Citation Nr: 21021638 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 18-41 386 DATE: April 13, 2021 REMANDED Entitlement to service connection for bilateral flatfoot (claimed as foot injury to include flatfeet) is remanded. Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from December 2005 to March 2011. This matter comes before the Board of Veteran’s Appeals (Board) from a January 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In January 2021, the Veteran testified via videoconference before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the record. The Board notes the Veteran did not perfect an appeal in the matter of service connection for hypertension following the issuance of a statement of the case (SOC) and consequently, this matter is not before the Board. Furthermore, the Board notes that although the Veteran initiated an appeal regarding the denial of his claim of service connection for tinnitus, the claim was granted in a June 2018 rating decision and is no longer on appellate status. 1. Entitlement to service connection for bilateral flatfoot (claimed as foot injury to include flatfeet) is remanded. The Veteran seeks service connection for bilateral flatfoot. In October 2015, the Veteran was administered a Foot Conditions, Including Flatfoot, Disability Benefits Questionnaire (Flatfoot DBQ). In this examination, diagnoses of bilateral flatfoot, left foot strain while in Japan, and shin splints were noted. The examiner noted the Veteran reported that in 2011, he had a physical and was told that he had flatfeet or fallen arches but that it was not put down in the report because the Veteran wanted to get into flight service. The examiner also noted that the Veteran thinks his bilateral feet pain is from having flatfeet which developed in service. Additionally, the examiner noted that the Veteran reported having cellulitis in 2006 which resolved with antibiotics, a left foot injury in Japan, athletes’ foot while on a boat in the Philippines, and shin splints since about 2007. Following the examination, the examiner opined that the Veteran’s claimed condition of flatfeet is less likely than not incurred in or caused by the claimed in-service injury event or illness. In favor of this opinion, the examiner noted that there is no medical correlation between cellulitis and flatfoot or strain and that she could not see any records in the Veteran’s service treatment records regarding his injury in Japan, which likely contributes to the Veteran’s current issues as well as his flatfeet from service. See Flatfoot DBQ of October 2015. When VA provides an examination, it must be an adequate one. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board finds this medical opinion inadequate for adjudication purposes as it relies on absence of contemporaneous medical evidence to support a negative nexus opinion and because it is largely speculative. The Board notes that the Veteran testified at the January 2021 hearing that, additionally to having been told about his flatfeet in an examination during service, that around 2007 or 2008 while running a relay race during physical training, his left foot caught the metal edge of the track. This resulted in a sprained left ankle and a strained left plantar fascia. He explains he was put on crutches and given light duty. He also asserted that his feet have never been the same following the incident as his left foot has constantly hurt and he has overcompensated by favoring it, thus putting more strain on his right lower extremity. See hearing transcript pages 8-9. A lay statement provided by a fellow soldier was associated with the claims file in March 2016 and again in February 2020. In this statement, the fellow soldier states that while in Japan, the Veteran suffered a strained plantar fascia and sprained ankle while taking part in mandatory physical training. The soldier states that the Veteran’s injury forced him to require 3 weeks of light duty as well as 2 weeks using crutches. See lay statement by Mr. M, dated February 2016 and associated with the claims file in March 2016 and in February 2020. The Veteran’s available service treatment records do not show any diagnosis or treatment for the injury the Veteran describes around 2007 or 2008. However, it is unclear from the claims file if Veteran’s complete service treatment records have been associated with the claims file. Upon remand, the RO must obtain any outstanding service treatment records. Based on all of the above, the Board finds the claim must be remanded for development, to include obtaining any outstanding service treatment records, a new examination and a new medical opinion regarding the Veteran’s claimed condition. 2. