Citation Nr: 21070486 Decision Date: 11/24/21 Archive Date: 11/24/21 DOCKET NO. 14-30 710 DATE: November 24, 2021 REMANDED Entitlement to service connection for bilateral pes planus is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from August 1991 to January 1997. In his August 2014 substantive appeal, the Veteran requested a BVA hearing by videoconference." He requested that the hearings scheduled for him in March 2020 and August 2020 be rescheduled, and ultimately did not report for the virtual hearing scheduled for him in June 2021. The request for a hearing is considered withdrawn. See 38 C.F.R. § 20.704(d). 1. Entitlement to service connection for bilateral pes planus is remanded. The Veteran is seeking entitlement to service connection for bilateral pes planus that he contends is due to military service. However, in his August 2014 substantive appeal, he conceded that the condition existed as service entrance. Indeed, the November 1991 entrance examination report showed a notation of "Pes Planus Moderate." A Veteran who served after December 31, 1946, is presumed to be in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious and manifest) evidence demonstrates that an injury or disease existed prior thereto and was not aggravated by such service. Only such conditions as are recorded in the examination reports are to be considered as noted. See 38 U.S.C. § 1111; 38 C.F.R. § 3.304(b). If an entrance examination notes a pre-existing condition that is alleged to have been aggravated, the Veteran may claim service-connected aggravation of that condition. In such cases, the burden falls on the Veteran to establish that the condition worsened in-service. Only when worsening of the condition is shown can it be presumed that the condition was aggravated by military service. At that point, the presumption of aggravation in service can be rebutted by VA with evidence showing, by clear and unmistakable evidence, that the aggravation was due to the natural progression of the condition. See 38 U.S.C. § 1153; Horn v. Shinseki, 25 Vet. App. 231 (2012). The provisions of 38 U.S.C. § 1153 apply to the Veteran's claim for service connection of bilateral pes planus because the condition was "noted at entrance into service." See 38 U.S.C. § 1111. The Veteran has produced evidence that his bilateral pes planus condition has worsened to include the May 2011 VA podiatry consult already of record, and an August 2014 VA treatment record. Therefore, the October 2011 VA examination is inadequate because it does not address aggravation of the Veteran's pre-existing bilateral pes planus condition. While the Board regrets the additional delay, a remand is necessary to obtain the appropriate VA medical opinion regarding aggravation of the Veteran's pre-existing bilateral pes planus condition. The matter is REMANDED for the following actions: 1. Obtain VAMC treatment records from October 2019 to present. 2. Once the updated treatment records are obtained, complete an addendum opinion from the VA provider who issued the October 2011 medical opinion (or a suitable replacement, if s/he is not available). The decision for an in-person examination of the Veteran is left to the discretion of the examiner. The Veteran's record, to include a copy of this remand, should be made available to and reviewed by the examiner, and an opinion as follows is requested: a. Whether the diagnosed pes planus disorder, which was noted on entrance, increased in severity during service or otherwise as a result of service. If there was an increase in severity, but only due to the natural progression of the disease, the examiner should so state. b. Considering the Veteran's and his representative's contention that there may be a connection between the Veteran's service-connected bilateral ankle disability and his bilateral pes planus, the examiner is also asked to opine as to whether the Veteran's bilateral pes planus is at least as likely as not aggravated by a service-connected disability, to include the bilateral ankle condition. c. The examiner is respectfully asked to provide a clear rationale for all opinions and a discussion of the facts and medical principles, including studies and literature, involved. Because it is important "that each disability be viewed in relation to its history (See 38 C.F.R. § 4.1)," copies of all pertinent records in the Veteran's claims file, or in the alternative, the claims file, must be made available to the examiner for review. 3. Thereafter, the AOJ should review the claims file and ensure that the development requested above has been completed; if the requested medical opinion is lacking, it should be returned to the examiner for clarification or addendum. 4. Readjudicate the claim. If the relief sought by the Veteran is not granted in full, issue a Supplemental Statement of the Case to the Veteran, and return the appeal to the Board. J. Kirby Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Small, Attorney Advisor 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.