Citation Nr: 21007341 Decision Date: 02/09/21 Archive Date: 02/09/21 DOCKET NO. 15-14 672 DATE: February 9, 2021 REMANDED Service connection for left foot plantar fasciitis, to include as secondary to deep venous thrombosis (DVT) of the left leg.   REASONS FOR REMAND The Veteran served on active duty from June 1986 to June 1989 and active duty for training (ACDUTRA) from July 1984 to October 1984, and February 12, 2011, to February 13, 2011, with additional service in the Army Reserve. This matter is on appeal from an August 2014 rating decision. In June2018 and February 2020, the Board remanded the case for additional development. Service connection for left foot plantar fasciitis, to include as secondary to DVT of the left leg. This issue is remanded for a further VA addendum opinion. The Board previously remanded the matter in February 2020 for an opinion as to whether the Veteran’s plantar fasciitis was caused or aggravated by the service-connected DVT. Upon remand, an opinion was given in February 2020. The VA examiner concluded that the Veteran’s plantar fasciitis was neither caused nor aggravated by DVT. The VA examiner gave an extensive rationale, including citation to Up To Date. Of note, the citation from Up To Date lists multiple potential risk factors for plantar fasciitis, including “[e]xtrinsic factors such as improper footwear, walking on hard surfaces, prolonged standing”; [e]xcessive training (particularly a sudden increase in the distance run)”; “[r]unning on unyielding surfaces (including some synthetic running tracks)”; and “[p]rolonged walking or standing on hard surfaces.” The VA examiner gave a separate opinion indicating that the Veteran’s condition was less likely than not incurred in or caused by service. The examiner reasoned that the Veteran’s plantar fasciitis was not diagnosed until October 2011, which was not during a period of active duty. The Board did not expressly ask for an opinion on direct service connection. However, to the extent the VA examiner gave such an opinion, it is does not follow from facts and information given in the secondary opinion. Most noticeably, the VA examiner in the secondary opinion cited excessive training, running, and other such physical activities as potential causes of plantar fasciitis. The VA examiner, however, did not take this into account in the direct opinion. The VA examiner did not consider whether the Veteran’s physical activities during service caused or contributed to the onset of his plantar fasciitis. This despite the VA examiner’s secondary opinion specifically noting that in 2011 the Veteran was noted to “run a lot.” In fact, his service treatment records (STRs) in April 2011 noted that he had recently decreased his running (after the DVT diagnosis) from 13 miles to 5 miles. The Veteran has not directly stated that he ran a lot during service, nor does the April 2011 STR state that he was running the 13 miles or 5 miles during any period of ACDUTRA or INACDUTRA. Nonetheless, it is common knowledge and within everyday experience to know that soldiers are required to run, march, and walk regularly, often on hard surfaces, and even Reserve service members are required to maintain physical standards. His STRs specifically include ongoing Functional Capacity Certificate Forms, in which he certified his ability to run or jog 2 miles pursuant to the Army Physical Fitness Test. Hence, the evidence indicates that the Veteran’s physical activities during service may have been a risk factor for the development of plantar fasciitis. The February 2020 VA examiner relied on the fact that plantar fasciitis was diagnosed after service. The examiner did not, however, indicate that the Veteran’s earlier physical activity did not likely cause or contribute to the eventual onset of plantar fasciitis. This theory is not raised by the record. Hence, remand for a new opinion is warranted. The matters are REMANDED for the following action: Obtain an addendum opinion from the examiner who previously gave an opinion in February 2020 (or a suitable substitute if such examiner is unavailable) regarding the claimed left plantar fasciitis. (The need for an additional in-person examination should be determined by the examiner.) The examiner is asked to clarify whether the Veteran’s left plantar fasciitis was at least as likely as not incurred in or caused by service. The VA examiner is particularly asked to address whether the routine physical activities associated with active and Reserve (ACUDTRA) service, such as running, walking, and marching, likely caused or contributed to the onset of his left plantar fasciitis to any degree. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Bosely, 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.