Citation Nr: 21008419 Decision Date: 02/17/21 Archive Date: 02/17/21 DOCKET NO. 14-09 020 DATE: February 17, 2021 REMANDED Entitlement to service connection for a low back disability, to include as secondary to pes planus with plantar fasciitis, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1988 to October 1992. This case comes before the Board of Veterans’ Appeals (Board) on appeal of a March 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This case was previously remanded in September 2019 for examinations and opinions for the Veteran’s lower back and pes planus with plantar fasciitis. The examinations for his pes planus with plantar fasciitis and lower back took place in January 2020. In a September 2020 rating decision, the Veteran was granted service connection for pes planus with plantar fasciitis with a 50 percent rating with an effective date of January 19, 2011. The claim for service connection for a low back disability is now back before the Board. The January 2020 VA examiner noted the Veteran as having a diagnosis for degenerative arthritis of the spine. The examiner provided a negative opinion regarding direct service connection. The examiner also opined that the Veteran's low back condition is less than likely as not caused by or aggravated by his bilateral foot condition. The examiner’s rationale addressed when the Veteran began to report symptoms of a low back disability. However, the opinion lacks an adequate rationale to either support or negate causation or aggravation for a secondary service connection claim. Much of the rationale for secondary service connection addressed the Veteran’s discharge examination. The same examiner carried out the January 2020 VA examination for the Veteran’s bilateral pes planus with plantar fasciitis. The examiner opined that the Veteran’s low back disability was less likely as not due to pes planus or plantar fasciitis. However, the examiner also opined that pes planus and plantar fasciitis at least as likely as not may cause low back pain. In September 2020, the RO received a clarifying opinion regarding the Veteran’s lower back disability being secondary to his pes planus with plantar fasciitis. A different examiner was assigned for the September 2020 opinion. The September 2020 examiner’s opinion addressed the Veteran’s history of back pain and his occupational history. The examiner reported that the only documentation of foot conditions was a September 2012 consult for orthotics and that the Veteran reported lower back pain as early as 2010. The examiner ultimately opined that it is less likely than not that the back condition was caused by plantar fasciitis. The RO found that the Veteran had preexisting pes planus and that service aggravated the condition. The examiner seems to rationalize her opinion that the Veteran’s lower back condition is not secondary to pes planus with plantar fasciitis because the Veteran was complaining about lower back pain before his bilateral foot disability. However, the January 2020 VA examination for the Veteran’s pes planus with plantar fasciitis shows the Veteran was diagnosed with the conditions around 1990. Unfortunately, the Board finds the opinions inadequate, and another remand is required. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). The Board finds that the January and September 2020 examiners’ opinions lack an adequate rationale as to the Veteran’s service-connected pes planus with plantar fasciitis causing or aggravating the Veteran’s lower back disability. Additionally, the Veteran’s representative submitted argument in his 2021 Appellate Brief regarding the lack of development for the secondary service connection claim. As part of the remand for another VA opinion, the Board finds that the RO should make another attempt to obtain all outstanding medical records. The matter is REMANDED for the following action: 1. Make another attempt to obtain all outstanding medical records, private and VA, regarding the Veteran’s low back disability in accordance with the duties set forth in 38 C.F.R.§ 3.159(c). 2. Then, forward the Veteran’s complete claims file to a VA medical professional in order to obtain a new opinion as to the current nature and etiology of the low back disability. The claims file, to include a copy of all remands, examinations, and opinions, must be made available to and be reviewed by the examiner. The examiner is requested to provide an opinion as to whether the Veteran’s low back disability is at least as likely as not (a 50 percent or greater probability): 1) etiologically related to service, or 2) either caused or aggravated by the service-connected pes planus with plantar fasciitis. The matter of aggravation MUST be addressed. A complete and thorough rationale for each opinion offered must be provided. The rationale must consider and discuss the pertinent evidence of record, to include all lay statements, in the claims file. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Hetman 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.