Citation Nr: 21076635 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 18-39 402 DATE: December 27, 2021 ORDER Entitlement to service connection for a left ankle condition is denied. FINDING OF FACT A current diagnosis involving the left ankle is not shown by the evidence of record and there is no indication the Veteran's left ankle pain is a symptom that results in functional impairment of earning capacity. CONCLUSION OF LAW The criteria for service connection for a left ankle disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 2013 to July 2017. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a August 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran's left ankle claim was first before the Board in April 2019, at which time it was denied. The Veteran appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court). In October 2020, the Court approved a Joint Motion for Partial Remand (JMPR), remanding the claim for further action consistent with the JMPR. In March 2021, the Board remanded the claim for a new VA examination. As that has been completed, the claim has been returned to the Board. Service Connection The Veteran contends that she suffers from a left ankle condition that began during active service. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The existence of a current disability is the cornerstone of a claim for VA disability compensation and in the absence of proof of a present disability, there can be no valid claim. See Degmetich v. Brown, 104 F.3d 1328 (Fed. Cir. 1997). Upon review of the record in this case, the Board concludes that the Veteran does not have a current diagnosis of a left ankle disability and has not had one at any time during the pendency of the claim or recent to the filing of the claim. The Veteran's service treatment records (STRs) indicate that she was on temporary physical profile for "Ankle/Foot Injury/Pain (Left)" from approximately January 2017 to May 2017. In a February 2017 record, the condition is noted to have an unknown cause and the severity is noted as "mild." A general medical examination in February 2017 found left ankle strength and reflexes, as well as balance, gait, and stance to all be normal. At an April 2017 VA examination, the Veteran reported that running caused a sense of pressure and popping in both ankles, greater in the left ankle. She also reported sharp pain when pressure is applied, but reported no flare-ups, functional loss or functional impairment of the left ankle. The examination showed a normal range of motion, as well as no evidence of pain on active or passive range of motion testing, or with weight bearing. Post-service treatment records contain a report of left ankle pain to an intake nurse at a VA primary care visit on August 31, 2018. The physician's notes from the August 31, 2018 visit mention bilateral foot pain but contain no mention of ankle pain or any diagnosis or treatment for a left ankle condition. The Veteran underwent a new VA examination in June 2021. The examiner conducted a comprehensive review of the Veteran's relevant medical records, evaluated the Veteran, and determined thatwhile the Veteran has subjective symptoms of ankle painthere are no findings, signs, or symptoms to support a diagnosis of a left ankle disability. The examiner noted that the Veteran reports intermittent left ankle pain during physical activities such as working out. The Veteran reports that the pain does not occur every time she performs specific movements or activities, and that when it does occur the pain will resolve within a few minutes of stopping the activity. The Veteran describes the pain as a "sharp" pain over the anterior ankle and foot area. The examiner noted that the Veteran denies receiving any current treatment for her ankle pain, that the Veteran does not report any functional loss or functional impairment of the ankle joint, and that the Veteran does not report or have a history of instability of the ankle. Upon examination of the ankle, the examiner documented full range of active and passive motion, as well as normal muscle strength. Repetitive use (i.e., at least three repetitions) caused no decrease in range of motion and no pain, fatigue, weakness, lack of endurance, or incoordination. The examiner further found no evidence of pain with weight bearing, no objective evidence of localized tenderness or pain on palpation of the joint, and no crepitus or ankylosis. The examiner concluded that "[b]ased on the subjective history of intermittent left ankle/foot pain only presenting during physical activity and resolving within a few minutes of stopping the activity, the previous normal radiographs on multiple occasions, and no abnormal findings during examination that would identify a cause of the intermittent symptoms, a diagnosis cannot be established or rendered at this time. The subjective history does not justify a 'disability' based on the symptoms due to intermittent brief nature of symptoms described by the veteran. Subjective pain noted intermittently during physical activities does not warrant a 'disability' and there are no limitations or restrictions with routine or occupational activities that would be incurred based on veteran's subjective history and physical examination findings." The Board finds the examiner's opinion to be highly probative as it is based on an accurate medical history, provides fully articulated and sound reasoning for the conclusion, and stands uncontroverted in the record. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Post-service treatment records contain only one further report of left ankle pain, in a record from June 23, 2021, which notes: "Patient has a history of chronic left ankle pain, started during active duty. She feels she injured it while exercising and carrying heavy equipment. Running, high impact activities, wearing heels aggravate the pain. Intensity increases to 8-9/10. Will order Xray and place podiatry consult." The Board notes that this record is contemporaneous with the June 15, 2021 VA examination and that the June 2021 VA examiner conducted a full review of the history of the Veteran's ankle conditionincluding normal left foot x-ray reports from April 2017 and August 2018 (post-service)and a comprehensive examination of the ankle. The Board notes that symptoms of pain that result in functional impairment causing decreased earning capacity can constitute a disability even without an identified underlying diagnosis. Saunders v. Wilkie, 886 F.3d 1356, 1367-68 (Fed. Cir. 2018). However, in this case, there is nothing in the record to suggest that the Veteran's left ankle pain results in functional impairment of earning capacity. As discussed above, the Board finds probative the June 2021 examiner's conclusion that the Veteran's reported pain would not cause any limitations or restrictions with routine or occupational activities. Without evidence of a current disability, or evidence of symptoms that result in functional impairment of earning capacity, service connection is not warranted, and the claim must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit of the doubt doctrine. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. As the preponderance of the evidence is against the Veteran's claim, the doctrine does not apply. See Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). James Springer Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Jesteadt, 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.