Citation Nr: 21076844 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 16-12 493A DATE: December 28, 2021 REMANDED Entitlement to service connection for a neck disability, to include degenerative arthritis of the cervical spine is remanded. Entitlement to service connection for a bilateral foot disability, to include plantar fascitis is remanded. REASONS FOR REMAND These matters come before the Board of Veterans' Appeals (Board) on appeal from a December 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In July 2020 and April 2021, the Board remanded the claims for additional development. Although the Board regrets the additional delay, another remand for further development is needed. 1. Entitlement to service connection for a neck disability, to include degenerative arthritis of the cervical spine is remanded. In April 2021 the Board remanded the Veteran's claim to afford the Veteran a new VA examination and to obtain an opinion on the etiology of any cervical spine disability. The Board ordered that the VA examiner specifically comment on the Veteran's reports of falling from a 12-foot ladder during service and lay reports of in-service neck pain. The Veteran underwent a VA examination in June 2021 at which he was diagnosed with degenerative arthritis, degenerative disc disease other than intervertebral disc syndrome, spinal stenosis, and right upper extremity radiculopathy. With respect to direct service connection, the examiner stated: "There is a lack of evidence of record to support a nexus between the veteran's diagnosed c-spine degenerative arthritis, DDD, spinal stenosis, or right upper extremity radiculopathy. Therefore it is less likely than not that the veteran's diagnosed c-spine degenerative arthritis, DDD, spinal stenosis, and right upper extremity radiculopathy are due to service." The Board finds the opinion is inadequate. It neither includes comment on the Veteran's report of falling from a ladder in service and lay reports of in-service neck pain nor includes any discussion of any evidence other than to say "there is a lack of evidence." On remand, a new opinion must be obtained. 2. Entitlement to service connection for a bilateral foot disability, to include plantar fascitis is remanded. In April 2021 the Board remanded the Veteran's claim to afford the Veteran a new VA examination and to obtain an opinion on the etiology of any bilateral foot disabilities, to include plantar fasciitis. The Board ordered that the examiner specifically comment on the Veteran's in-service foot treatment, lay reports of in-service foot pain, and the September 2016 medical examination regarding the feet. The Veteran underwent an examination in June 2021. The examiner diagnosed left and right foot callus and noted the Veteran reported current plantar foot pain. With respect to an etiology opinion, the VA examiner stated: "There was no objective evidence on exam to support a diagnosis of plantar fasciitis at this time. Therefore it is less likely than not that the veteran's claimed bilateral plantar fasciitis is due to service." The Board finds that the June 2021 VA opinion is inadequate. Specifically, the Board notes that the Veteran has multiple diagnoses of foot conditions, including plantar fasciitis, during the period on appeal. The examiner offered no discussion of those diagnoses. A review of the record reflects that an April 2012 private medical examination notes a diagnosis of plantar fasciitis. In October 2012, the Veteran was afforded a VA examination at which the examiner suggested a current diagnosis of plantar fasciitis. The Veteran underwent another VA examination in in August 2015 at which the examiner indicated that plantar keratosis and calluses were not seen on examination although the Veteran complained of pain in his feet. Plantar fasciitis was not diagnosed or discussed. In September 2016, the Veteran submitted a DBQ completed by a private physician that listed a diagnosis of bilateral metatarsalgia. In October 2020 the Veteran underwent another VA examination at which he was diagnosed with plantar fasciitis. The Board notes that the Veteran was granted service connection for right and left foot callus in an October 2020 rating decision and has a 10 percent evaluation for each based on pain on use of the foot. On remand, an opinion should be obtained as to whether the Veteran has, or has had during the period on appeal, any foot condition or disability separate from the already service-connected right and left foot callus. In so opining, the VA examiner should discuss the April 2012 private medical report, the October 2012 VA examination, the August 2015 VA examination, the September 2016 private medical report, and the October 2020 VA examination. For each condition or disability found to have been present during the period on appeal, the VA examiner should then opine as to whether it is at least as likely as not that it onset in or is causally related to the Veteran's service or his service-connected right and left callus. In so opining, the VA examiner should discuss the Veteran's in-service foot treatment, his lay reports of in-service foot pain, and the VA and private examinations listed above. The matters are REMANDED for the following action: 1. Obtain a new VA opinion as to the etiology of the Veteran's cervical spine disability. A new VA examination is not necessary unless the VA examiner/reviewer opines one is needed. The VA examiner/reviewer should provide the following opinions: (a.) Whether it is at least as likely as not that the Veteran's cervical spine disability onset in or was caused by the Veteran's service, or in the case of arthritis, had its onset within one year of separation from service. A full rationale must be provided, and the examiner/reviewer should specifically comment on the Veteran's reports of falling from a 12-foot ladder during service and lay reports of in-service neck pain. 2. Schedule the Veteran for a VA foot examination. The examiner should provide the following opinions: (a.) Whether the Veteran has, or has had during the period on appeal, any foot condition or disability separate from the already service-connected right and left foot callus. A full rationale should be provided, and the VA examiner should discuss the April 2012 private medical report, the October 2012 VA examination, the August 2015 VA examination, the September 2016 private medical report, and the October 2020 VA examination. (b.) For each condition, whether it is at least as likely as not that the condition or disability onset in or is causally related to the Veteran's service A full rationale should be provided, and the VA examiner should discuss the Veteran's in-service foot treatment, his lay reports of in-service foot pain, and the VA and private examinations listed above. (c.) For each condition that did not onset in or was caused by service, whether it is at least as likely as not that it was caused or aggravated by the Veteran's service-connected disabilities, to include his right and left ankle disability and right and left foot callus. H. SEESEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Christensen 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.