Citation Nr: 21071645 Decision Date: 12/01/21 Archive Date: 12/01/21 DOCKET NO. 16-63 341 DATE: December 1, 2021 REMANDED Service connection for a bilateral foot disability, to include bilateral pes planus and plantar fasciitis is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1991 to December 1992 in the U.S. Navy. This matter comes before the Board of Veterans' Appeals (Board) from a September 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in North Little Rock, Arkansas. This matter was most recently before the Board in July 2021, at which time the issue on appeal was remanded for additional development. This case has now returned to the Board for appellate consideration. The issue of service connection for a neck disability was also previously before the Board, however the RO granted service connection in a September 2021 rating decision. Accordingly, the issue has been granted in full and is no longer before the Board. Additional evidence was associated with the Veteran's file after the RO issued a September 2021 Supplemental Statement of the Case (SSOC). In October 2021, the Veteran stated that he wanted the RO to review this evidence before sending it back to the Board. See October 2021 VA 27-0820 Report of General Information; see also October 2021 Correspondence. Additionally, the Board finds the September 2021 VA opinion inadequate for adjudication purposes because it relies on the lack of documentation of a bilateral foot diagnosis during service and does not consider the Veteran's lay statements of record. Accordingly, remand is warranted to obtain a new VA medical opinion. The Board also finds that a new opinion regarding secondary service connection should be obtained on remand because the July 2020 opinion does not adequately address the Veteran's contentions. Additionally, the July 2020 VA examiner stated that pes planus is common in people with obesity. The record shows that the Veteran has obesity that may be related to his service-connected back disability or psychiatric disability. The opinion did not address whether obesity is an intermediate step between the Veteran's service-connected disabilities and bilateral foot disability. Although obesity itself is not considered a disability for VA purposes, when obesity has been caused by a service-connected condition, and subsequently causes another disability, obesity may be considered an "intermediate step" for establishing service connection on a secondary basis. See Walsh v. Wilkie, 32 Vet. App. 300 (2020). Thus, an addendum opinion is warranted. The matter is REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. Obtain an addendum opinion from an appropriate clinician to determine the nature and etiology of the Veteran's bilateral foot disability, to include foot pain, pes planus, and plantar fasciitis. If an examination is deemed necessary to respond to the questions presented, one should be scheduled. After review of the claims file, the clinician should identify all diagnoses related to the Veteran's claimed bilateral foot disability throughout the appeal period. For each diagnosis, the clinician should opine as to the following: (a.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's bilateral foot disability had its onset during active service or is otherwise related to any in-service injury, event, or disease. The clinician should consider the Veteran's complaints and treatment for bilateral foot pain during service. Additionally, the clinician should consider the continuity of the Veteran's symptoms. The clinician should also consider the Veteran's contentions that his bilateral foot condition worsened during military service due to continued use of military issued boots and while performing military duties, including frequently climbing stairs and long hours on his feet. See October 2021 Correspondence. The Board notes that the Veteran is competent to attest to observable symptomatology. The physician is advised that an opinion based solely on lack of documentation of a diagnosis in service and since service is not sufficient. (b.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's bilateral foot disability was (1) caused or (2) aggravated by his service-connected disabilities, to include thoracic scoliosis with thoracolumbar pain, cervicalgia, and major depression associated with thoracic scoliosis with thoracolumbar pain. The clinician should consider the Veteran's statement that he always had foot trouble when he was treated for back pain during military service. In addressing secondary service connection, the examiner must also discuss the relationship, if any, between the Veteran's service-connected disabilities and his obesity and, if warranted, the relationship, if any, between the Veteran's obesity and any diagnosed bilateral foot disability. The clinician should consider the lay statements of record and the Veteran's medical history. A complete rational should be provided for all opinions and conclusions expressed. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Kernen, 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.