Citation Nr: 21010852 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 20-06 632 DATE: February 25, 2021 REMANDED Entitlement to service connection for bilateral pes planus with arthritis is remanded. REASONS FOR REMAND The Veteran had active duty service with the United States Marine Corps from March 1985 to June 1992. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). In November 2020, the Veteran testified before the undersigned at a Board hearing held via videoconference. A transcript of that hearing is of record. 1. Entitlement to service connection for bilateral pes planus with arthritis Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease. In order to prevail on the issue of service connection there must be competent evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in-service occurrence or aggravation of a disease or injury; and competent evidence of a nexus between an in-service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may be established on a secondary basis for a disability which is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a nonservice-connected disability which is aggravated by a service-connected disability. In such an instance, the Veteran may be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. 38 C.F.R. § 3.310(b); see Allen v. Brown, 7 Vet. App. 439, 448 (1995). The Veteran claims entitlement to service connection for bilateral pes planus. The Veteran contends that her bilateral pes planus was incurred during or caused by her period of active service. Alternatively, the Veteran asserts that her bilateral pes planus was caused or aggravated by her service-connected osteoarthritis of the bilateral knees. The Veteran’s current diagnosis of bilateral pes planus and an in-service event or injury have been recognized by the Agency of Original Jurisdiction (AOJ). At issue in the Veteran’s claim if her bilateral pes planus was incurred during or caused by her period of active service, or if her current bilateral pes planus was caused or aggravated by her service-connected bilateral knee osteoarthritis. The Veteran’s bilateral pes planus was examined by the VA in a December 2017 Foot Conditions examination. Following an in-person examination and review of the Veteran’s medical history, the VA examiner noted that it was less likely than not that her bilateral pes planus incurred during or caused by her period of active service. The VA examiner noted that the Veteran had a pre-existing foot disability that caused her current bilateral pes planus. The Veteran’s February 1985 enlistment examination noted that her feet were normal. The presumption of soundness therefore attaches. Every veteran shall be taken to have been in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance, and enrollment, or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service. 38 U.S.C. § 1111; 38 C.F.R. § 3.304(b). “When no preexisting condition is noted upon entry into service, the veteran is presumed to have been sound upon entry. The burden then falls on the government to rebut the presumption of soundness by clear and unmistakable evidence that the veteran’s disability was both preexisting and not aggravated by service.” Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004). The December 2017 VA medical opinion does not address if there was clear and unmistakable evidence of a pre-existing foot disability and that the foot disability was not aggravated by service. The December 2017 VA medical also does not address if the Veteran’s current bilateral pes planus was caused or aggravated by her service-connected osteoarthritis of the bilateral knees. Accordingly, the December 2017 medical opinion is inadequate for addressing the Veteran’s claims for service connection. A new VA medical opinion is necessary to comprehensively evaluate the Veteran’s claim. When VA provides an examination or obtains an opinion, the examination or opinion must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). The matters are REMANDED for the following action: 1. Return the Veteran’s claims file to a qualified VA clinician so a new medical opinion regarding the etiology of the Veteran’s bilateral pes planus may be provided. The entire claims file and a copy of this remand must be made available to the examiner for review. A new examination is only required if deemed necessary by the clinician. The clinician must provide an opinion as to whether: a. There is clear and unmistakable evidence that the Veteran had pre-existing bilateral foot disabilities prior to her active service. And if so, is there clear and unmistakable evidence that the Veteran’s pre-existing bilateral foot disability was not aggravated by her period of active service b. If not, is it at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral pes planus began during active service, or is related to an incident of service? c. If not, is it at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral pes planus is proximately due to her service-connected bilateral knee osteoarthritis? d. If not, is it at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral pes planus was aggravated beyond its natural progression by her service-connected bilateral knee osteoarthritis? The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. (Continued on the next page)   2. After all completed development, the AOJ should then readjudicate the claim. If the benefits sought on appeal are not granted, the Veteran and his representative should be provided a Supplemental Statement of the Case and afforded the requisite opportunity to respond before the case is returned to the Board. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Riordan, 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.