Citation Nr: 21072296 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 16-37 683 DATE: December 2, 2021 REMANDED Entitlement to service connection for a toenail condition is remanded. REASONS FOR REMAND The Veteran served on active duty for training (ACDUTRA) from May 2010 to September 2010, and on active duty from May 2013 to May 2014. He testified at a videoconference hearing before the undersigned in July 2019. A transcript is of record. This issue was before the Board in July 2020 and was remanded for additional development. Entitlement to service connection for a toenail condition is remanded. The Veteran asserts that he has a toenail condition that began during basic training. Specifically, July 2010 treatment records indicate that he had a wedge excision of a toenail due to it being ingrown, which the Veteran asserts was due to having ill-fitting boots during basic training. See July 2019 Hearing Transcript. In November 2014, the Veteran underwent VA examination, at which time the examiner noted that the Veteran's toes hurt if he wore his boots too long. The examiner proffered that the Veteran did not have a toenail condition at the time of examination. During his July 2019 Board hearing, the Veteran testified that he has continued pain associated with the toenail and that his toenail periodically falls off typically every year. See July 2019 Hearing Transcript, at 3. The Veteran reported that one of his doctors indicated that this happens because of his history of ill-fitting boots during service. Id. In its July 2020 decision, the Board directed the agency of original jurisdiction (AOJ) to schedule the Veteran for a new examination and obtain an addendum opinion that considered the Veteran's competent lay statements regarding his reported toenail loss. Upon examination in July 2021, the Veteran's toenail and cuticle were fully intact with good cap refill and a pink nail bed. The examiner indicated that this demonstrated a healthy toenail base and that no physical aspects of the toenail demonstrated a disease process or injury deformity. She stated that no toenail condition was identified at the time of examination and that it was her opinion that the claimed disability may have been an acute concern during service as there were no signs of a chronic condition. However, the examiner failed to consider and comment on the Veteran's lay statements that he has continued pain associated with the toenail and that the nail periodically falls off. Additionally, while no disease process was identified at the time of examination, the examiner did not comment on whether a toenail disability existed at any time during the appellate period. Prior to adjudication, remand is warranted to obtain an addendum opinion that adequately considers the Veteran's competent lay statements, as well as to address whether a toenail disability existed at any time during the appellate period. The matters are REMANDED for the following action: 1. Notify the Veteran that he may submit lay statements from himself and from other individuals who have first-hand knowledge of his post-service toe symptomatology. He may also submit photographs of his toe during a time period where he is symptomatic. The Veteran should be provided an appropriate amount of time to submit this evidence. 2. After completing the above development, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any toenail disability. If possible, the examination should be scheduled during a period of flare-up, and every reasonable effort should be made to secure such an examination during a flare-up. Appropriate instructions must be provided to the Veteran in this regard. If this cannot be accomplished, an examination should still be scheduled, but an explanation should be provided as to why such could not be done while the toe is symptomatic. Upon review of the record, and after interview and examination of the Veteran, the examiner should respond to the following questions: a) Does the Veteran at least as likely as not (approximately 50 percent probability) have a toenail disability, manifesting in pain and recurrent loss of nail, including at any time during the appellate period (i.e., since August 2014)? If not, please discuss how that conclusion was reached with discussion of the Veteran's lay statements regarding continued pain associated with the toenail and the toenail periodically falling off. If there is medical reason to call into question the Veteran's reported history, please indicate as much. The examiner is reminded that pain alone can constitute a disability if it causes functional impairment. b) If the Veteran has a toe or toenail disorder (or one has resolved during the appeal period) is it at least as likely as not that such had onset in, or is otherwise related to his active-duty service, to specifically include wearing ill-fitting boots during basic training, and his care for an ingrown toenail in 2010? 3. Then, readjudicate the issue on appeal. V. Chiappetta Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Bristow Williams, 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.