Citation Nr: 21010857 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 16-30 111 DATE: February 25, 2021 REMANDED Entitlement to service connection for right foot arthritis, secondary to service-connected right knee degenerative arthritis is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1985 to April 1986, January 1991 to May 1991, October 2000 to September 2001, November 2001 to July 2002 and from October 2006 to September 2009. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In July 2019, the Veteran testified at a Board video conference hearing before the undersigned Veterans Law Judge. A transcript of this hearing is of record. 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). This matter was last before the Board in November 2020, when it was remanded for further development. 1. Entitlement to service connection for right foot arthritis, secondary to service-connected right knee degenerative arthritis is remanded The Veteran contends that his right foot arthritis is a result of wear and tear and deterioration from his service-connected right knee degenerative arthritis. An August 2012 diagnostic study revealed the Veteran had mild degenerative diseases/arthritis of the right foot. A February 2018 diagnostic study revealed the Veteran had flexion deformities of toes with mild degenerative changes. In August 2019, the Veteran’s private physician assistant completed a nexus statement form, relating the Veteran’s right foot arthritis to active duty service to include as secondary to the service connected right knee. However, adequate rationale was not provided. In accordance with the November 2019 remand directives, the Veteran was afforded a VA examination in March 2020. The examiner found that there was no current right foot arthritis. Additionally, the opinions provided were confusing. As the Veteran had a diagnosis of arthritis during the course of the claim, the matter was remanded in November 2020 to address whether the right foot degenerative changes diagnosed during the course of the claim is related to active service. An addendum was obtained in November 2020, but the examiner did not provide an opinion because the February 2020 x-ray did not reveal arthritis. As there were degenerative findings noted on a 2018 x-ray, during the course of the claim, the Veteran is deemed to have a current disability. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007) (The requirement that a current disability be present is satisfied "when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim . . . even though the disability resolves prior to the Secretary's adjudication of the claim."). Thus, the absence of arthritis on the February 2020 x-ray is not fatal to the claim. Accordingly, a remand is warranted for substantial compliance with its prior remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician. If a new examination is deemed necessary to respond to the questions presented, one should be scheduled. After review of the claims file, the examiner should respond to the following: (a.) Is it at least as likely as not (50 percent probability or greater) that the right foot degenerative changes shown on February 13, 2018 VA radiographic study arose in or are etiologically related to active service? The examiner should explain why or why not. If the examiner concludes that the February 13, 2018 x-ray finding of mild degenerative changes was erroneous, the examiner should fully explain the rationale for that conclusion. (b.) Is it at least as likely as not that the Veteran’s right foot degenerative changes shown on the February 13, 2018 VA radiographic study has been caused by service-connected bilateral knee disabilities, to include wear and tear on the foot caused by knee impairment? The examiner should explain why or why not. If the examiner concludes that the February 13, 2018 x-ray finding of mild osteoarthritic change was erroneous, the examiner should fully explain the rationale for that conclusion. (c.) Is it at least as likely as not that the Veteran’s right foot degenerative changes shown on the February 13, 2018 VA radiographic study has been worsened beyond normal progression (aggravated) by the service-connected bilateral knee disabilities, to include wear and tear on the foot caused by knee impairment? The examiner should explain why or why not. If the examiner concludes that the February 13, 2018 x-ray finding of mild osteoarthritic change was erroneous, the examiner should fully explain the rationale for that conclusion. (d.) If the examiner finds the right foot degenerative changes has been aggravated by the service-connected bilateral knee disabilities, the examiner should attempt to quantify the degree of aggravation beyond the baseline level of right foot degenerative changes. A rationale for the opinion expressed should be provided. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Asare, Associate 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.