Citation Nr: A21020265 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 200417-82466 DATE: December 20, 2021 ORDER Entitlement to service connection for a bilateral foot condition is granted. FINDING OF FACT Resolving all doubt in his favor, the Veteran's bilateral foot condition was causally related to his documented in-service frost bite injury. CONCLUSION OF LAW The criteria for entitlement to service connection for a bilateral foot condition have been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2021). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1963 to March 1965. In a July 2016 rating decision, the agency of original jurisdiction (AOJ) denied entitlement to service connection for a bilateral foot condition. In January 2020, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of entitlement to service connection for a bilateral foot condition most recently addressed in the July 2016 rating decision. In March 2020, the AOJ issued the supplemental claim decision on appeal, which found that new and relevant evidence had been received and denied the claim based on the evidence of record at the time of that decision. In the April 2020 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Hearing docket. In January 2021, the Veteran and his spouse testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is included in the electronic claims file. Therefore, the Board may only consider the evidence of record at the time of the supplemental claim decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). Evidence was added to the claims file during a period of time when new evidence was not allowed. As the Board is deciding this service connection claim, it may not consider this evidence in its decision. 38 C.F.R. § 20.300. Entitlement to service connection for a bilateral foot condition In written statements of record and during his January 2021 Board hearing, the Veteran contended that his in-service cold exposure and treatment for frost bite caused his claimed bilateral foot condition, diagnosed as bilateral neuropathy. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Service treatment records dated in January 1964 revealed that the Veteran was treated for foot pain for four days after previous frost bite injury with decreased sensation in the right toe. In the January 1965 service discharge examination report, his feet and lower extremities were marked as normal on clinical evaluation. A January 1965 Report of Medical History showed the Veteran marked yes to having or ever had foot trouble. Post-service VA treatment records dated from 2016 showed complaints of numbness in bilateral big toes for the past 50 years as well chronic lower limb paresthesia pain. A December 2016 VA EMG testing report showed normal electrodiagnostic studies of the right and left lower limbs. However, additional VA treatment notes dated from 2019 showed findings of idiopathic peripheral neuropathy as well as complaints of bilateral foot pain, tingling, and numbness. In a November 2019 VA podiatry consult, the provider listed an assessment of neuropathy secondary to frostbite, noting the Veteran's frost bite during service in Korea and listing findings of diminished sensation and unsteady gait due to thermal neuropathy. A January 2020 telephone note reiterated that the Veteran had known peripheral neuropathy and was recently seen by podiatry, who concurred it was likely secondary to a known frostbite injury greater than 20 years ago. In a February 2020 VA examination report/medical opinion, the examiner listed a diagnosis of neuropathy secondary to frostbite. The Veteran complained of pain, numbness, and burning in his feet. Symptoms were listed as tissue loss, locally impaired sensation, and nail abnormalities in the right foot and as locally impaired sensation and nail abnormalities in the left foot. Additional objective physical findings were listed as locally impaired sensation with inconsistent results with pin prink test throughout right and left ankle and foot as well as right and left great toe with slight thickening of the nail. The examiner opined that the claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. In the cited rationale, the examiner noted that the documented medical treatment, service treatment records, and diagnostic evidence was more probative than the one and only diagnosis from a podiatrist approximately 55 years after the cold exposure in 1964. It was noted that available medical records found no evidence of a chronic disability on active service and no continuity of symptomatology after service for chronicity to establish a nexus. Therefore, she concluded that the claimed bilateral foot condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed frost bite injury. During the January 2021 Board videoconference hearing, the Veteran's spouse asserted that he had suffered from unsteady balance, discolored/thick toenails, foot pain, and numbness since 1965. The Veteran reported that a family doctor had told him early on that nothing could be done about his feet after his frost bite injury, so he obtained arch supports and did not keep going back for treatment. He indicated that his only frost bite injury was during active service and that he had worked indoors after service doing various maintenance jobs. In view of the totality of the evidence, including the current findings of neuropathy secondary to frostbite by VA treatment providers since 2019; the competent and credible lay assertions from the Veteran and his spouse in written statements of record as well as during the January 2021 Board videoconference hearing; the favorable conclusions reached by the VA podiatry provider in the November 2019 VA treatment record; and the unfavorable conclusions reached by the February 2020 VA examiner, the Board has determined that the evidence is at least in equipoise as to whether the Veteran's currently diagnosed bilateral foot condition was causally related to his documented in-service frost bite injury. Applying the doctrine of reasonable doubt, service connection for a bilateral foot condition is warranted. 38 U.S.C. § 5107(b) (2012); 38 C.F.R. § 3.102 (2021); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. D. Deane, 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.