Citation Nr: 21069727 Decision Date: 11/19/21 Archive Date: 11/19/21 DOCKET NO. 18-07 541 DATE: November 19, 2021 REMANDED Entitlement to service connection for a bilateral ankle disability is remanded. REASONS FOR REMAND The Veteran had active military service from September 1969 to August 1971. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In December 2019, the Veteran testified at a Board hearing. The transcript of the hearing is of record. By way of background, in February 2020, the Board dismissed the claim for entitlement to service connection for dermatitis of the bilateral lower legs and remanded the claim for service connection for bilateral foot disability and bilateral ankle disability. During the appeal process, in an October 2020 rating decision, the RO granted service connection for bilateral foot disability. As such, the only claim on appeal is for entitlement to service connection for bilateral ankle disability. This claim is once again before the Board. Entitlement to service connection for a bilateral ankle disability is remanded. At the outset, the Board notes that the June 2016 VA examiner diagnosed the Veteran with bilateral tendonitis of the ankles. In an October 2017 VA treatment record, he was diagnosed with ankle edema. See December 2017 CAPRI. A review of the service treatment records (STRs) shows that in the July 1969 pre-induction examination, he was noted to have normal lower extremities and feet. He denied having arthritis. See March 2015 STR Medical. In a July 1970 STR, he complained that his combat boots when laced up would cause pressure and pain over the lower leg. He stated that he has been lacing his boots just over his ankle with some results. He was recommended to wear mechanic boots or low quarters to relieve pain over the lower legs for 30 days. In a September 1970 STR, he was recommended to continue wearing mechanic boots or low quarters for an additional 30 days. In a May 1971 STR, he complained of subjective pain over the lower legs. It was noted that he has been on low quarters due to his leg pain. On examination, there was no findings except for very mild [illegible] between toes. On the same day, he was seen for his separation examination. In the May 1971 separation examination, the examiner noted that he has normal lower extremities. During the December 2019 hearing, he attested that his bilateral ankles swelled in service and that he even went on sick call a couple of times. He was instructed not to wear any boots and refrain from standing, jumping, or running. In an October 2017 VA treatment record, he was noted to have nerve pain in his legs and feet. He exhibited ankle edema and was diagnosed with ankle edema. See December 2017 CAPRI. He stated that he did not seek medical treatment for his bilateral ankle disability as they would swell but then would return to a normal state. In the June 2016 VA examination, the examiner opined that his bilateral ankle disability is less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner explained that although in a July 1970 STR he had a right ankle pressure from boots which caused swelling he did not have a chronic ankle diagnosis while on duty. Further a May 2016 x-ray scan of the bilateral ankles revealed no acute fracture or acute bony pathology. During the appeal process, he was service connected for his bilateral foot disability in an October 2020 rating decision. The Veteran argued that his bilateral ankle disability is secondary to his service-connected bilateral foot disability. See October 2021 Appellate Brief. The Board finds that a remand is warranted as the Veteran claims that his bilateral ankle disability is secondary to his service-connected bilateral foot disability. The matter is REMANDED for the following action: Obtain an addendum to the June 2016 VA examination report. The claims file must be made available to be reviewed by the examiner. The Veteran should be scheduled for a physical examination if determined necessary. The examiner must provide an opinion as to whether it is at least as likely as not (50 percent probability or more) that the bilateral ankle disability had its onset in service or is otherwise etiologically related to service. The examiner must state whether it is at least as likely as not (a fifty percent probability or greater) that the Veteran's bilateral ankle disability was (a) caused by or has been (b) aggravated (worsened beyond the natural progress of the disorder) by his service-connected bilateral foot strain. The examiner should consider that the Veteran wore mechanic boots or low quarters in service due to his leg pain. For instance, in a July 1970 STR, he complained that his combat boots when laced up caused pressure and pain over the lower leg. He reported that he has been lacing his boots just over his ankle with some results. He was recommended to wear mechanic boots or low quarters to relieve pain over the lower legs. In a September 1970 STR, he was recommended to continue wearing mechanic boots or low quarters for additional 30 days. In a May 1971 STR, he complained of pain over the lower legs. It was noted that he has been wearing low quarters due to his leg pain. In the May 1971 separation examination, he exhibited normal lower extremities. The October 2020 VA examiner rendered a positive nexus opinion stating that his bilateral foot disability is at least as likely as not related to his wearing boots during service. A detailed rationale for all opinions must be provided. If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. S. HENEKS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. Noh, 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.