Citation Nr: 21071199 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 11-21 849 DATE: November 30, 2021 REMANDED 1. Entitlement to service connection for bilateral pes planus is remanded. 2. Entitlement to service connection for a left foot disability, to include tendonitis, tarsal tunnel syndrome, and neuropathy is remanded. 3. Entitlement to service connection for a right foot disability, to include tendonitis, tarsal tunnel syndrome, and neuropathy is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1979 to November 1982 and from March 1984 to November 2002. On the August 2011 VA Form 9, the Veteran requested a Board hearing. On the June 2014 VA Form 21-4138 Statement in Support of Claim, the Veteran cancelled his request for a Board hearing. In September 2020, the Board remanded the claims for service connection for bilateral pes planus, a left foot disability, and a right foot disability for an addendum medical opinion. Unfortunately, there has not been substantial compliance with the Board's previous remand directives as previously directed by the Board. Stegall, 11 Vet. App. at 271. 1. Entitlement to service connection for bilateral pes planus is remanded. 2. Entitlement to service connection for a left foot disability, to include tendonitis, tarsal tunnel syndrome, and neuropathy is remanded. 3. Entitlement to service connection for a right foot disability, to include tendonitis, tarsal tunnel syndrome, and neuropathy is remanded. The September 2020 Board decision remanded the claims for an addendum medical opinion to consider whether pes planus, which was noted at entry into service, was aggravated beyond its natural progression. The Veteran underwent a VA examination in October 2020. The October 2020 VA examiner stated that she could not find a record of a pes planus diagnosis on active duty, and she did not provide the required opinion. The Board finds this examination is inadequate because the examiner failed to provide the requested opinion. The September 2020 Board determined, and the Veteran agrees that the notation of "PPL2" on the November 1979 entrance Report of Medical Examination (RME) is a diagnosis of pes planus level 2. The December 2019 VA examiner stated that pes planus can increase the risk of developing the other foot disabilities for which the Veteran seeks service connection. Accordingly, the Veteran's claim for service connection for bilateral tendonitis, tarsal tunnel syndrome, and neuropathy is intertwined with Veteran's claim for service connection for bilateral pes planus. In the February 2021 Appellate Brief, the Veteran, through his representative, raised the issue of secondary service connection. The Veteran's representative stated that the Veteran's bilateral knee arthritis is contributing to his foot pain because research has shown that people with knee arthritis are 25 percent more likely to have bilateral foot pain. He also noted the Veteran is service-connected for Achilles' tendonitis which is also contributing to his tarsal tunnel syndrome. The Veteran provided two articles that shows a connection between ankle sprains, which the Veteran experienced in service, and inflammation/swelling in or near the tarsal tunnel and knee arthritis and foot pain. The matters are REMANDED for the following action: 1. Obtain addendum opinions from an appropriate clinician, other than the October 2020 VA examiner, regarding the Veteran's bilateral foot disabilities. The examiner is asked to opine as follows: a) With respect to pes planus, whether it is at least as likely as not (50 percent or greater probability) that there was an increase during service in the Veteran's disability, which existed prior to service. Please note that the Veteran contends extensive running and marching in service aggravated his pes planus. The Board found the notation of "PPL2" on the November 1979 entrance RME is a diagnosis of pes planus level 2. This notation MUST be considered by the VA examiner when forming their opinion. b) If the Veteran's pes planus increased during service, provide an opinion as to whether the increase was clearly and unmistakably due to the natural progress of the disease. c) With respect to the remaining foot disabilities, bilateral tendonitis, tarsal tunnel syndrome, and neuropathy, is it at least as likely as not that the foot disabilities were (i) incurred in service, or (ii) caused or aggravated by a service-connected disability (to include whether it was caused or aggravated by the pes planus disability if it is determined to be etiologically related to the Veteran's service.) The examiner should reference and consider the two articles provided within the February 2021 Appellate Brief. J. NICHOLS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. McDaniels, Associate 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.