Citation Nr: 21021657 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 14-02 628 DATE: April 13, 2021 REMANDED Service connection for a left foot condition, to include as secondary to bilateral knee disabilities and a left ankle disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1984 to June 1990. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a March 2013 rating decision by the Department of Veterans Affairs Regional Office (RO). In May 2015, the Veteran testified before a Veterans Law Judge (VLJ) who is no longer employed at the Board. The Veteran was notified and offered the opportunity to have another hearing. In March 2019, the Veteran testified before the undersigned VLJ via videoconference. This case was previously before the Board in August 2015 and November 2019 when it was remanded for additional development. Unfortunately, for the reasons discussed below, another remand is required. See Stegall v. West, 11. Vet. App. 268 (1998)). Service connection for a left foot is remanded. In a September 2020 VA examination report, the Veteran was diagnosed with hallux rigidus, plantar fasciitis, and degenerative arthritis. He reported that he believed his knees and left ankle injuries affected his left foot, causing him to walk abnormally. He reported that he believed that, because of this, he developed pain in his left foot which had been bothering him constantly since 2010. In multiple opinions, the VA examiner opined that it was less likely than not that the Veteran’s left foot condition was proximately due to or the result of his service-connected ankle and knee disabilities. The rationales for all these opinions were similar. The examiner opined that the left foot and the service-connected disabilities were not medically related and that the left foot condition was a separate entity from the service-connected ankle or knee disabilities. The rationale was that one joint’s disease did not “spread” to another joint or cause damage to it. According to the VA examiner, there was no evidence that the Veteran’s left foot condition was caused by or aggravated by his service-connected disabilities because the Veteran walked with a normal gait. The Board finds that the September 2020 VA opinions are inadequate. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (a medical opinion based on an inaccurate factual premise has no probative value). The VA examiner seemed to ignore the Veteran’s competent and credible statements that he did not walk normally and that his gait may be affected by his service-connected ankle and knee disabilities. The September 2020 VA opinions have no probative value. Because of this, a new VA opinion or telehealth interview is necessary to determine if the Veteran’s left foot disability is related to his other service-connected disabilities. The matters are REMANDED for the following actions: 1. Please note that, by law, ALL remanded claims must be processed expeditiously. 2. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), contact the Veteran for additional information about treatment for his condition and make efforts to obtain all VA and private treatment records concerning this claim. 3. Then, arrange for the Veteran’s file to be forwarded to a VA examiner for clarifying addendum opinions, or a telehealth interview, regarding the likely cause of the Veteran’s left foot condition. The examiner or consulting physician must review the entire record (including all updated records obtained pursuant to the above development order). Based on his or her review, the examiner or consulting physician should provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s left foot disability is proximately due to or aggravated by his service-connected ankle and knee disabilities. In reaching any conclusion, the examiner must assume, for the purposes of any opinion, that the Veteran’s statements about having an abnormal gait are credible and accurate. (Continued on next page)   4. A detailed explanation (rationale) is requested for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested). VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Abrams, 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.