Citation Nr: 21015749 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 16-61 913 DATE: March 18, 2021 ORDER Entitlement to service connection for right foot numbness is denied. Entitlement to service connection for left foot numbness is denied. FINDING OF FACT The preponderance of the evidence reflects that the Veteran’s subjective bilateral foot numbness does not result in a disability separate from his service-connected bilateral calcaneal bursitis with heel spurs. CONCLUSIONS OF LAW 1. The criteria for service connection for right foot numbness have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2019). 2. The criteria for service connection for left foot numbness have not been met. 38 U.S.C. §§ 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from January 2002 to October 2002, from February 2003 to February 2004, and from July 2006 to January 2008.The Veteran had additional service in the Army National Guard. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a November 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the appeal in July 2018 and September 2020. Entitlement to service connection for right and left foot numbness is denied. Historically, the Veteran submitted a claim for “foot condition (numbness), bilateral” in July 2013. A January 2014 rating decision denied his claim, and the Veteran did not appeal. In June 2015, the Veteran submitted new claims for entitlement to service connection for right and left foot conditions in June 2015. During the pendency of this appeal, the RO granted service connection for bilateral calcaneal bursitis with heel spurs and assigned a 50 percent rating under 38 C.F.R. § 4.71a, Diagnostic Code 5276. The 50 percent rating contemplates marked pronation, extreme tenderness of plantar surfaces of the feet, marked inward displacement and severe spasm of the tendo Achillis on manipulation, not improved by orthopedic shoes or appliances unilaterally when such symptoms manifest bilaterally. Id. At an October 2013 VA podiatry consultation, the Veteran presented with a chief complaint of painful heels for several months, especially when taking his first step after rest. Monofilament testing was intact bilaterally. The examiner elicited tenderness upon palpation of plantar medial aspect bilateral heels, left greater than right. X-ray of bilateral feet revealed mild arthropathic changes of the feet, suggesting mild degenerative joint disease. The examiner assessed heel spur syndrome and calcaneal bursitis bilateral feet. A November 2013 VA treatment record noted that the Veteran received a bilateral foot pain evaluation. Examination revealed dry skin, callus, deformity (bunions) and fungus on nails. The Veteran rated his pain as 3 out of 10 bilaterally. He examiner administered lidocaine, Vitamin B12, Kenalog and Dexamethasone to bilateral heels. During a September 2015 VA back conditions examination, sensory examination of the foot/toes was normal. Straight leg raising test was negative. The examiner opined that the Veteran did not have radicular pain or any other signs or symptoms due to radiculopathy in the lower extremities. At a November 2015 VA podiatry consultation, the Veteran complained of painful heels for several months. He stated pain occurred mainly after rest. The Veteran also described a burning sensation and numbness. Examination revealed no tenderness, edema, erythema, or maceration of bilateral feet. The examiner assessed pes planus, rule out radiculopathy. At an April 2016 VA foot conditions examination, the Veteran reported bilateral heel pain and described the pain as a burning, pressure-like sensation localized in his heel (left greater than right). The Veteran reported that his pain was greatest in the mornings when he took his first steps. He reported that he received bilateral heel injections with short-term relief. At a February 2018 VA podiatry consultation, the Veteran complained of burning sensation and numbness in the bilateral feet. Monofilament testing was intact. There was no edema, erythema, or maceration noted. At a June 2018 VA podiatry consultation, the Veteran complained of burning sensation and numbness bilateral feet. NCV/EMG studies revealed bilateral L5 and S1 anterior rami irritability. At an October 2019 VA foot conditions examination, the examiner diagnosed bilateral calcaneal bursitis with heel spurs and flat foot. The Veteran reported pain which worsened with prolonged standing and walking. He described the pain as throbbing to constant “getting up to 7-8/10 pain scale requiring medication.” Examination revealed pain in both feet. At a November 2020 examination, the Veteran stated that around 2011 to 2012 he began having bilateral foot numbness while sitting. He denied having numbness at the examination but reported intermittent numbness of the feet. The examiner characterized the Veteran’s symptoms as mild paresthesias/dysesthesias and numbness of lower extremities. However, muscle strength, sensory, and reflex examinations were all normal. There were no trophic changes attributable to peripheral neuropathy. The examiner opined that there was no clinical or EMG evidence of peripheral neuropathy or radiculopathy of lower extremities. The examiner reasoned that a May 2018 EMG showing bilateral L5 and S1 anterior rami irritability was not a finding of radiculopathy but rather an electrodiagnostic finding. Further, subjective numbness is not a diagnosis but a symptom that is part and parcel of his service-connected feet condition. Medical evidence supports the fact that having bilateral calcaneal bursitis with heel spurs could include symptoms of numbness at the feet. Finally, the examiner opined that the Veteran’s bilateral feet numbness was not aggravated by any other service-connected condition. Based on the foregoing, the Board finds that service connection is not warranted for right and left foot numbness. The Board does not doubt that the Veteran experiences bilateral foot numbness, and acknowledges that the Veteran has consistently reported bilateral feet numbness throughout the appellate period. While the Veteran is competent to report his symptoms and those lay statements must be considered when determining service connection, the Veteran’s subjective complaints are less probative than the medical findings in this case, which are the result of physical examinations and diagnostic testing. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). In this case, the preponderance of the evidence does not show that the Veteran had a separate disability, such as radiculopathy or neuropathy, due to bilateral foot numbness during the appeal period. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The evidence instead indicates that his complaints of numbness are more likely than not a symptom of his service-connected bilateral calcaneal bursitis with heel spurs, which is assigned a 50 percent rating for severe symptoms including extreme tenderness and spasms. See November 2020 VA examination report. Consequently, the claims for right and left foot numbness must be denied. 38 U.S.C. § 5107 (2018); 38 C.F.R. § 3.102 (2019); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Roya Bahrami, 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.