Citation Nr: 21009320 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 10-29 213 DATE: February 22, 2021 REMANDED The issue of entitlement to an initial increased rating for bilateral pes planus, rated as 10 percent disabling prior to June 7, 2017, and 30 percent thereafter, is remanded. REASONS FOR REMAND The Veteran served on active duty for training in the United States Army National Guard from August 2000 to February 2001. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a September 2009 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In December 2017, the Board, in pertinent part, denied the Veteran’s increased rating claim for bilateral pes planus. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (the Court). In an October 2018 Order, the Court granted a Joint Motion for Remand (JMR), which vacated and remanded the Board’s December 2017 decision. The parties to the JMR agreed that the Veteran’s June 2017 bilateral pes planus examination was inadequate. The Board then remanded this matter in April 2019 and June 2020 to obtain an examination and opinion that were adequate, in compliance with the JMR. Unfortunately, because the September 2020 examination and November 2020 addendum obtained on remand are not fully responsive or adequate, further remand is necessary. Specifically, the September 2020 examiner stated in a November 2020 addendum that an opinion regarding additional loss of foot motion during flares or with repetitive use over time could not be given, in part, because range of motion was not part of the foot disability benefits questionnaire, and because there are multiple foot/toe joints involved in foot function, and “it is not applicable to describe ROMs for each joint.” However, the examiner offered no opinion as to how or why describing foot range of motion for pes planus is not applicable or appropriate, to include whether pes planus results in limitation of foot motion. Additionally, the Board notes that the September 2020 examiner indicated on the examination report that the Veteran did not have inward bowing of the Achilles tendon (i.e. hindfoot valgus, with lateral deviation of the heel) of either foot. However, February 2018 imaging of the feet objectively showed “bilateral pes planus and hindfoot valgus deformity.” There is no reconciliation for the discrepancy and thus, the entirety of the Veteran’s bilateral foot disability picture is not clear. The Board emphasizes that in describing the full severity of the Veteran’s pes planus disability, the examiner is not limited to addressing only that which is included in the foot disability benefits questionnaire. Given the foregoing deficiencies, the Board finds that a new opinion and/or examination is necessary. The matters are REMANDED for the following action: 1. Request an addendum from the September 2020 VA examiner, if available, or from another qualified examiner. If a new examination is deemed necessary, one should be scheduled. Following a review of the claims file and, if appropriate, examination of the Veteran, the examiner should respond to the following: (a) In order to comply with Sharp v. Shulkin, 29 Vet. App. 26, 33 (2017), the examiner is asked to describe whether pain, weakness, fatigue and/or incoordination significantly limits functional ability during flares or repetitive use, and if so, the examiner must estimate range of motion during flares or repetitive use. The Board emphasizes that in describing the full severity of the Veteran’s pes planus disability, the examiner is not limited to addressing only that which is included in the foot disability benefits questionnaire, i.e., range of motion. (b) If the examination does not take place during a flare or repetitive testing cannot be performed, the examiner should have the Veteran describe and/or demonstrate the extent of motion loss during flares or repetitive use and provide the extent of motion loss described in terms of degrees. (c) If there is no pain and/or no limitation of function, such facts must be noted in the report. The examiner should comment as to whether there is any medical reason to accept or reject the Veteran’s description of reduced range of motion during flares or repetitive use. (d) If the examiner determines that range of foot motion testing as it relates to pes planus is not appropriate or applicable, please explain why. (e) If the examiner determines that it is not possible to determine without resorting to mere speculation the degree of functional loss of the Veteran’s feet during flare-ups or with repeated use over time, he or she must clearly specify whether this reflects a limitation of knowledge in the medical community at large, as opposed to insufficient knowledge of the individual examiner. S. C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Fagan 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.