Citation Nr: 21010708 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 14-16 562 DATE: February 25, 2021 ORDER Entitlement to service connection for low back condition, to include lumbar spondylosis with radiculopathy, as secondary to service-connected pes planus, is granted. FINDING OF FACT Resolving reasonable doubt in favor of the Veteran, the Board finds that the Veteran’s low back condition is proximately due to or caused by his service-connected pes planus. CONCLUSION OF LAW The criteria for entitlement to service connection for low back condition as secondary to service-connected pes planus have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty with the United States Navy from September 1974 to January 1976. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2012 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a hearing in April 2017. This case was previously before the Board in January 2018 and again in October 2019, where it was remanded for Agency of Original Jurisdiction (AOJ) development. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the current disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also 38 C.F.R. § 3.303, Hickson v. West, 12 Vet. App. 247, 252-53 (1999). Service connection may be granted on a secondary basis for a disability that is shown to be proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Service connection on a secondary basis may not be granted without medical evidence of a current disability and medical evidence of a nexus between the current disability and a service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512-14 (1998); see also Allen v. Brown, 7 Vet. App. 439, 488 (1995). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (b); 38 C.F.R. § 4.3. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current low back disability, claimed as lumbar spondylosis with radiculopathy, is proximately due to his service-connected pes planus disability. The Veteran contends that his current low back disability is related to his service-connected pes planus. The Veteran experienced low back pain during his service, for which he sought treatment between May and September of 1975, as demonstrated by his service treatment records. At that time, the back pain was characterized as back strain. Viewing the facts in the light most favorable to the Veteran, the Board accepts the Veteran’s testimony at his most recent September 2020 examination that he next noticed his back pain in 1997, which progressively worsened until it began to affect his ability to work in his occupation as a truck driver, eventually seeking treatment in 2010. The Veteran was subsequently diagnosed with degenerative disc disease with radiculopathy in July 2011. The Veteran’s contention that his pes planus caused his current back disability is supported by the evidence of record. Specifically, a VA-contracted podiatrist opined in September 2019 that the Veteran’s back pain was “more than likely related to the [bilateral] flat foot deformity.” However, in a September 2020 VA examination, the examiner opined that the Veteran’s low back condition was less likely than not caused by his service-connected pes planus. The examiner gave a conditional rationale, stating that in order for the Veteran’s back condition to be related to his foot condition, there had to be evidence that the Veteran suffered with pain in his ankles, knees, and hips within the 20 year period prior to the date of that examination, although the examiner did not provide any medical reason why the pain in the joints needed to be demonstrated for 20 years. In any event, the Veteran’s medical record is replete with documentation that he suffered from bilateral pain in all the joints of interest consistently at least as early as 2009. This includes regular complaints of pain in the ankles, knees, and hips, along with discrete imaging findings of narrowing of joint space in the hips and degenerative joint disease in both knees, for which he uses braces. Furthermore, the Veteran reported having undergone arthroscopic surgery in his right knee around 1982, indicating that he had long been experiencing joint issues contemporaneously with his pes planus that fall squarely within the VA examiner’s 20-year requirement. Thus, the September 2020 VA examiner’s opinion has low probative value as it is based on an incorrect factual premise and does not contain a cogent rationale. After resolving the benefit of reasonable doubt in favor of the Veteran, the Board finds the evidence of record is at least in a state of equipoise with respect to whether the Veteran’s service-connected pes planus caused his lumbar spine disability. Accordingly, the Board finds that service connection for a low back disability, to include lumbar spondylosis with radiculopathy, is warranted. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Narnor, Harriyah 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.