Citation Nr: 21013092 Decision Date: 03/08/21 Archive Date: 03/08/21 DOCKET NO. 20-01 289 DATE: March 8, 2021 REMANDED Entitlement to service connection for bilateral flat feet is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1956 to August 1984. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from July 2018 and November 2018 rating decisions issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) in January 2021; a transcript is of record. The Board acknowledges receipt of various opinions regarding the etiology of the Veteran’s bilateral flat feet. However, as the opinions are conflicting in nature and, as discussed below, are inadequate to ascertain the etiology of the Veteran’s bilateral flat feet, the Board finds that an addendum opinion is necessary. First, there is an opinion from the Veteran’s private provider submitted in June 2018. In this opinion, the provider opined that the Veteran’s “long standing military service significantly contributed” to his bilateral flat feet; however, she did not provide a rationale explaining her conclusions. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). When the Veteran was examined in July 2018, the examiner concluded that the Veteran’s bilateral flat feet were less likely than not etiologically related to service, reasoning that this disability was recently diagnosed with no continuity of treatment or symptomatology since the Veteran’s separation from service. The examiner also opined that the Veteran’s bilateral flat feet were not related to his service-connected back condition but did not provide his reasoning behind this finding. See Nieves-Rodriguez, 22 Vet. App. at 301. Furthermore, the examiner did not address the Veteran’s competent lay statements of record noting the onset and continuity of his bilateral flat feet condition. See May 2018 Statement by Veteran (labeled “Correspondence”); June 2018 VA Form 21-4138. The Veteran is competent to attest as to his first-hand experiences and the onset and continuity of his symptomatology. See Washington v. Nicholson, 19 Vet. App. 362 (2005); Barr v. Nicholson, 21 Vet. App. 303 (2007). Because the examiner did not consider or address the Veteran’s competent lay statements, and the examiner did not provide a rationale explaining the conclusion that the Veteran’s bilateral flat feet were less likely than not due to his back condition, the Board finds this opinion inadequate. In October 2018, the Veteran’s private physician provided a new positive opinion, reasoning that although one may be born with a tendency towards a flat foot deformity, “the strenuous activity attributed to service in the Armed Forces can make this deformity progress rapidly and cause ongoing chronic problems that Veteran has experienced.” See October 2018 Opinion by R.A. Vargo, D.O. However, she did not indicate that she reviewed the Veteran’s service treatment records, which not only reflect normal foot examinations, but also that the Veteran did not enter service with flat feet. Accordingly, the Board finds that she did not review all pertinent evidence of record and therefore her opinions is inadequate to determine the etiology of the Veteran’s bilateral flat feet. In light of the positive October 2018 opinion, the VA requested an addendum opinion reconciling the conflicting medical evidence of record. In November 2018, however, an opinion was received noting that there is no conflicting medical evidence of record as “[a]mong the provided [service treatment records], there is no reference to a diagnosis of pes planus.” However, the examiner did not address the positive opinion issued by the Veteran’s private physician or the service medical records indicating that the Veteran reported a history at various times of athlete’s foot. See August 1978 Officer Physical Examination Questionnaire; May 1980 Officer Physical Examination Questionnaire; June 1981 Officer Physical Examination Questionnaire; June 1982 Officer Physical Examination Questionnaire; June 1983 Officer Physical Examination Questionnaire; April 1984 Officer Physical Examination Questionnaire. Accordingly, the Board finds that an addendum opinion regarding the nature and etiology of the Veteran’s bilateral flat feet should be obtained on remand. The matters are REMANDED for the following action: 1. Forward the claims file to an appropriate clinician who has not previously provided an opinion in this matter to determine the nature and etiology of the Veteran’s bilateral flat feet. If the clinician determines that a new examination (or telehealth interview, etc., if an in-person examination would not be feasible) would be beneficial, one is to be provided. The clinician is asked to opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral flat feet manifested during, or is the result of, his active service. The clinician is also asked to explain and/or reconcile the conflicting findings of record as to the nature and etiology of the Veteran’s bilateral flat feet. In formulating his or her opinion, the clinician should consider and address the competent medical and lay evidence of record, including but not limited to: (a) The Veteran’s service treatment records, including various reports by the Veteran of a history of Athlete’s Foot; (b) The Veteran’s post-service VA medical records; (c) The Veteran’s post-service private medical records; and (d) The Veteran’s competent lay statements, including his May 2018 lay statement, June 2018 VA Form 21-4138, and January 2021 hearing testimony, regarding the onset and continuity of his symptomatology. If the clinician determines that the Veteran’s bilateral flat feet is less likely than not due to his active service, the clinician should discuss what other factor(s) caused it. A complete rationale must be provided for all opinions and conclusions reached. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Seserman 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.