Citation Nr: 21011657 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 17-63 418 DATE: March 2, 2021 ORDER Service connection for cold weather injury to left foot is denied. Service connection for cold weather injury to right foot is denied. FINDINGS OF FACT 1. The Veteran had active service from September 1983 to March 1988. 2. A diagnosis of cold weather injury to the left foot or the right foot has not been shown. CONCLUSIONS OF LAW 1. A left foot disorder was not incurred in service. 38 U.S.C. §§ 1131, 5103(a), 5103A (2012); 38 C.F.R. §§ 3.159, 3.303 (2020). 2. A right foot disorder was not incurred in service. 38 U.S.C. §§ 1131, 5103(a), 5103A (2012); 38 C.F.R. §§ 3.159, 3.303 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS In connection with this appeal, the Veteran testified at a September 2020 hearing before the undersigned Veterans Law Judge. A transcript of that hearing has been associated with the claims file. Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). For a disability to be service connected, it must be present at the time a claim for VA disability compensation is filed or during or contemporary to the pendency of the appeal. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). The record does not establish that the Veteran has a confirmed diagnosis for the residuals of cold weather injury. The Veteran contends that he experienced frostbite during service. The service treatment records (STRs) contain no diagnoses, complaints, or treatment for a bilateral foot disorder. The February 1988 separation examination reflects that his lower extremities, vascular system, and skin were all clinically normal. While not all of his STRs are available, the fact that his clinical evaluation was normal at the time of discharge weighs against of finding of an in-service incurrence. Therefore, the second element of direct service connection in-service incurrence has not been met. As to a medical nexus, in a March 2017 VA examination, the Veteran reported that he was stationed in Korea during active duty and it was cold. He did not describe any single incident just day in and day out exposure and stated that he received no treatment for frostbite. The examiner noted that the Veteran had left little toe amputation last year. He indicated that the Veteran reported constant pain for past year or two in the soles next to the toes, numbness on the outside of the soles that began a few years ago, cold sensitivity the Veteran described as increased pain and his feet get really cold, and arthralgia in the toes. After a physical examination, the examiner noted that the Veteran had diabetic polyneuropathy with mild incomplete sensory loss all 4 extremities. He concluded that there was no evidence for cold injury residuals. This evidence weighs against the claim. The Board finds the medical evaluations to be adequate and of high probative value. Indeed, diagnostic testing did not reveal cold weather injury to left and right foot. This was further supported in the March 2017 examination. At that time, the examiner had the opportunity to examine the Veteran and fully reviewed the claims file, which was used in formulating the opinion. While the examiner acknowledged the Veteran’s lay reports, there was no medical evidence to establish a current diagnosis. To the extent that the Veteran asserts a nexus between his bilateral foot disorder and his active service, he submitted a September 2020 private medical opinion. The clinician noted that the Veteran experienced cold exposure/frostbit to both feet while on active duty in Korea and that over time the resulting tissue damage most likely contributed to and exacerbated his foot pain. However, the clinician offered no explanation or underlying rationale, nor any indication of how she reached her conclusion. Stefl v. Nicholson, 21 Vet. App. 120 (2007). Further, the medical opinion was based on an inaccurate factual premise that the Veteran experienced frostbite to both feet while on active duty. As noted, the STRs were negative for frostbite and the separation examination of the feet and skin were normal. As such, the September 2020 private medical opinion is of lesser probative value. Additionally, as previously noted, the STRs did not reflect a diagnosis of a bilateral foot disorder during service or identify any symptoms reasonably attributed to cold weather exposure. Further, none of the other post-service treatment records establish a connection between a bilateral foot disorder and service. Therefore, the record does not support the claim based on medical nexus. The Board has considered the Veteran’s lay statements that his foot disorders were caused by service. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses; however, he is not competent to offer an opinion as to the etiology of his current disorder due to the medical complexity of the matter involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file, including the September 2020 private opinion discussed above. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claim for service connection and there is no doubt to be otherwise resolved. As such, the appeal is denied. In sum, the competent medical evidence does not support a causal nexus between the Veteran’s current bilateral foot disorder and his reported in-service injuries. Therefore, the preponderance of the evidence is against the claim, entitlement to service connection for a bilateral foot disorder is not warranted, and the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Grzeczkowicz 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.