Citation Nr: 21005527 Decision Date: 02/01/21 Archive Date: 02/01/21 DOCKET NO. 15-47 019 DATE: February 1, 2021 REMANDED Entitlement to service connection for a right foot disability, to include as secondary to one or more service-connected disabilities, is remanded. Entitlement to service connection for a left foot disability, to include as secondary to one or more service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran had active duty service from August 1974 to August 1977. This appeal comes to the Board of Veterans’ Appeals (Board) from a rating decision, dated February 2016, issued by a Department of Veterans Affairs (VA) Regional Office (RO). In its decision, the RO denied service connection for degenerative joint disease of the left foot and denied service connection for degenerative joint disease of the right foot. The Veteran timely appealed. In August 2018, the Board remanded these issues for additional development. The issues have now been returned to the Board for adjudication. 1. Entitlement to service connection for a right foot disability, to include as secondary to one or more service-connected disabilities, is remanded. 2. Entitlement to service connection for a left foot disability, to include as secondary to one or more service-connected disabilities, is remanded. Although additional delay in readjudication of the Veteran’s appeal is regrettable, the Board concludes that another remand is necessary to ensure substantial compliance with the Board’s prior remand directives. The Board’s August 2018 remand directed that additional VA opinions be obtained to determine whether the Veteran’s foot disabilities were caused or aggravated by her service-connected disabilities of the hips, knees, ankles, and thoracolumbar spine, as she contends. The requested opinions were provided by a VA clinician in January 2020; however, the Board concludes that such are inadequate because the examiner did not consider whether the Veteran’s foot disabilities were caused or aggravated by an antalgic/altered gait resulting from her service-connected disabilities of the hips, knees, ankles, and thoracolumbar spine. Accordingly, the Board’s prior remand directives have not been substantially completed, and another remand is necessary. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007); see also, Stegall and Dyment, both supra. Accordingly, the matters are REMANDED for the following action: 1. Request a medical opinion addressing the Veteran’s right and left foot disabilities. In-person examination is not required unless deemed necessary by the examiner. Based upon a review of the entire claims file, the examiner is requested to provide an opinion as to the following questions: (a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s right and left foot disabilities were caused by her service-connected disabilities of hips, knees, ankles, and thoracolumbar spine, to include the theory that the chronic pain from these disabilities (individually and/or collectively) result in an antalgic/altered gait? (b.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s right and left foot disabilities were aggravated beyond their natural progression by her service-connected disabilities of hips, knees, ankles, and thoracolumbar spine, to include the theory that the chronic pain from these disabilities (individually and/or collectively) result in an antalgic/altered gait? Explanations for all opinions must be provided. In providing the requested rationale, the examiner is asked to cite to the pertinent evidence of record, including clinical records and the Veteran’s statements regarding the onset of her symptoms. SCOTT W. DALE Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Bristor 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.