Citation Nr: 21013410 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 20-03 602 DATE: March 9, 2021 ORDER Entitlement to service connection for left heel spur is granted. FINDING OF FACT The Veteran’s left heel spur condition began in service and has continued with treatment since then. CONCLUSION OF LAW The criteria for service connection for left heel spur condition are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303(b). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from June 1997 to October 1997, from September 2005 to December 2006; from November 2005 to November 2006, and from July 2010 to September 2011, with service in Iraq and in Afghanistan. In March 2021, the Veteran and his spouse testified before the undersigned Veterans Law Judge (VLJ) at a Board Virtual Tele-hearing. Of note, the Veteran requested a copy of his VA file in a September 2020 correspondence. The Veteran testified on the record before the undersigned VLJ that his request has been satisfied and he is no longer waiting for any VA records. Accordingly, the appeal is ready for appellate review. 1. Entitlement to service connection for left heel spur The Veteran testified that his left heel spur warrants service connection as it began on active duty and has continued since then. The Board agrees. Service connection will be granted if it is shown that a Veteran has a disability resulting from an injury or disease contracted in the line of duty, or for aggravation of a preexisting injury or disease contracted in the line of duty in the active military, naval or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. “To establish a right to compensation for a present disability, a veteran must show: ‘(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 or aggravated during service’ - the so-called “nexus” requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). In certain cases, competent lay evidence may demonstrate the presence of any of these elements. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). The nexus element may also 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. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may be established 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. Evidence of continuity of symptomatology from the time of service until the present is required where the chronicity of a chronic condition manifested during service either has not been established or might reasonably be questioned. 38 C.F.R. § 3.303(b); see also Walker v. Shinseki, 708 F.3d 1331, 1340 (Fed. Cir. 2013) (holding that only conditions listed as chronic diseases in § 3.309(a) may be considered for presumptive service connection under 38 C.F.R. § 3.303(b)). Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Here, the Board notes that heel spurs are not “chronic disabilities” as defined in 38 C.F.R. § 3.309, but the Veteran’s reports of continuous symptoms can still support the claim under 38 C.F.R. § 3.303(d). As an initial matter, the Veteran has a current diagnosis of a left heel traction spur, see September 2018 Podiatry Note and January 2018 VA Medical Opinion. In addition, the Board notes several entries for bilateral heel pain in the Veteran’s service treatment records (STR) with treatment in the Podiatry Clinic. Thus, the Board finds that the first two elements for service connection are met. Turning to the nexus requirement, the Board notes that the Veteran has credibly testified before the undersigned VLJ that his left heel spur began in service and has continued since then, becoming progressively worse, and requiring continual treatment.  In addition, the Veteran’s spouse competently and credibly testified that she could see his bone heel spurs from his period on active duty and she also testified to witnessing his complaints of pain throughout the entire time to the present. The Board notes that a layperson is competent to report on the onset and continuity of his or her current symptomatology.  See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge).  When considering whether lay evidence is competent, the Board must determine on a case by case basis, whether the Veteran’s particular disability is the type of disability for which lay evidence may be competent.  Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (“[T]he Board cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence”).  Here, the Board finds that the Veteran, and his spouse, are competent to report the onset and continuation of his left heel spur and accompanying pain symptomology. The Board finds their testimony credible, and therefore, probative. See Charles v. Principi, 16 Vet. App. 370, 374 (2002); see also Layno v. Brown, 6 Vet. App. 465 (1994); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).    The Board notes that the Veteran attended a VA Foot Conditions examination in November 2017. The examiner noted the Veteran’s already service-connected Achilles right heel spur and residuals of foot injury and obliquely referenced the left foot heel spur in the diagnostic section. The examiner also reported “bilateral calcaneal spurring with distal Achilles tendon thickening bilaterally.” No nexus opinion was provided with that examination. The examiner was asked to provide a nexus opinion in January 2018. The examiner noted the diagnosis of left heel spur. The examiner opined, “there is a large amount of documentation in the multiple volumes of this veterans VBMS file. It would have been impossible to review all this material in detail with the time allotted for this examination…You cannot say a condition is related to military service itself… There was no inservice diagnosis or treatment of a left heel spur, that writer could locate, therefore this veterans [sic] left heel spur is not secondary to inservice subjective complaints, objective diagnosis, and/or treatment as there was none.” As the Board found several entries for left heel (bilateral heel) pain in the STRs, this conclusion is factually inaccurate. Moreover, the Board recognizes that a nexus opinion is defined as a causal relationship between the present disability and the disease or injury incurred or aggravated during service; that is, stating whether a condition is related to military service itself. It is precisely this opinion that the examiner was asked to provide. He did not. For all these reasons, the Board finds the VA examiner’s opinion is without probative value. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); see also Kowalski v. Nicholson, 19 Vet. App. 171, 179 (2005) (a VA examination must be based on an accurate factual premise); Nieves-Rodriguez, 22 Vet. App. at 301 (explaining that a medical report without “a reasoned medical explanation” lacks probative value).    Accordingly, as the probative evidence of record shows that the Veteran’s left heel spur began in service, and has continued since then, service connection is warranted.  38 C.F.R. § 3.303(b).  T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Nelson 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.