Citation Nr: 21014775 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 15-42 707 DATE: March 15, 2021 REMANDED Entitlement to service connection for hammer toe, to include as secondary to service-connected bilateral pes planus, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from April 1981 to April 1984. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2010 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Decatur, Georgia. By way of background, the claim was previously before the Board most recently in August 2020, at which time the Board remanded the claim to the agency of original jurisdiction (AOJ) in order to obtain a nexus opinion for direct service connection, supported by an adequate rationale. The case has now been returned to the Board for further appellate consideration. Entitlement to service connection for hammer toe, to include as secondary to service-connected bilateral pes planus, is remanded. Regrettably, the Board finds that an additional medical opinion is required before the Veteran’s claim can be properly adjudicated on its merits. In recent correspondence with VA, the Veteran’s representative raised a theory of entitlement to service connection on a secondary basis. See Appellate Brief dated January 29, 2021. Although the record contains multiple negative nexus opinions concerning direct service connection for hammer toe, no medical opinion addressing service connection of hammer toe on a secondary basis, as caused by or aggravated by the Veteran’s service-connected pes planus, is currently of record. In rendering a decision, the Board must consider all theories of entitlement if raised by the evidentiary record, applying all relevant laws and regulations. In this case, the Veteran’s representative has specifically raised a theory of entitlement for service connection on a secondary basis; and VA has a duty to assist the Veteran in the development of this claim. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c). Therefore, before the Board can render a fully-informed decision on the merits of the Veteran’s appeal, the AOJ must obtain a medical opinion addressing the Veteran’s contention that his hammer toe was caused by or aggravated by his service-connected bilateral pes planus. Accordingly, the matter is REMANDED for the following action: 1. Send the Veteran’s claims file to an appropriate clinician for review and for the opinion sought regarding the Veteran’s claim for service connection for hammer toe, as secondary to his service-connected bilateral pes planus. ONLY IF another examination is deemed necessary to answer the questions below, one should be scheduled. The clinician is asked to address the following: (a.) Is it at least as likely as not (50 percent probability or greater) that the Veteran’s hammer toe was caused by or aggravated by his service-connected bilateral pes planus? The clinician should note that the phrase “as least as likely as not” does not mean “within the realm of medical possibility,” but rather that the medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of a conclusion as it is to find against it. The clinician is advised that a finding that the hammer toe disability was aggravated beyond its natural progression by a service-connected disability does not require evidence of permanent worsening and may encompass any additional impairment in earning capacity resulting from an already service-connected condition. The clinician should take into consideration that the Veteran is competent to report in-service and post-service symptomology. A clear rationale for all opinions expressed would be helpful; and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Tolbert, 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.