Citation Nr: 21072188 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 15-36 470 DATE: December 2, 2021 REMANDED Entitlement to service connection for bilateral foot condition, to include bilateral heel spur, plantar fasciitis, and left foot Morton's neuroma, is remanded. REASONS FOR REMAND The Veteran served on active duty from February 2011 to February 2013. This matter comes before the Board of Veterans' Appeals (Board) on appeal from May 2013 and February 2016 rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO). This case was most recently before the Board in March 2021, at which time it was remanded for further development, as discussed below. The Board finds that the remand directives were not substantially complied with and thus another remand is warranted. Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to service connection for bilateral foot condition, to include bilateral heel spur, plantar fasciitis, and left foot Morton's neuroma, is remanded. A March 2021 Board decision remanded the claim of service connection for a bilateral foot condition. The Board noted that the October 2020 VA examination did not adequately address the Veteran's theory of entitlement that his bilateral foot conditions are proximately due to or aggravated by his right ankle condition. Nonetheless, the examiner considered the Veteran's lay statements regarding the onset of symptoms during active service but remarked that servicemembers typically have foot pain due to field work and marching. The rationale otherwise relied on lack of treatment records regarding any foot condition prior to a diagnosis of bilateral plantar fasciitis and Morton's neuroma in 2015, multiple years after separation from service in February 2013. See 10/01/2020, C&P Exam. The Board directed the Agency of Original Jurisdiction (AOJ) to obtain an addendum opinion from an appropriate clinician to determine the nature and etiology of the Veteran's bilateral foot conditions. The clinician was directed to provide an opinion as to whether the Veteran's foot conditions are proximately due to or aggravated by a service-connected disability, to include a right ankle condition. 03/09/2021, BVA Decision. An August 2021 VA examiner opined that the Veteran's bilateral foot conditions are less likely than not proximately due to or aggravated by a service-connected disability, to include a right ankle condition. The rationale was based on a lack of credible research showing that a left calcaneal spur could be caused by a right ankle degenerative arthritis. However, the examiner did not provide an opinion regarding the Veteran's right calcaneal spur, bilateral plantar fasciitis, and left foot Morton's neuroma, despite noting diagnoses for the aforementioned conditions. 08/09/2021, C&P Exam; 08/09/2021, C&P Exam (medical opinion). Subsequently, the Veteran asserted that he complained of foot pain in February 2012, during his period of active service. 04/22/2021, Correspondence. These assertions are corroborated by the service treatment records. 06/19/2013, STR Medical, page 14. Upon review of the record, none of the VA examinations and medical opinions adequately address the Veteran's theory of entitlement that his bilateral foot conditions, to include bilateral heel spur, plantar fasciitis, and left foot Morton's neuroma are proximately due to or aggravated by his right ankle condition. Moreover, none of the VA examinations and medical opinions explicitly consider the service treatment records showing in-service complaints of foot pain. Accordingly, the Board finds that all of the examinations and medical opinions are incomplete to adjudicate this issue, to include on a secondary basis, at this time and an addendum opinion is necessary. This matter is REMANDED for the following actions: 1. Obtain any outstanding VA treatment records. Additionally, request the Veteran to submit any relevant private treatment reports or provide VA with authorization to obtain any such records. 2. After completing directive #1, obtain an addendum opinion from an appropriate clinician to determine the nature and etiology of the Veteran's bilateral foot conditions. An in-person examination is not required unless deemed necessary by the clinician. The clinician is to review the virtual file, including a copy of this Remand. The clinician is to address the following: (a.) Whether it is at least as likely as not that any of the Veteran's bilateral foot conditions are related to active service, to include falling in a hole during service? If not, does the record at least as likely as not show any bilateral foot conditions manifested within one year of the Veteran's separation from service in February 2013? (b.) Whether it is at least as likely as not that any of the Veteran's bilateral foot conditions are either 1) proximately due to OR 2) aggravated by a service-connected disability, to include a right ankle condition. The clinician must consider all lay and medical evidence, to include service treatment records showing complaints of foot pain in February 2021. See 06/19/2013, STR Medical, page 14. The clinician must also provide opinions as to all of the Veteran's foot conditions, to include bilateral heel spur, plantar fasciitis, and left foot Morton's neuroma. If an in-person examination is deemed necessary, then one should be scheduled. If an examination is scheduled, all pertinent symptomatology and findings must be reported in detail. Any indicated diagnostic tests and studies should be accomplished. The claims file should be made available to the examiner. A comprehensive rationale for all opinions is to be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans' Appeals Attorney for the Board David Han 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.