Citation Nr: 21007518 Decision Date: 02/09/21 Archive Date: 02/09/21 DOCKET NO. 14-11 605 DATE: February 9, 2021 REMANDED Entitlement to service connection for right claw foot is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from January 2006 to January 2011. By way of background, this matter was previously before the Board of Veterans’ Appeals (Board) in January 2019, at which time the Board denied the Veteran’s appeal for entitlement to service connection for right claw foot. The Veteran appealed the decision to the U.S. Court of Appeals for Veterans Claims (Court); and the Court issued a Joint Motion for Partial Remand in January 2020, remanding the issue to the Board to provide adequate reasons and bases for its denial. In July 2020, the Board remanded the Veteran’s claim to the agency of original jurisdiction (AOJ) to provide the Veteran with a new VA examination in order to determine the nature and etiology of any right foot disability discernible during the period on appeal. However, for the reasons discussed below, the Board finds that there has not been substantial compliance with its July 2020 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to service connection for right claw foot is remanded. Regrettably, the Board finds that another remand is warranted before the Veteran’s appeal can be properly adjudicated on its merits. Pursuant to the directives of the Board’s July 2020 remand, the Veteran was afforded a VA examination for his claimed right claw foot. In August 2020, a physician examined the Veteran and confirmed the earlier diagnosis of hammer toes of the right foot. See VA examination dated August 11, 2020. Additionally, the physician diagnosed the Veteran with bilateral pes planus. Regarding a nexus between the Veteran’s medical history of right claw toe and his military service, the physician indicated that the claimed condition was less likely than not related to the Veteran’s service. However, in his reasoning for the opinion, the physician remarked that the Veteran’s hammertoe deformity is at least as likely as not related to ankle trauma the Veteran had sustained, which required subsequent surgical correction. The only mention of claw foot in the opinion was in reference to a lack of documented evidence of such condition prior to service. In an effort to clarify the August 2020 opinion, the AOJ requested an addendum medical opinion from the physician. In September 2020, the physician who had examined the Veteran the month before added that the Veteran did not have a separate diagnosis of right claw foot, reasoning that claw foot and hammertoe are “one and the same.” See addendum medical opinion dated September 21, 2020. The Board finds the reasoning of both the August 2020 medical opinion and the September 2020 addendum opinion inadequate for adjudicative purposes, as neither is supported by an adequate rationale. Specifically, the August opinion referred to the Veteran’s hammertoe, a condition for which the Veteran is already service connected, rather than claw foot, in the context of the nexus opinion. The reasoning behind the addendum medical opinion is also inadequate. Nowhere else in the record does any medical information demonstrate that hammertoe and claw foot are synonymous terms. Indeed, the Disability Benefits Questionnaire (DBQ) specific to foot examinations contains separate diagnostic descriptions of hammer toes and acquired pes cavus (or claw foot). The Board must ensure compliance with the terms of its prior remand directives. See Stegall, supra (a remand confers on the veteran, as a matter of law, the right to compliance with the remand orders). In the present case, the Board finds that there has not been substantial compliance with the directives of its July 2020 remand. Therefore, another remand is necessary in order to procure a medical opinion providing diagnoses and nexus opinions for any right foot disabilities, for which the Veteran is not service connected, present throughout the course of the appeal. Accordingly, the matter is REMANDED for the following action: 1. Send the Veteran’s claims file to an appropriate clinician for review and for the opinions sought regarding the Veteran’s claim for service connection for right claw foot. ONLY IF another examination is deemed necessary to answer the questions below, should one be scheduled. The clinician should identify all right foot disabilities present throughout the period on appeal. If any previously diagnosed disorder is no longer present, the clinician must provide an explanation. For each diagnosed right foot disability that is not service connected (i.e., any disability other than hammertoes of the second, third, and fourth toes of the right foot), the clinician is asked to provide the following opinion: (a.) Is it at least as likely as not (50 percent probability or greater) that the diagnosed right foot disability was incurred in, or is otherwise etiologically related to, the Veteran’s military service, to include as due to complication associated with a June 2006 fracture of the right tibia and fibula? The clinician is reminded that an absence of prior medical documentation of symptoms or treatment is not, per se, a sufficient basis upon which to find the lack of an association between a current disability and an in-service event or injury. The clinician must explain the rationale for all opinions in detail, citing to supporting clinical data and/or medical literature, as appropriate. The clinician should take into consideration that the Veteran is competent to report in service and post-service symptomology. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Tolbert, 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.