Citation Nr: 21020965 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 16-23 919 DATE: April 8, 2021 ORDER Entitlement to service connection for residuals of ankle injury is denied. FINDING OF FACT The preponderance of the evidence is against finding that residuals of ankle injury began during active service or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for residuals of ankle injury have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from November 1964 to October 1966. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from November 2014 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO). The Board issued a remand in May 2019 instructing the RO to obtain a VA examination to determine the nature and etiology of the Veteran’s residuals of a left ankle injury. A remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with the remand instructions, and imposes upon VA a concomitant duty to ensure compliance with the terms of the remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The RO obtained June 2020 VA examination and medical opinion. The Board finds the RO substantially complied with the May 2019 remand directives. Entitlement to service connection for residuals of ankle injury. The Veteran contends that his in-service ankle injury is the result of his current left ankle disability. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service treatment records (STR) show the Veteran suffered an ankle injury while in service. See December 1965 STR. X-ray revealed no fracture. A provisional diagnosis was given of osteochondroma. Post-service treatment records document the Veteran’s complaints of left ankle pain in March 2008 and ongoing left ankle pain and swelling in October 2008. This evidence is sufficient to meet the requirements of an in-service injury and a current disability for the purpose of service connection. The Veteran was provided a VA examination in October 2014. The Veteran reported that he twisted his ankle in the process of breaking up a fight in 1965. He stated that he was diagnosed with a fracture and his ankle was put in a cast. The Veteran reported he experienced short episodes of pain every two or three months, as well as pain triggered by cold. Upon examination, the Veteran demonstrated normal range of motion and did not report any functional loss or flare ups. No pain was noted during the range of motion examination, and there was no evidence of pain with weight bearing. Although the Veteran had some decreased muscle strength in his right ankle, his left ankle strength was normal. The examiner did not suspect any instability or dislocation. The VA examiner reviewed notes in the STRs documenting that the Veteran sprained his left ankle and was put in a cast due to ligament swelling. The examiner noted that there was no fracture diagnosed at that time and no ankle strain diagnosed during active duty or within a presumptive period. Furthermore, the examiner noted that muscle strains do not create residuals. Finally, the examiner stated that the Veteran’s VA medical records did not contain any complaints of ankle problems. Although the medical opinion was very thorough, the VA examiner did not express any opinion as to whether the Veteran’s osteochondroma developed in service or clearly and unmistakably pre-existed service. The examiner also did not indicate whether the Veteran has a current diagnosis of osteochondroma or whether osteochondroma was related to the Veteran’s ongoing pain. Therefore, the Board remanded the claim for an addendum opinion to clarify this finding. The June 2020 addendum opinion found that there was no current diagnosis of osteochondroma. The clinician wrote that osteochondroma was an overgrowth of cartilage and bone that happens at the end of the bone near the growth plate. Most often, it affected the long bones in the leg, the pelvis, or the shoulder blade. Osteochondroma was the most common noncancerous bone growth. The STR noted that the Veteran injured his left ankle in 1966. He was evaluated and treated by the "hospital ER". Veteran subsequently had orthopedic consult due to the reported "osteochondroma". There was no x-ray report to support an osteochondroma diagnosis. Orthopedic evaluation in 1966 showed diagnosis of left ankle strain which resolved with leg casting. Veteran's separation physical in 1966 clearly noted "normal" lower extremities with no evidence of residual for the left ankle strain. Podiatry consult in 2019 was silent for osteochondroma diagnosis. The Board acknowledges the Veteran's assertion that his left ankle disability is related to his military service. However, a lay person is not considered competent to medically attribute the residuals of a left ankle disability to an in-service injury as doing so to requires medical knowledge and expertise the Veteran has not been shown to possess. See Kahana v. Shinkseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). However, the competent medical evidence of record answered the question and did not support a causal relationship between the Veteran's left ankle disability and his in-service injury. As previously stated, the evidence of record indicates the Veteran suffered an in-service ankle injury, but no fracture was found on examination. The record also showed that the Veteran complained of ankle plain and was treated for his ankle after service. However, the evidence does not support a causal relationship between the Veteran’s in-service injury and his current ankle pain. The Veteran has submitted no objective medical opinion in support of his claim. Accordingly, the criteria for entitlement to service connection for left ankle disability has not been established, either through medical or lay evidence. In arriving at the decision to deny the claim, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim of entitlement to service connection for left ankle disability, that doctrine is not applicable. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Harris, Attorney Advisor 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.