Citation Nr: 21071710 Decision Date: 12/01/21 Archive Date: 12/01/21 DOCKET NO. 17-32 265 DATE: December 1, 2021 REMANDED Service connection for bilateral pes planus is remanded. Service connection for chronic obstructive pulmonary disease (COPD) is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1968 to June 1971, including service in the Republic of Vietnam (Vietnam), and from June 1977 to August 1980. The Veteran participated in an August 2019 hearing before the undersigned Veterans Law Judge, and a transcript of this hearing has been associated with the record. Service Connection for Bilateral Pes Planus In June 2021, the Board remanded the Veteran's claim for service connection for bilateral pes planus to obtain an additional opinion addressing the etiology of the Veteran's disability. The Board requested a number of opinions from the examiner, including whether the Veteran's bilateral pes planus clearly and unmistakably existed before either of his periods of active service. If the examiner found that bilateral pes planus clearly and unmistakably existed before service, the examiner was asked to opine whether such disability clearly and unmistakably was not aggravated during service. If the examiner found that bilateral pes planus did not clearly and unmistakably exist before service, the examiner was asked to opine whether it was at least as likely as not that the Veteran's bilateral pes planus had its onset during, or was otherwise related to, either of the Veteran's periods of active duty service. The Veteran underwent an additional examination in July 2021, at which time the examiner appeared to opine that the Veteran's bilateral pes planus did not clearly and unmistakably exist before either of his periods of active service. The examiner did not, however, then address whether it was at least as likely as not that the Veteran's bilateral pes planus had its onset during, or was otherwise related to, either of the Veteran's periods of active duty service, to include his in-service complaints of foot pain and a plantar wart. The Board thus remands the Veteran's claim for service connection for bilateral pes planus in order to obtain an additional opinion addressing the etiology of his disability. Service Connection for COPD In June 2021, the Board remanded the Veteran's claim for service connection for COPD to obtain an opinion addressing the etiology of the Veteran's COPD, including whether the Veteran's service-connected coronary artery disease (CAD) caused or aggravated his COPD. The Veteran underwent an additional examination in July 2021, at which time the examiner offered an opinion addressing the direct relationship between the Veteran's COPD and his military service. The examiner did not, however, offer the requested opinions addressing the secondary relationship between the Veteran's COPD and his service-connected CAD. The Board thus remands the Veteran's claim for service connection for COPD in order to obtain an additional opinion addressing the etiology of his disability. This matter is REMANDED for the following actions: Solicit the following addendum opinions from the July 2021 examiner. If the July 2021 examiner is unable to render the requested opinions, then solicit such opinions from another examiner. The examiner should order an additional physical examination of the Veteran if it is required in order to render the requested opinions. The examiner should answer the questions exactly as they are phrased below. After reviewing the Veteran's claims file, the examiner should address the following questions, in each case providing a complete rationale: (a.) Did the Veteran's bilateral pes planus clearly and unmistakably (that is, obviously or manifestly) preexist either of his periods of active duty service? After answering this question, the examiner should answer either question b) or c) below, as appropriate: (b.) If the Veteran's bilateral pes planus did not clearly and unmistakably preexist either of his periods of active duty service, is it at least as likely as not (that is, a probability of 50 percent or greater) that the Veteran's pes planus originated during, or is etiologically related to, either of the Veteran's periods of active duty service, to include his in-service complaints of foot pain and treatment for a plantar wart. (c.) If the Veteran's bilateral pes planus did clearly and unmistakably preexist either of his periods of active duty service, is it clear and unmistakable (obvious, manifest, and undebatable) that the Veteran's bilateral pes planus was not aggravated during either of the Veteran's periods of active duty service? (d.) Is it at least as likely as not (that is, a 50 percent likelihood or greater) that the Veteran's COPD is proximately due to his service-connected CAD, to include the medications used to treat such disability? (e.) Is it at least as likely as not (that is, a 50 percent likelihood or greater) that the Veteran's COPD underwent an incremental increase in disability, regardless of its permanence, due to his service-connected CAD, to include the medications used to treat such disability? The term "incremental increase in disability" means an additional impairment of earning capacity. Objective measurement, or numerical quantification, is not required to ascertain an increase in disability. Moreover, any "incremental increase in disability" need not be permanent. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J.A. Flynn, 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.