. Brown, 4 Vet. App. 462, 464 (1993); Tedeschi v. Brown, 7 Vet. App. 411, 414 (1995). Metatarsalgia is a term that refers to chronic pain in the ball of the foot from any of a variety of causes, one of which is Morton's neuroma. Morton's neuroma (or disease) is a painful neuropathy of the digital plantar nerve that usually results in pain in the ball of the foot between the third and fourth MTP heads. The Board has considered whether the Veteran's hallux valgus is entitled to a compensable rating in accordance with 38 C.F.R. 4.59. The United States Coufrt of Appeals for Veterans Claims (Court) has held that the criteria under 38 C.F.R. 4.59 can apply to foot disabilities involving painful motion. Southall-Norman v. McDonald, 28 Vet. App. 346 (2016). As explained above, the Veteran is being compensated for painful motion in his feet through his assigned 10 percent rating for bilateral metatarsalgia. Therefore, assigning a 10 percent rating under 38 C.F.R. 4.59 would result impermissible pyramiding, which is prohibited. 38 C.F.R. § 4.14; Esteban v. Brown, 6 Vet. App. 259, 262 (1994). The Board has also considered whether the Veteran's foot conditions should be evaluated under Diagnostic Code 5284, which provides ratings for residuals of other foot injuries. When determining whether Diagnostic Code 5284 is "more appropriate" than Diagnostic Code 5280, the Court has noted that a more specific statute should be "given precedence over a more general one." Zimick v. West, 11 Vet. App. 45, 51 (1998); Tedeschi v. Brown, 7 Vet. App. 411, 414 (1995). Importantly, Diagnostic Code 5284 "does not apply to the foot conditions specifically listed in § 4.71a." Copeland v. McDonald, 27 Vet. App. 333, 338 (2015). The Veteran's bilateral hallux valgus is specifically listed in 4.71a. Therefore, a rating under Diagnostic Code 5284 is not appropriate in this matter. (CONTINUED ON NEXT PAGE) The Board is sympathetic to the Veteran's claim. However, the preponderance of the evidence is against the assignment of compensable ratings for his left and right hallux valgus. THERESA M. CATINO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Middleton, 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.