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran seeks service connection for bilateral hearing loss. In favor of his claim, the Veteran asserts that he was exposed to hazardous noise levels while in service. Specifically, at the January 2021 hearing, the Veteran testified that as an air traffic controller equipment operator in Japan, he worked on the airfield and was exposed to noise from aircrafts taking off and landing. The Veteran also reported that he worked side by side with artillery while in the Philippines. See hearing transcript pages 4 – 5. The Veteran further testified that although he was issued some hearing protection that the protection was not effective and that there is an ongoing class lawsuit regarding that hearing protection. See hearing transcript page 6. The Board notes the Veteran has already been granted service connection for his tinnitus, which was found to be related to his noise exposure in service. Accordingly, based on the Veteran’s credible testimony regarding acoustic trauma in service, and considering he has already been granted service connection for his tinnitus, the Board concedes that the Veteran was exposed to acoustic trauma in service. Hearing loss for the purpose of VA disability compensation is considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz (Hz) is 40 decibels (dB) or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hz are 26 dB or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. In October 2015, the Veteran was administered a Hearing Loss and Tinnitus Disability Benefits Questionnaire (Hearing Loss DBQ). The examiner opined that the Veteran’s hearing loss was not at least as likely as not caused by or a result of an event in military service. The examiner noted that the Veteran experienced a significant threshold shift in the left ear during military service and that he scored a 92 percent during word recognition testing in his left ear, qualifying him for hearing loss due to poor word recognition. The examiner also noted that the Veteran had low frequency hearing loss in his right ear. See Hearing Loss DBQ of October 2015. The Board finds this medical opinion inadequate for adjudication purposes as it does not provide a complete rationale for the opinion expressed. In June 2018, the Veteran was administered another Hearing Loss DBQ. The Veteran was diagnosed with normal hearing in both ears. Based on that finding, the examiner opined that as the Veteran’s hearing was within normal limits, it was less likely as not that the hearing loss is due to military noise exposure. See Hearing DBQ of June 2018. The Veteran testified that he feels his hearing has worsened since the last examination. See hearing transcript page 8. As the medical evidence of record is conflicting as to whether the Veteran currently suffers from bilateral hearing loss, and considering his testimony regarding a worsening of his hearing loss since his last VA examination; the Board finds a remand is necessary to provide the Veteran a new hearing examination to determine whether his hearing loss meets the threshold requirements for VA purposes and to obtain a new medical opinion as to the etiology of the Veteran’s hearing loss. The matters are REMANDED for the following action: 1. Obtain all outstanding VA treatment records and associate them with the claims folder. If no records are available, a negative response must be included in the record. 2. Contact the appropriate service department and attempt to obtain all outstanding service personnel and treatment records for the Veteran's service. All attempts to procure such records, including medical records from the time the Veteran was in Japan, must be documented in the file. If no records are available, a negative response must be included in the record and the Veteran must be notified in accordance with 38 C.F.R. § 3.159(e). 3. After the preceding steps have been completed, schedule the Veteran for a new examination regarding his bilateral flatfoot condition. The examiner is asked to opine: a. Whether it is at least as likely as not that the Veteran’s bilateral flatfoot condition originated in service, or is otherwise etiologically related to service, to include the Veteran’s injury in Japan. 4. Schedule the Veteran for a new examination regarding his hearing loss. a. Whether the Veteran’s hearing loss is at least as likely as not related to his military service, to include his conceded acoustic trauma. The examiner is asked to provide a complete rationale for all opinions expressed. If the examiner cannot provide the requested opinion(s) without resorting to speculation, the report should expressly indicate this, and the examiner should explain why an opinion cannot be provided without resorting to speculation. If the inability to provide an opinion is the result of a need for additional information, the physician must identify the additional information needed. 4. After completing the above requested actions, and any additional notification and/or development deemed warranted, readjudicate the issues on appeal. If the benefits sought on appeal remain denied, furnish to the Veteran and his representative an appropriate supplemental statement of the case that includes clear reasons and bases for all determinations, and afford them the appropriate time period for response before the claims file is returned to the Board for further appellate consideration KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Gonzalez-Maldonado 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.