Citation Nr: 21020793 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 18-14 078 DATE: April 8, 2021 ORDER Entitlement to service connection for a right ankle disorder, claimed as a right ankle fracture, is granted. FINDING OF FACT The Veteran's right ankle disorder had its onset during service or is otherwise related to service, to include a period of active duty for training. CONCLUSION OF LAW The criteria for service connection for a right ankle disorder, claimed as right ankle fracture, have been met. 38 U.S.C. §§ 101, 1101, 1110, 1131, 1137, 5107; 38 C.F.R. §§ 3.6, 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 7, 1977 to March 3, 1978, with additional service in the Reserves. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). On April 5, 2021, the Veteran testified in a virtual hearing before the undersigned Veterans Law Judge. A hearing transcript will be associated with the record. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). “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). Service connection may be granted for disability resulting from disease or injury incurred or aggravated while performing active duty for training (ACDUTRA), or from injury incurred or aggravated while performing inactive duty for training (INACDUTRA/IDT). 38 U.S.C. §§ 101(24), 106, 1131. ACDUTRA is, among other things, full-time duty in the Armed Forces performed by Reserves for training purposes or by members of the National Guard of any state. 38 U.S.C. § 101(22); 38 C.F.R. § 3.6(c)(1). INACDUTRA/IDT is part-time duty in the Armed Forces performed by Reserves for training purposes or by members of the National Guard of any state. Id. Active service also includes authorized travel to or from such duty or service. 38 U.S.C. § 106(d); 38 C.F.R. § 3.6(e). The Veteran can provide competent reports of factual matters of which he has first-hand knowledge, such as experiencing pain in service, reporting to sick call, being placed on limited duty, and undergoing physical therapy. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a lay person is competent to identify the medical condition (noting that sometimes the lay person will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer), (2) the lay person is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. See Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Similarly, laypersons are competent to diagnose and provide nexus opinions to some extent, notably where the diagnosis or opinion is not of a complex nature. Id. see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 1. Entitlement to service connection for a right ankle disorder, claimed as fracture The Veteran contends his current right ankle disorder was incurred in or caused by his service. Specifically, he contends that he injured his right ankle while performing physical training during Officer Candidate School. During the April 2021 hearing, the Veteran testified that he attended Officer Candidate School during a summer break from college and that he was on orders to attend, but that he did not recall the specific nature of the orders. He also testified that he has suffered from right ankle problems consistently since service. As an initial matter, the evidence shows that the Veteran has a current right ankle disorder. Specifically, an X-ray study report of the right ankle, dated in July 2015, noted findings of degenerative changes and impingement at the posterior superior calcaneus. In addition, a VA examination in February 2018 reported diagnoses of impingement and degenerative arthritis, right ankle. As such, the first element of service connection has been met. Moreover, the service treatment records show that the Veteran was seen at a podiatry clinic at Marine Corps branch clinic in Quantico, Virginia in August 1982, during a period of ACDUTRA or INACDUTRA , with complaints of pain in the right ankle when pressure is applied to the foot. The assessment was stress fracture of the right tibia. Therefore, the second element of service connection has been met. What is necessary in order to grant service connection is competent medical evidence linking the current right ankle disorder, diagnosed as impingement and degenerative arthritis, right ankle, to Veteran's period of service. In this regard, following the VA examination in August 2015, the examiner opined that the claimed condition was at least as likely as not incurred in or caused by the claimed inservice injury, event, or illness. The examiner noted that the enlistment exam dated July 20, 1982 showed no prior history of left ankle or foot disorder; and, service treatment record in August of 1982 in Quantico showed stress fracture of the right medial malleolus. The examiner further noted that the Veteran was discharged from training due to the right ankle injury and continued to have pain as described above. The examiner explained that posterior impingement condition is known to occur following an inadequately healed ankle sprain or fracture, and calf atrophy and limited ankle range of motion is consistent with history of fracture to ankle and recurrent pain in ankle. Therefore, the examiner found that the Veteran's current right ankle condition is directly related to miliary service. The examiner reviewed the evidence of record, accounted for the lay statements and provided a medical opinion based on an adequate rationale. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). There is no contrary opinion of record nor is there sufficient basis for the Board to reject these supportive opinions and to further develop the claim. Cf. Mariano v. Principi, 17 Vet. App. 305, 312 (2003) (holding that, because it is not permissible for VA to undertake additional development to obtain evidence against an appellant's case, VA must provide an adequate statement of reasons or bases for its decision to pursue such development where such development could be reasonably construed as obtaining additional evidence for that purpose). In light of the foregoing, the Board concludes that the Veteran’s right ankle disorder was incurred in August 1982, which was not during a period of active duty. However, it was during a period of ACDUTRA or INACDUTRA as the Veteran received treatment at a base camp in Quantico during an officer’s training program. Service personnel records confirm that the Veteran was transferred to a OIC Candidate unit in Quantico, Virginia in July 1979. In light of the probative evidence of record, the Board finds that the evidence supports a nexus between the in-service right ankle injury that occurred while the Veteran was on ACDUTRA or INACDUTRA and the currently diagnosed right ankle disorder. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. Accordingly, the criteria for service connection for a right ankle disorder have been met, and the claim is granted. KRISTY L. ZADORA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Suzie S. Gaston, 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.