Citation Nr: 21075935 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 19-07 095 DATE: December 21, 2021 REMANDED Entitlement to service connection for a bilateral foot disorder is remanded. Entitlement to service connection for a cervical spine disability is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1979 to July 1983. Unfortunately, a remand is required in this case. Although the Board of Veterans' Appeals (Board) sincerely regrets the additional delay, it is necessary to ensure the Veteran is given every possible consideration. The Veteran appeared before at a Board hearing before the undersigned in December 2020. A transcript of that hearing is of record. 1. Service connection for a bilateral foot disorder is remanded. The Board finds that the March 2017 VA medical opinion is inadequate as the examiner did not address the Veteran's specific lay contentions of bilateral foot pain with a pressure sensation. During the VA examination, the Veteran reported that he had bilateral foot pain that felt like his toes were in a vice. However, the March 2017 VA examiner noted that foot pain, numbness, and tingling are symptoms of his service-connected lower extremity radiculopathy without addressing the specific type of pain that the Veteran had experienced. During his December 2020 Board hearing, the Veteran stated he experienced bilateral foot pain that seemed to be unassociated with his lower extremity radicular symptoms. Specifically, he had bilateral foot pain that was separate from the numbness associated with radiculopathy. He noted that he had increased foot pain when his activity level was higher. Also, he had increased foot pain when his back pain was worse. In January 2017, a VA podiatrist diagnosed the Veteran with bilateral foot pain and rule out radiculopathy. He reported bilateral foot pain with increased walking and/or standing and the VA podiatrist noted that the foot pain was likely due to a back issue. Therefore, the Agency of Original Jurisdiction (AOJ) should obtain a medical opinion to address the Veteran's specific reports of bilateral foot pain. 2. Service connection for a cervical spine disability is remanded. The AOJ obtained a September 2014 medical opinion. However, this medical opinion does not provide an adequate rationale regarding whether the Veteran's cervical spine disability had its onset in service or is otherwise related to service. Although the September 2014 VA examiner provided an opinion as to whether the Veteran's diagnosed cervical spine disability was secondary to his service-connected lumbar spine disability, the Board finds that another opinion is needed because the opinion did not address the Veteran's contention of direct service connection. Notably, during his December 2020 Board hearing, the Veteran stated that his military occupational specialty was as a telephone lineman and that he repeatedly jumped from several feet from telephone poles with heavy equipment. He reported rapid jarring sensations after jumping from telephone poles as he landed on hard ground. In September 2013, a VA examiner diagnosed the Veteran with displacement of a cervical disc. During an October 2014 VA examination, the Veteran was diagnosed with degenerative joint disease and spondylosis of his cervical spine. Therefore, an addendum opinion is required. The matters are REMANDED for the following action: 1. Obtain a VA addendum opinion pertaining to the etiology of the Veteran's bilateral foot pain. All necessary tests should be conducted. The AOJ should ensure that the examiner has access to the Veteran's claims file, including a copy of this remand. Based on a review of the record, the examiner should opine (a.) whether the Veteran has disability from foot pain separate and apart from that due to his service-connected radiculopathy, and if so, (b.) is it at least as likely as not that such foot disability is proximately due to, or aggravated by, the service-connected lumbar spine disability and/or service-connected bilateral lower extremity radiculopathy. In rendering the opinions, the examiner should consider the statements of the Veteran regarding the symptoms of his bilateral foot pain to be competent. Specifically, that bilateral foot pain is manifested in a pressure sensation, occurs separate from the numbness associated with radiculopathy, often mirrors his back pain, and is increased in sensation and frequency with increased standing and/or walking. The examiner should provide a complete rationale for all opinions expressed and conclusions reached. If it is not possible to provide an opinion without speculation, the examiner must 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), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). 2. Obtain an addendum opinion by an appropriate clinician to determine the nature and etiology of the Veteran's cervical spine disability. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including repeated jumps from several feet from telephone poles with heavy equipment as a telephone lineman. Specifically, the examiner must address the Veteran's statements that he had rapid jarring sensations after jumping from telephone poles. See December 2020 Board hearing testimony, p. 10. The examiner should provide a complete rationale for all opinions expressed and conclusions reached. If it is not possible to provide an opinion regarding symptoms without speculation, the examiner must 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), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). S. L. Kennedy Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Costello, 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.