Citation Nr: 21067083 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 20-00 204A DATE: November 3, 2021 REMANDED Entitlement to service connection for a bilateral foot disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 2007 to February 2008, with additional Reserve service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the claim for further development in October 2020. 1. Entitlement to service connection for a bilateral foot disability is remanded. Remand is warranted, as the VA opinions obtained in March and June 2021 are inadequate. In this regard, the examiners did not provide sufficient rationales for their opinions and primarily relied on the lack of foot complaints documented in the service treatment records, even though the March 2021 examiner noted that the Veteran was diagnosed with plantar fasciitis during her Reserve service. Therefore, an addendum opinion is necessary on remand, in addition to any outstanding treatment records. The Veteran's Reserve duty status, active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA), should also be verified on the dates she reported foot pain and was diagnosed with plantar fasciitis. The matter is REMANDED for the following action: 1. Verify the Veteran's duty status (INACDUTRA or ACDUTRA) on October 20, 2009 and December 20, 2009, coincident with her reports of foot pain and diagnosis of plantar fasciitis. 2. Then refer the claims file to an examiner other than the March and June 2021 VA examiners for preparation of an addendum opinion addressing the etiology of the Veteran's bilateral foot disability. The entire claims file should be made available to the examiner. No additional examination is necessary, unless the examiner determines otherwise. Following a review of the claims file, the examiner should opine as to whether it is at least as likely as not (approximate balance of evidence) that any diagnosed bilateral foot disability, including plantar fasciitis and hallux valgus (see March 2021VA examination report): (a) had its onset during active duty or a period of ACDUTRA (please discuss the October 20, 2009 and December 20, 2009 treatment records, if verified as ACDUTRA); (b) is the result of a disease or injury incurred during active duty or a verified period of ACDUTRA; (c) is otherwise the result of an injury incurred during a verified period of INACDUTRA; (d) is proximately due to service-connected other specified depressive disorder, lumbosacral strain, right pelvic bone stress fracture residuals, right lower extremity radiculopathy, left knee strain, and/or left hip trochanteric pain syndrome and pelvic fracture; or (e) has been aggravated (worsened beyond natural progression) by service-connected other specified depressive disorder, lumbosacral strain, right pelvic bone stress fracture residuals, right lower extremity radiculopathy, left knee strain, and/or left hip trochanteric pain syndrome and pelvic fracture. If the answer to questions (a) (e) are no, then is it at least as likely as not (approximate balance of evidence) that the Veteran's service-connected psychiatric disorder and/or musculoskeletal disabilities caused her to become obese/gain weight? (a) If so, is it at least as likely as not that obesity/weight gain was a "substantial factor" in causing her bilateral foot disability? (b) If so, is it at least as likely as not that her bilateral foot disability would not have occurred but for the obesity/weight gain caused by service-connected psychiatric and/or musculoskeletal disabilities? In addressing these questions, the examiner must discuss: (1) the Veteran's report that her service-connected disabilities limited her physical activity, which led her to gain weight and become obese; and (2) assume as true the Veteran's statements regarding the onset of foot pain in-service (see March 2021 VA foot examination, Section II Medical History) and determine, based on the same, whether a nexus between the Veteran's bilateral foot disability and service is "medically plausible." (Continued on the next page) The examiner should also consider and discuss the medical articles cited by the Veteran's representative in April 2020 (indicating obesity as a risk factor for plantar fasciitis and the article entitled "Does Depression Cause Obesity?: A Meta-analysis of Longitudinal Studies of Depression and Weight Control"). Failure to consider the Veteran's lay statements will result in an inadequate opinion. Please note that the lack of contemporaneous medical records is not dispositive and may not be used as a basis for a negative opinion. A complete rationale should be given for all opinions and conclusions expressed. If unable to opine without speculation, please provide a basis for that conclusion. Marissa Caylor Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S.S. Mahoney 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.