Citation Nr: 21021726 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 16-14 052 DATE: April 13, 2021 ORDER Entitlement to service connection for bilateral pes planus is denied. FINDING OF FACT The Veteran is currently diagnosed with bilateral pes planus; the current bilateral pes planus is not etiologically related to an injury or disease sustained during active duty for training (ACDUTRA) service, or to an injury sustained during inactive duty for training (INACDUTRA) service, or is otherwise etiologically related to active service. CONCLUSION OF LAW The criteria for entitlement to service connection for bilateral pes planus have not been met. 38 U.S.C. §§ 101, 1110, 5107; 38 C.F.R. §§ 3.6, 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably on active duty from September 1972 to February 1973 with additional periods of Reserve service. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision of a Regional Office (RO) of the Department of Veterans Affairs (VA). As a preliminary matter, the Board notes that this matter has previously been before the Board in October 2018 at which time it was remanded to the Agency of Original Jurisdiction (AOJ) for further evidentiary development. Such development was completed and the appeal has been presently returned for adjudication. Entitlement to service connection for bilateral pes planus is denied. The Veteran contends that he was diagnosed with bilateral pes planus during his active military service. See e.g., July 2015 notice of disagreement. Service connection will be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Generally, the three-element test for service connection requires: (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). In the context of Reserve service, service connection may only be granted for a disability resulting from disease or injury incurred or aggravated while on active duty or performing active duty for training (ACDUTRA), or for an injury incurred or aggravated while performing inactive duty training (INACDUTRA), but not a disease during INACDUTRA (except from an acute myocardial infarction, a cardiac arrest, or a cerebrovascular accident). 38 U.S.C. §§ 101(24), 106; 38 C.F.R. § 3.6. The Veteran contends that his bilateral pes planus first occurred during his active duty military service. The evidence establishes a current diagnosis of bilateral pes planus. As such, the first element of service connection is established. The Veteran’s service treatment records (STRs) for his period of active duty do not contain complaints, treatment, or diagnosis for the Veteran’s current bilateral pes planus or any other disabilities of the feet. In Reserve records dated as early as December 1986, the physical examiner noted that the Veteran had a diagnosis of moderate pes planus, but that it was asymptomatic. The Veteran’s diagnosis was also noted on the November 1990 Reserve examination. There are no post-service treatment records reflecting treatment for the Veteran’s bilateral pes planus of record. The Veteran was afforded a VA examination in February 2020 in connection with his claim. During the February 2020 examination, the Veteran reported that he was “at one point diagnosed with flat feet.” However, the Veteran indicated that he has never seen a podiatrist for his condition, did not get any arch supports, or any other treatment for his bilateral pes planus. The Veteran reported that his flat feet “have not bothered” him. The Veteran’s current complaints during the examination included numbness in the plantar surface and intermittent, sharp, stinging pain. The February 2020 VA examiner noted that the Veteran has also been diagnosed with diabetes for the past 25 years. The February 2020 VA examiner opined that the Veteran’s current complaints of symptoms of his bilateral feet is nerve pain from his diabetes. The Board notes that the Veteran is not currently service-connected for diabetes, and as such, a secondary service connection theory of entitlement will not be discussed. An addendum medical opinion was obtained in December 2020 once the Veteran’s periods of ACDUTRA and INACDUTRA were clarified. The December 2020 VA examiner opined that the Veteran’s pes planus is less likely than not incurred in or caused by any in-service injury, event, or illness. The December 2020 VA examiner explained that the Veteran was “initially examined for pre-induction exam on November 17, 1971, he did not have any abnormality of his feet documented. Specifically, he did not have pes planus or flat feet. Subsequent medical examinations and reports of medical histories in 1973, 1977, 1982 are negative for any documented pes planus or foot complaints. It is not until the Reserves quadrennial examination of December 1986 that pes planus is documented on a physical exam. However, [the Veteran] did not have any foot complaints on his report of medical history form from the same date. His pes planus was not giving him problems when first documented by the examiner in 1986, and he did not have any active duty foot injury, event, or illness that induced the pes planus. This information indicates that he did not have a congenital or developmental pes planus. His pes planus had its onset in adulthood after skeletal maturity. This is called adult acquired pes planus. The Veteran’s medical records during Reserve periods, including weekend drills, do not include any injury to the Veteran’s feet. There are no LODs documenting a foot problem, injury, or profile for the Veteran’s feet. The majority of the Veteran’s adult life was not spent on active duty, but in civilian life. It is unlikely that the military is the cause or played any significant role in his acquired pes planus. His active duty periods are minimal compared to the time spent in civilian life. In the absence of any trauma to his feet documented while on active duty, or any complaints of the feet during the military, it is less likely than not that this Veteran’s acquired pes planus was incurred in or caused by an in-service injury, event, or illness.” The December 2020 VA examiner also corroborated the February 2020 VA examiner’s opinion and noted that “[the Veteran’s] foot symptoms are consistent with diabetic peripheral neuropathy, and not acquired pes planus.” The probative value of a medical opinion is based on the medical expert's knowledge and skill in analyzing the data and the examiner’s medical conclusion. As is true with any piece of evidence, the credibility and weight to be attached to these opinions are within the province of the adjudicator. Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). Whether a physician provides a basis for his or her medical opinion goes to the weight or credibility of the evidence in the adjudication of the merits. See Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). Other factors for assessing the probative value of a medical opinion are the physician's access to the relevant records in the claims folder and the thoroughness and detail of the opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). In this case, the Board accords great probative weight to the December 2020 VA opinion that there is no nexus between the Veteran's current bilateral pes planus and his active service, as the opinion was predicated on a detailed review of the pertinent records, including the Veteran's in-service medical records, his statements, and other medical evidence. The VA examiner provided a clear explanation as to why the Veteran's current bilateral pes planus was less likely than not related to his active service. The examiner clearly explained that the Veteran's current bilateral pes planus was likely acquired following his military service, based on the time of onset and medical evidence, and the Veteran himself has indicated that such symptoms did not exist during his active military service. Further, the VA examiner explained that the Veteran's current symptoms of his feet are likely a result of his non-service-connected diabetes, rather than bilateral pes planus. The record does not reflect any other competent medical opinion to the contrary and the opinion is not otherwise contradicted by the medical evidence of record. Based on the foregoing, the Board finds that the Veteran’s current bilateral pes planus is not related to active service, to an injury or disease sustained during ACDUTRA service, or to an injury sustained during INACDUTRA service, therefore, service connection for bilateral pes planus must be denied. E. Choi Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. M. Lowman, 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.