Citation Nr: 21071559 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 16-54 384 DATE: November 30, 2021 ORDER Service connection for left foot pes planus and plantar fasciitis is granted. Service connection for right foot hammertoes is granted. FINDINGS OF FACT 1. The Veteran has current diagnoses of left foot pes planus and plantar fasciitis and right foot hammertoes. 2. Symptoms of bilateral foot disorder began during service and have been present since service separation. CONCLUSIONS OF LAW 1. Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for left foot pes planus and plantar fasciitis have been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. 2. Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for right foot hammertoes have been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1982 to March 1983. He had an additional period of Army National Guard service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2016 rating decision from the Regional Office (RO), which, in pertinent part, denied service connection right and left foot disorders. The Veteran initially requested a Board videoconference hearing on the September 2018 substantive appeal; however, in written correspondence submitted September 2018 and August 2019, the Veteran's representative withdrew the hearing request. 38 C.F.R. § 20.704(e). This case was previously before the Board in January 2020 and August 2021, where the issues on appeal were remanded to obtain VA examinations and medical opinions from a VA examiner. While cognizant of its responsibilities under Stegall v. West, 11 Vet. App. 268 (1998), as the Board grants service connection for the left foot pes planus and plantar fasciitis and right foot hammertoes, which is a total grant of benefits as to the issues on appeal, the Board need not address remand compliance. An August 2021 rating decision granted service connection for right foot plantar fasciitis, metatarsalgia, and pes planus, which is a full grant of benefits, based on a positive nexus opinion provided during an August 2021 foot VA examination, so service connection for right foot pes planus, plantar fasciitis, and metatarsalgia is no longer on appeal. The VA examiner also diagnosed bilateral peripheral neuropathy and provided a negative nexus opinion for these conditions during the August 2021 VA foot examination. However, as the Board has already denied the claims for service connection for peripheral neuropathy of the right and left lower extremities in a January 2020 Board decision, which the Veteran characterized as numbness in the feet, the Board need not readjudicate the issue of bilateral lower extremity peripheral neuropathy of the feet in this instance, as the January 2020 Board Decision is final as to that matter. 38 U.S.C. § 7104; 38 C.F.R. §§ 3.156(a), 20.1100. 1. Service Connection for Left Loot Pes Planus and Plantar Fasciitis 2. Service Connection for Right Foot Hammer Toes The Veteran contends that he injured or fractured both feet during physical training in service, as he was forced to jump in a ditch while marching in full gear, injuring the feet. The Veteran asserts that he was barely able to complete the march, but he pushed through and then sought treatment in the days thereafter. The Veteran asserts that his feet have hurt most of the time since the injury. See August 2019 correspondence. Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Generally, service connection for a disability requires evidence of: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. The evidence shows current diagnoses of bilateral foot disorders, including left plantar fasciitis and pes planus and right hammertoes. See February 2020, August 2020, August 2021 VA examination report. After a review of all the lay and medical evidence of record, the Board finds that the evidence is at least in equipoise on the question of whether there was an onset of symptoms of bilateral foot disorder in service that continued after service separation, and were later diagnosed as left plantar fasciitis and pes planus and right hammertoes. Service treatment records show that the feet were clinically normal, and the Veteran denied any history of problems with the feet during the July 1982 enlistment examination. The record shows that the Veteran was treated for left and right foot problems during training in December 1982 and January 1983. Physical examinations revealed pain and tenderness over 2nd and 4th metatarsals and palpable edema in the left foot, as well as swelling in the dorsum of the right foot with tenderness over the lateral aspect of the foot and the arch. The diagnoses were plantar fasciitis, metatarsalgia, and pes planus of the right foot during service, but no diagnosis was rendered for the left foot. Physical restrictions were implemented to accommodate the Veteran's foot conditions. In written correspondence and during VA examinations the Veteran has provided a lay history of an onset of pain in the feet due to injuries sustained while marching during service, and that his feet remain painful and symptomatic since service. On the question of relationship of currently diagnosed disabilities to service, the Board has considered the opinions of the VA examiners in February 2020 and August 2021. The February 2020 VA opinion does not address the etiology of the right hammertoes and does not consider and address the onset of symptoms in the left foot during service. The VA examiner in August 2021 rendered a negative nexus opinion for right foot hammertoes and left foot pes planus and plantar fasciitis because the conditions were not diagnosed during service; however, the VA examiner did not adequately consider whether symptoms of pain in the metatarsals and edema in the left foot were indicative of the onset of plantar fasciitis and pes planus in the left foot during service or whether the right hammertoes are otherwise etiologically related to the right pes planus, metatarsalgia, and plantar fasciitis noted during service. The Veteran need not have been diagnosed with right foot hammertoes and left foot pes planus and plantar fasciitis in service, as such is not required to meet the requirements for service connection for the bilateral foot conditions under any theory of service connection, including direct service connection. See 38 C.F.R. § 3.303(d) (providing service connection may be granted for any disease diagnosed after service when the evidence establishes in-service incurrence). While right foot hammertoes and left foot pes planus and plantar fasciitis are not chronic diseases listed under 38 C.F.R. § 3.309(a), the Board has nonetheless found the evidence at least in equipoise on the question of whether the Veteran had bilateral foot disorder symptoms that began during service and continued since service separation, which symptoms were later diagnosed as right foot hammertoes and left foot pes planus and plantar fasciitis, thus tending to show direct service incurrence. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a), (d). The Board is granting the service connection claim based on evidence, including that pertinent to service, which establishes that symptoms of left and right foot disorders (later diagnosed as right foot hammertoes and left foot pes planus and plantar fasciitis) began in service, so was "incurred in" service. The grant of direct service connection renders moot other theories of service connection. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moore, Shanna 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.