Citation Nr: 21075348 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 17-54 222 DATE: December 20, 2021 ORDER Entitlement to service connection for bilateral plantar fasciitis is granted. Entitlement to service connection for a back disability is granted. Entitlement to service connection for a left knee disability is granted. Entitlement to service connection for a right knee disability is granted. REMANDED Entitlement to service connection for lattice degeneration with retinoschisis (claimed as bilateral retinal detachment) is remanded. FINDINGS OF FACT 1. The Veteran's bilateral plantar fasciitis began during active service. 2. The Veteran's plantar fasciitis proximately caused her back disability. 3. The Veteran's plantar fasciitis proximately caused her left knee disability. 4. The Veteran's plantar fasciitis proximately caused her right knee disability. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral plantar fasciitis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria to establish service connection for a back disability have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. 3. The criteria to establish service connection for a left knee disability have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. 4. The criteria to establish service connection for a right knee disability have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from April 2011 to August 2011 and from April 2014 to May 2014. She appeals an August 2015 rating decision by the Agency of Original Jurisdiction (AOJ). A Board hearing was held in September 2021. A transcript is of record. Service Connection A Veteran is entitled to VA disability compensation if there is a current disability resulting from personal injury or disease incurred in, or aggravated by, active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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 or aggravated during service, the so-called nexus requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disease or injury. See 38 C.F.R. § 3.310(a). To prevail on the issue of entitlement to secondary service connection, there must be evidence of (1) a current disability; (2) a service-connected disability; and (3) a nexus establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). As to the third Wallin element, the current disability may be either (a) proximately caused by, or (b) proximately aggravated by a service-connected disability. See Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). 1. Bilateral Plantar Fasciitis The Board concludes that the Veteran has bilateral plantar fasciitis that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). A May 2015 VA examination report shows the Veteran has a current diagnosis of bilateral planar fasciitis. See May 2015 VA examination report. The Veteran asserts that her plantar fasciitis began during active service and has continued to present. The Veteran's service treatment records (STRs) indicate that she was first seen for plantar fasciitis in June 2011. See June 24, 2011 STR. Various other treatment notes during service indicate plantar pain and note that the pain began in the year 2011. See, e.g. September 11, 2011 and December 05, 2015 STRs. Finally, in a June 2017 opinion, Dr. E.K.R. opined the Veteran's bilateral plantar fasciitis is related to her active-duty service. See June 2017 Dr. E.K.R. opinion. Accordingly, resolving all doubt in favor of the Veteran, the Board finds that service connection for bilateral plantar fasciitis is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 2. Back and Bilateral Knees The Veteran generally contends that her back and knee disabilities are caused or aggravated by her plantar fasciitis. See Board Hearing Tr. at 15. The Veteran has a diagnosis of lumbosacral strain. See May 2015 VA examination report. The Board notes that the May 2015 VA examiner did not diagnose the Veteran with a knee disability. However, in Saunders v. Wilkie, the Federal Circuit held that pain alone can constitute a disability if it causes functional impairment. 886 F.3d 1356, 1365-68 (Fed. Cir. 2018). The Federal Circuit further explained that to establish a disability, "the [V]eteran will need to show that his pain reaches the level of a functional impairment of earning capacity." Id. at 1367-68. Here, the Veteran has credibly described her knee pain sufficient to rise to the level of a functional impairment of earning capacity as contemplated in Saunders. See Board Hearing Tr. at 10. This description is also corroborated within Dr. E.K.R.'s opinion, including several trips to urgent care noted for treatment of knee pain. See June 2017 Dr. E.K.R. opinion. Further, within the instant decision, the Veteran has been service connected for plantar fasciitis. Accordingly, the first and second Wallin elements are met. The Veteran submitted a June 2017 private medical opinion from Dr. Dr. E.K.R. He provided a positive nexus opinion attributing the Veteran's back and knee disabilities to her now service-connected plantar fasciitis. See June 2017 Dr. E.K.R. opinion. The doctor provided a logical rationale for his opinion. As such, the Board finds this opinion credible. Thus, Dr. E.K.R.'s medical opinion provided a causal link between the Veteran's service-connected plantar fasciitis and her back and knee disabilities. As the evidence for and the evidence against the Veteran's claim is in relative equipoise, the Board affords the Veteran the benefit of the doubt and finds there is evidence of record establishing a link between the Veteran's back, left knee, and right knee disabilities and her now service-connected plantar fasciitis. Accordingly, the Board finds that a grant of service connection is warranted for back, left knee, and right knee disabilities. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Eye Condition During her Board hearing, the Veteran reported that she currently seeks treatment for her eye condition at Eyecare Center of the Rockies. See Board Hearing Tr. at 6. She also stated that just before her period of service with the Coast Guard, she sought treatment at Jackson Eye Center. Id at 7. There is no indication in the record that VA has made any attempt to locate and obtain these private treatment records. Such efforts should be undertaken at this time. 38 C.F.R. § 3.159(c)(1). Further, the Board notes that the April 2015 VA examiner noted that the Veteran's eye condition is more likely than not "a pre-existing condition and is not likely to have been incurred or aggravated by her time in service." See April 2015 VA examination report. However, the Veteran contends that upon entering service she was only given a waiver for nearsightedness. See Board Hearing Tr. at 4. She stated that it was not until an incident during bootcamp where she was struck with a rucksack that her current, more serious, eye problems began and were thereafter diagnosed. Id at 3. Further, an August 2017 VA addendum opinion concluded that "there is no evidence that [the Veteran's] retinal detachment was present during her first tour of active duty. See August 2017 VA addendum opinion. Given the conflicting evidence, the Board cannot make a fully informed decision on the issue. As such, the Board remands this matter for clarification as to whether the Veteran's eye condition, including lattice degeneration with retinoschisis, clearly and unmistakably preexisted service and, if so, whether the preexisting eye condition was clearly and unmistakably not aggravated by the Veteran's military service. The matters are REMANDED for the following action: 1. Obtain any outstanding VA and/or private treatment records relevant to treatment the Veteran received for her eye condition that are not already of record. The AOJ must specifically attempt to obtain treatment records from Eye Care Center of the Rockies and Jackson Eye Center. All obtained records should be associated with the evidentiary record. If any identified records are not obtainable (or none exist), the Veteran and her representative should be notified, and the record clearly documented 2. Then, obtain an opinion from an appropriately qualified clinician to determine the nature and etiology of the Veteran's eye condition. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the reviewing clinician. It is up to the discretion of the reviewing clinician whether a new examination is necessary to provide an adequate opinion. After a thorough review of the record to include all in-service and post-service treatment records, the reviewing clinician should answer the following: (a.) Did the Veteran's eye condition, including lattice degeneration with retinoschisis, clearly and unmistakably (obvious, manifest, and undebatable) preexist the Veteran's active service? (b.) If so, was the Veteran's eye condition clearly and unmistakably NOT aggravated by service? (c.) If the Veteran's eye condition is NOT found to clearly and unmistakably exist prior to her service, the reviewing clinician should opine as to whether it is at least as likely as not (a 50 percent probability or more) that the Veteran's eye condition was incurred in or is otherwise related to her service. The reviewing clinician should note the Veteran is competent to report her symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinions. If the reviewing clinician rejects the Veteran's reports of symptomatology, a reason for doing so should also be provided. The complete rationale for all opinions should be set forth, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. 3. Thereafter, readjudicate the claim. If any benefit sought remains denied, provide the Veteran and her representative with a Supplemental Statement of the Case (SSOC) and return the case to the Board. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Katie Poe, 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.