Citation Nr: 21064745 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 19-32 031 DATE: October 21, 2021 REMANDED The issue of entitlement to service connection for bilateral plantar fasciitis, plantar fibromatosis and enthesophyte formation at calcaneal insertion of achilles tendon (claimed as bilateral foot condition), as secondary to service-connected right knee patellofemoral syndrome, is remanded. The issue of entitlement to a rating in excess of 50 percent for PTSD (excluding the temporary total rating period from March 9, 2018 to May 1, 2018) is remanded. The issue of entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disability is remanded. REASONS FOR REMAND The Veteran served on active duty from March 2001 to May 2006, with additional reserve service. His medals include the Combat Action Badge. These matters come before the Board of Veterans' Appeals (Board) on appeal from November 2016 and August 2018 rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). The issues of entitlement to an increased rating for PTSD and a TDIU were previously before the Board in October 2019, when they were remanded for further development. 1. Entitlement to service connection for a bilateral foot condition, as secondary to service-connected right knee patellofemoral syndrome 2. Entitlement to a rating in excess of 50 percent for PTSD (excluding the temporary total rating period from March 9, 2018 to May 1, 2018) 3. Entitlement to a TDIU due to service-connected disability The Veteran seeks service connection for a bilateral foot disability, as secondary to his service-connected right knee patellofemoral syndrome. While VA opinions addressing secondary service connection were provided in May 2018 and June 2018, the opinions are inadequate to adjudicate the claim. The May 2018 VA examiner's positive causation opinion was conclusory and speculative; moreover, neither the May 2018 nor June 2018 examiner addressed whether the service-connected right knee patellofemoral syndrome aggravated (worsened) the diagnosed bilateral foot conditions. Thus, an addendum opinion is needed. Regarding the PTSD and TDIU claims, the Board finds that there has not been substantial compliance with the requirements articulated in the Board's October 2019 remand decision. See Stegall v. West, 11 Vet. App. 268 (1998); D'Aries v. Peake, 22 Vet. App. 97 (2008). In the October 2019 decision, the Board remanded the PTSD and TDIU claims to, among other things, obtain an addendum opinion addressing the occupational impact of the Veteran's service-connected PTSD on his occupational functioning/employability. While a January 2020 VA examiner opined that the Veteran's PTSD does not affect his ability to perform physical or sedentary activities as related to usual employment, the examiner did not provide any explanation or rationale for the conclusion, as instructed on remand. Thus, remand to obtain an addendum opinion is needed. Updated medical treatment records should also be requested. The matters are REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for his claimed bilateral foot disability and PTSD. After securing any necessary releases, request any relevant records identified that are not duplicates of those associated with the claims file. In addition, obtain updated VA treatment records from September 2020. If any requested records are unavailable, the Veteran should be notified of such. 2. After records development is completed, obtain an addendum opinion from an appropriate VA examiner on the claimed bilateral foot disability. If an examination is deemed necessary to respond to the questions presented, one should be scheduled. Following review of the claims file, the examiner should opine whether it is at least as likely as not (50 percent probability or greater) that the diagnosed bilateral plantar fasciitis, plantar fibromatosis and enthesophyte formation at calcaneal insertion of achilles tendon was worsened (aggravated) beyond natural progression by the service-connected right knee patellofemoral syndrome. The examiner should explain why or why not, and the opinion should address each of the three diagnosed bilateral foot conditions separately. If so, the examiner should attempt to qualify the degree of worsening beyond the baseline level of the diagnosed bilateral foot condition. A rationale for the conclusions reached must be provided. 3. Obtain an addendum opinion from an appropriate VA examiner regarding the claims for an increased rating for PTSD and a TDIU. If an examination is deemed necessary to respond to the questions presented, one should be scheduled. Following review of the claims file, the examiner should provide an opinion describing the functional impairment, if any, caused by the Veteran's PTSD and the effect of any such functional impairment on the Veteran's employability, to include his ability to perform physical and sedentary activities of employment. The examiner must explain why or why not. A rationale for the conclusions reached must be provided. 4. If the claims remain denied, issue a supplemental statement of the case. K. A. BANFIELD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. C. Birder 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.