Citation Nr: 21021727 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 13-30 467 DATE: April 13, 2021 REMANDED Entitlement to service connection for bilateral foot condition is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Air Navy from March 1971 to July 1971. In September 2020, the Board of Veterans’ Appeals (Board) remanded the issue of entitlement to service connection for bilateral foot condition for further development. Specifically, the Board instructed the regional office (RO) to obtain an addendum opinion pertaining to the Veteran’s claim. Entitlement to service connection for bilateral foot condition is remanded. The Veteran underwent a VA examination in December 2020, in which the examiner noted that the Veteran had diagnoses of bilateral flat foot from 1971, bilateral hammer toes and right calcaneal fracture from 2011, as well as left metatarsalgia, bilateral hallux valgus, and bilateral malunion/nonunion of tarsal/metatarsal bones from 2017. The December 2020 examiner opined that the Veteran’s bilateral foot condition was less likely than not related to service because, though the Veteran’s entrance examination noted pes planus, there were no medical records showing complaints of any foot conditions. He also opined that the bilateral foot condition, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service incurrence. He explained that it was less likely than not a three-month period of time in service without significant injury would aggravate his congenital condition beyond its natural progression. Additionally, it was not likely that the Veteran’s malunion/nonunion of tarsal metatarsal bones first manifested during service. Finally, the examiner noted a congenital condition of talo-calcaneal coalition, which was likely not visualized on exam, but found that three-month service period was unlikely to cause severe injury that resulted in long-term disability. Unfortunately, the Board finds that the examination and opinion do not substantially comply with the Board’s September 2020 remand directives. Stegall v. West, 11 Vet. App. 268 (1998). In particular, the December 2020 examiner failed to address whether each of the Veteran’s diagnosed foot conditions pre-existed his service, only noting that a condition was not aggravated beyond its natural progression and that malunion/nonunion of tarsal/metatarsal bones was not likely to first manifest during service. Furthermore, the examiner did not discuss specific medical and lay evidence that the Board requested. Accordingly, a remand is necessary to afford the Veteran a new VA examination to ascertain the nature and etiology of his bilateral foot condition. The matter is REMANDED for the following actions: 1. Assist the Veteran in associating with the claims folder updated treatment records. 2. Thereafter, schedule the Veteran for a VA examination with an appropriate examiner to determine the nature and etiology of his bilateral foot condition. A complete history from the Veteran should be obtained and recorded. The Veteran’s electronic claims file must be accessible for review by the VA examiner in conjunction with the examination and this review should be acknowledged in the report. Following the review of the claims file and examination of the Veteran, the examiner is then requested to respond to the following: (a.) Obtain a detailed history of the Veteran’s bilateral foot condition, to include any and all symptomatology and diagnoses, including bilateral flat foot, bilateral hammer toes, right calcaneal fracture, left metatarsalgia, bilateral hallux valgus, and bilateral malunion/nonunion of tarsal/metatarsal bones. (b.) Clarify whether any bilateral foot condition identified constitutes a congenital “disease” or “defect.” (c.) For any congenital “defect” identified, determine whether there was any superimposed injury or disease in service that resulted in additional disability. (d.) For any congenital “disease” identified, determine whether such disease clearly and unmistakably preexisted service. The examiner must specifically discuss the evidence showing: • The Veteran had a history of painful feet since childhood; • The Veteran was found to have first degree pes planus upon March 1971 entrance examination; • The Veteran was diagnosed with bilateral congenital talocalcaneal coalition in June 1971, three months into service; • The Veteran was accepted into service and not noted to be symptomatic. (e.) If any such disease is found to have preexisted service, determine whether any such disease was not aggravated beyond its natural progression during active service. The examiner must specifically discuss the Veteran’s lay statements that his foot condition was aggravated in service from prolonged standing, walking, or marching. (f.) For any bilateral foot condition that is not a congenital defect or disease, determine whether it is at least as likely as not that such condition was incurred in service or was otherwise related to service. The examiner must specifically discuss: • The Veteran’s March 2015 testimony; • The Veteran’s June 2017 statements of ongoing symptomatology since service; • The Veteran’s mother’s December 2014 written statement. The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that his reports must be taken into account in formulating the requested opinions. The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic and requests flexibility and understanding in affording the Veteran an opportunity for an examination. If an in-person examination cannot be provided, consider other appropriate alternatives, such as a telehealth examination. The examiner must provide the rationale for all proffered opinions. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. PAUL METZNER Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. L. Park, 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.