Citation Nr: 21010091 Decision Date: 02/24/21 Archive Date: 02/24/21 DOCKET NO. 17-66 107 DATE: February 24, 2021 REMANDED Entitlement to service connection for a left ankle disorder, to include as secondary to service-connected bilateral knee disabilities, is remanded. Entitlement to service connection for a right ankle disorder, to include as secondary to service-connected bilateral knee disabilities, is remanded. Entitlement to service connection for athlete’s foot is remanded. REASONS FOR REMAND The Veteran had active military service from September 1978 to April 1985. He testified before the undersigned Veterans Law Judge during a November 2019 hearing. This matter is on appeal from a March 2017 rating decision and was previously remanded by the Board of Veterans’ Appeals (Board) in February 2020. 1. Entitlement to service connection for a left ankle disorder is remanded. 2. Entitlement to service connection for a right ankle disorder is remanded. The Board cannot make a fully-informed decision on the issues of service connection for bilateral ankle disorders because no VA examiner has opined an adequate opinion considering the Veteran's contentions. These issues were remanded, in part, to obtain an addendum medical opinion considering the Veteran's testimony of continuing ankle problems since service and having an altered gait due to his knee disabilities. Addendum opinions were obtained in February 2020 and August 2020. The rationale for the negative opinions for direct service connection was that there were no records of a diagnosis or treatment since service until 2019, so there was no chronicity. Such did not adress the Veteran's competent testimony of ankle problems since service. Further, relying on the absence of evidence of “chronicity of care” is not an adequate rationale. Dalton v. Nicholson, 21 Vet. App. 23 (2007). Regarding secondary service connection, the sole rationale was that the Veteran had inflammation of ankle tendons, and are less likely than not proximately due to or aggravated by his service-connected knees. The Board finds these opinions to also be inadequate, and remand is necessary. 3. Entitlement to service connection for athlete’s foot is remanded. Similarly, as with the Veteran's claimed ankle conditions, the Board cannot make a fully-informed decision on the issue of service connection for athlete’s foot because no VA examiner has opined an adequate opinion considering the Veteran’s contentions. This issue was remanded, in part, to obtain an addendum medical opinion considering the Veteran’s testimony suggesting that the onset of his current athlete’s foot was during service. A negative nexus opinion was obtained in February 2020; the rationale was that there were no records of any diagnosis or treatment for athlete’s foot during service. This rationale did not consider the Veteran's statements of foot problems during service, or address in-service treatment in July 1984 for rule out athlete’s foot. A remand for an additional opinion is necessary. The matters are REMANDED for the following action: 1. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), make efforts to obtain all records identified by the Veteran, including any outstanding VA treatment records. 2. Obtain an addendum medical opinion from a medical professional with appropriate expertise, preferably other than the February and August 2020 examiner, to determine the etiology of the diagnosed bilateral ankle disorders. The examiner is requested to review the record and offer an opinion as to whether it is at least as likely as not (i.e., probability of approximately 50 percent) that the diagnosed bilateral ankle disorders had their onset in service or are caused or aggravated by the service-connected bilateral knee disabilities. (If a bilateral ankle disorder is found to have been aggravated by the service-connected bilateral knee disabilities, the examiner should quantify the approximate degree of aggravation.) The examiner must consider the Veteran's November 2019 testimony indicating continuing ankle problems since service and an altered gait due to his knee disabilities. The examiner is reminded that the absence of “chronicity of care” is not a valid basis for a negative medical conclusion. A complete rationale should be given for all opinions and conclusions expressed. 3. Obtain an addendum medical opinion from a medical professional with appropriate expertise, preferably other than the February 2020 examiner, to determine the etiology of the diagnosed athlete’s foot. The examiner is requested to review the record and offer an opinion as to whether it is at least as likely as not (i.e., probability of approximately 50 percent) that the diagnosed athlete’s foot had its onset in service. The examiner must consider the July 1984 treatment for rule out athlete’s foot, and the Veteran’s November 2019 testimony suggesting that the onset of his current athlete’s foot was during service. The examiner is reminded that the absence of “chronicity of care” is not a valid basis for a negative medical conclusion. A complete rationale should be given for all opinions and conclusions expressed. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Barstow, 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.