Citation Nr: 21011593 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 17-24 254 DATE: March 2, 2021 ORDER Entitlement to service connection for bilateral hammertoes and claw feet is granted. FINDING OF FACT Bilateral hammertoes and claw feet were incurred in the line of duty during active military service. CONCLUSION OF LAW Resolving all reasonable doubt in the Veteran’s favor, the criteria for service connection for bilateral hammertoes and claw feet have been met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran honorably served in the United States Army from July 31, 2002 to April 30, 2006. This matter comes before the Board of Veterans’ Affairs (Board) on appeal of an April 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran filed a timely Notice of Disagreement (NOD) in July 2016. In April 2017, the RO issued a Statement of the Case (SOC). In May 2017, the Veteran filed a VA Form 9 and requested a videoconference hearing before the Board. In September 2020, the Veteran attended a videoconference hearing before the undersigned VLJ. This matter is now properly before the Board. SERVICE CONNECTION Service connection is warranted where the evidence of record establishes that an injury or disease resulting in a disability was incurred in the line of duty during active military service or, if an injury or disease pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F. 3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995). Service connection may also be granted for any disease diagnosed after military discharge, when all the evidence, including that pertinent to the period of military service, establishes that the disease was incurred during the active military service. 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d). Service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.310. In order to prevail on the theory of secondary service connection, there must be evidence of a current disability; evidence of a service-connected disability; and evidence establishing a connection between the service-connected disability and the current disability. Wallin v. West, 11 Vet. App. 509, 512 (1998). The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for the evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. See Masors v. Derwinski, 2 Vet. App. 181 (1992). Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value. In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the Veteran. Entitlement to service connection for bilateral hammertoes and claw feet. The Veteran contends that he should be service connected for bilateral hammertoes and claw feet. In a June 2015 medical note, the physician indicated that the Veteran presented from a referral from his primary care doctor for toe deformities, and that the Veteran noted he had the deformities in his feet since 2006. In an October 2018 medical note, the Veteran’s physician noted pain on both feet. In a December 2018 medical note, the physician noted that the Veteran presented with hammertoes on both feet. In an April 2019 medical note, the physician indicated the Veteran had foot pain for years. In September 2020, the Veteran attended a videoconference hearing before the undersigned VLJ, the Veteran testified that he entered service with normal feet and that he had no problems with his feet prior to service. The Veteran testified that now he feels uncomfortable with his feet, he has to wear braces every night on his feet and he constantly has to take breaks and take off his shoes throughout the day. The Veteran also testified that the braces and insoles for his shoes to help his feet were provided by the VA. The Veteran testified that upon his exit exam, the examiner noted that there was something wrong with both of the Veteran’s feet. The examiner also noted that the Veteran noticed pain and symptoms of the hammertoes during service. The Veteran testified during the hearing that his symptoms began in service and continued to present day. The Board finds that the Veteran has had symptoms of hammertoes and craw feet while in service and since leaving service. The Veteran’s records as well as his testimony indicate that he has consistently had pain and problems in and since service. The Board finds the Veteran’s testimony to be highly probative. The Veteran is competent to report his pain and symptoms and the Board finds the Veteran to be credible. Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). The Board finds that the Veteran is entitled to service connection for hammertoes and craw feet. The Veteran has a current diagnosis of hammertoes and craw feet. The Veteran entered service with normal feet, however while in service and upon discharge he began to show symptoms of hammertoes and craw feet. The Veteran has constantly had symptoms since service, and although the record does not have a medical nexus opinion relating service to the Veteran’s symptoms, the Board finds that the evidence of record supports a finding of a nexus between the Veteran’s current disability and service. The nexus element may be fulfilled by (1) a nexus opinion or (2) competent and credible evidence showing that the Veteran has experienced frequent and persistent symptoms of the disease since service. 38 U.S.C. § 1154(a); 38 C.F.R. § 3.303(a)(d); see also Davidson v. Shineski, 581 F.3d 1313 (Fed Cir. 2009). The Veteran has consistently had symptoms while still in service and after service. (Continued on the next page)   Therefore, resolving all reasonable doubt in favor of the Veteran, the Board finds that it is appropriate to grant the Veteran service connection for bilateral hammertoes and craw feet. B. MULLINS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Hellina Y. Hailu, 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.