Citation Nr: 21069771 Decision Date: 11/19/21 Archive Date: 11/19/21 DOCKET NO. 16-13 480 DATE: November 19, 2021 REMANDED Entitlement to service connection for bilateral hallux valgus, claimed as bunions, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1996 to November 1999. This case comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision of the Department of Veteran Affairs (VA) Regional Office (RO). In March 2018, the Veteran testified at a hearing before a Veterans Law Judge (VLJ). A transcript of this hearing has been associated with the record. This VLJ has since become unavailable to participate in the appeal. In May 2021, the Board sent a letter to the Veteran providing them with an opportunity to present testimony at a new hearing before a different VLJ. As explained in that letter, as the Veteran did not respond within 30 days from the date of the letter, the Board may assume that they do not want another hearing. This issue was previously before the Board in September 2018, February 2021, and July 2021, each time remanded for further development. That development was completed, and the case has since been returned to the Board for appellate review. The July 2021 Board decision granted service connection for dry eye syndrome. A September 2021 rating decision effectuated this grant with a 10 percent evaluation effective April 24, 2012. This represents a full grant of the benefits sought, and this issue is no longer in appellate status. See Grantham v. Brown, 114 F. 3d 1156, 1158 (Fed. Cir. 1997). Entitlement to service connection for bilateral hallux valgus, claimed as bunions is remanded. Remand is required for an addendum VA medical opinion. Where VA provides the Veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). A medical opinion based upon an inaccurate factual premise has no probative value. Reonal v. Brown, 5 Vet. App. 458, 461 (1993). The RO obtained an addendum VA medical opinion in September 2021. The examiner opined that the hallux valgus, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated during service. They stated that the hallux valgus was indicated as asymptomatic upon entry, but that at separation there were no related foot issues, and explained that this does not fall within the projected natural history of the condition. However, the Board notes while the Veteran did indeed deny foot issues on the report of medical history at separation in November 1999, the corresponding report of medical examination actually indicates mild right hallux valgus. This is in contradiction of the examiner's statement that there were no related foot issues at separation. Accordingly, remand is required for an addendum VA medical opinion. The matters are REMANDED for the following action: 1. Obtain an addendum opinion regarding the etiology of the hallux valgus from a VA examiner. The entire claims file must be made available to and be reviewed by the examiner. If an examination is deemed necessary, it shall be provided. An explanation for all opinions expressed must be provided. (a) The examiner must provide an opinion regarding whether it is clear and unmistakable (undebatable) that the hallux valgus pre-existed the Veteran's active service. (b) If the answer to (a) is in the positive, provide an opinion regarding whether it is also clear and unmistakable (undebatable) that the hallux valgus was not aggravated by active service beyond its natural progression. The examiner is reminded that they may not rest on the notion that the record contains insufficient evidence of aggravation, rather must rely on affirmative evidence to prove there was no aggravation. (c) If the examiner finds that the hallux valgus disorder did NOT clearly and unmistakably preexist service, or was clearly and unmistakably NOT aggravated by service, the examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that hallux valgus had onset in, or is otherwise related to, active service. (Continued on the next page) (d) The examiner should consider the following: 1) the April 1996 report of medical examination noting asymptomatic hallux valgus; 2) the November 1999 report of medical examination noting mild right hallux valgus; and 3) the March 2018 Board hearing testimony. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Rogos 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.