Citation Nr: 21015964 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 14-40 381 DATE: March 18, 2021 REMANDED Entitlement to a disability rating in excess of 20 percent for Achilles tendonitis, right heel, with degenerative joint disease of right ankle is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1984 to July 1985. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an August 2011 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The service-connected Achilles tendonitis right heel disability has been recharacterized as shown above. This is because a February 2004 rating decision reflects that degenerative joint disease of the right ankle was found to be part of the service-connected right heel Achilles tendonitis disability. In May 2018, the Board remanded the matters on appeal, and service connection for a right hip disability, for further development. Service connection for the right hip disability was granted in a January 2021 rating decision and is thus no longer before the Board. 1. Entitlement to a disability rating in excess of 20 percent for Achilles tendonitis, right heel, with degenerative joint disease of right ankle is remanded. The Board regrets further delay, but further development is necessary before deciding this claim. In May 2018, the Board remanded this matter for further development, to include obtaining a VA examination on the current severity of the Veteran’s service-connected disability. The Veteran was provided this examination in November 2020. At the VA examination in November 2020, the examiner diagnosed the Veteran with Achilles tendonitis and noted he had undergone three previous foot and ankle surgeries with another surgery planned for approximately six months from then. In her concluding remarks, the examiner noted the Veteran’s ankle disability had progressed and that as a result of progression of the condition, he has had multiple surgeries with continued worsening symptoms. In March 2021 correspondence, the Veteran’s representative argued his right foot and ankle disability includes chronic neuropathy and nerve compression, muscle atrophy, tarsal tunnel syndrome, plantar fasciitis, vascular malformation, chronic cyst formation, and heel spurs. The representative referenced a May 2012 report from Dr. J.C. who indicated the Veteran “has a right ankle derangement which has grown beyond the ankle tendinitis with complaints and findings indicative of chronic right ankle instability with ligament sprain.” The Veteran’s medical records contain diagnoses of these conditions; however, it is unclear whether any of these conditions may be related to, or are progressions of, the Veteran’s service-connected right heel achilles tendonitis and right ankle degenerative arthritis. Further clarification from a qualified medical professional as to whether the claimed chronic neuropathy and nerve compression, muscle atrophy, tarsal tunnel syndrome, plantar fasciitis, vascular malformation, chronic cyst formation are in fact related to the Veteran’s service-connected disability. 2. Entitlement to a TDIU is remanded. Because the outcome of the Veteran’s increased rating claim for a right foot and ankle disability could impact the outcome of the TDIU claim, these issues are inextricably intertwined and adjudication of the TDIU claim must be deferred. Henderson v. West, 12 Vet. App. 11, 20 (1998). The matters are REMANDED for the following action: If feasible, schedule the Veteran for a VA examination to determine the current severity of his service-connected right heel Achilles tendonitis with right ankle degenerative arthritis. The claims folder and copy of the remand must be made available to the examiner for review. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. An additional goal of this examination is to determine what additional right foot and ankle signs and symptoms may or may not be attributable to the Veteran’s service-connected disability. Thus, following review of the file and examination of the Veteran, the examiner is asked to opinion on whether it is at least as likely as not that any neuropathy or nerve entrapment, muscle atrophy, tarsal tunnel syndrome, plantar fasciitis, vascular malformation, chronic cyst formation, and heel spurs is etiologically related to the Veteran’s service-connected right heel Achilles tendonitis with right ankle degenerative arthritis. (Continued on the next page)   A rationale must be provided. An adequate rationale is one with clear conclusions and supporting data, as well as a reasoned explanation connecting the two. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P.A. Infante, 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.