Citation Nr: 21021996 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 15-23 308A DATE: April 14, 2021 ORDER Entitlement to service connection for a left ankle strain is denied. FINDING OF FACT The Veteran does not have a diagnosed left ankle disability that had its onset in service or is otherwise related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for a left ankle strain have not been met. 38 U.S.C.A. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1978 to June 1978, January 1990 to June 1990, and from November 1990 to September 1991. He died in August 2018, during the pendency of the appeal. The Appellant is his surviving spouse and the substituted party. In July 2020, the Board remanded the issue for a VA opinion on the etiology of any diagnosed left ankle condition. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § § 3.303 (a). To establish a right to compensation for a present disability, a veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Entitlement to service connection for a left ankle strain The appellant asserts that the Veteran injured his left ankle during service while doing physical training and it persisted until his death. Specifically, the Veteran reported that in November of 1990 while playing football he stepped in a hole and twisted his ankle. The Board notes that the Veteran was service-connected for right ankle injury with residuals of osteoarthritis. A review of the Veteran’s service treatment records (STRs) does not reveal any evidence of a left ankle injury. The records do reflect an injury to the right ankle in the same manner as the Veteran described for the left ankle injury. A February 1991 treatment note shows that the Veteran reported in November 1990 he injured his right ankle when he stepped in a hole while playing football. He was diagnosed with a right ankle sprain and put on light duty for several months. The STRs show several follow-up visits to assess the status of the right ankle. VA treatment records show that from October 1996 until the Veteran’s death in 2018 the Veteran had continued complaints of and treatment for right ankle pain. The only mention of the left ankle is a history of left ankle pain as reported by the Veteran. A December 2014 VA ankle examination reflects that the examiner informed the Veteran that the examination was for the existing service-connected right ankle injury, however the Veteran and the appellant repeatedly stated it was his left ankle that was injured and that he had no current symptoms in the right ankle and did not have a right ankle condition in the past. The Veteran stated he injured the left ankle in service in 1990 during physical training. He stated he was seen in sick call and seen several times after for the left ankle condition. The Veteran declined x-rays of the right ankle and x-rays of the left ankle showed taken at the time of the examination showed no fractures or dislocations and the bones and soft tissues were within normal limits. The impression was left ankle series within normal limits. The examiner diagnosed left ankle strain but noted the diagnosis was provided per the request of the Veteran and the appellant. Based on the diagnosis of left ankle sprain by the December 2014 VA examiner, the Board remanded the issue for an etiological opinion. In October 2020, a VA examiner opined it was less likely than not the Veteran’s diagnosed left ankle strain was incurred in or caused by the claimed in-service injury, event, or illness to include physical training. The rationale provided was that there is no objective medical evidence to indicate the Veteran's claimed in-service injury did not resolve without residual. There's no immediate objective post service medical evidence to indicate treatment for chronic/ongoing ankle pain/condition/pathology of a left ankle injury. The examiner concluded the left ankle strain was caused by acute post service overuse and not by service. Based on the competent medical evidence of record, the Board finds that service connection for a left ankle disability is not warranted. Despite the assertions by the Veteran and appellant that the ankle injury in service was to the left ankle all of the medical evidence shows that it was actually the right ankle that sustained an in-service injury. The STRs show a history, reported by the Veteran, of injury to his right ankle during physical training in November 1990. All in-service follow-up treatment notes were for a right ankle injury, not the left ankle. Post-service VA treatment notes also consistently and repeatedly reflect complaints of and treatment for a right ankle injury. Lastly, despite the Veteran’s assertion that he never had a right ankle injury in the past and had no symptoms service connection has been in effect for a right ankle disability since 2000. In sum, the evidence is against a finding the Veteran has a left ankle disability that is etiologically related to service. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine enunciated in 38 U.S.C. § 5107 (b) is not applicable, as there is no approximate balance of evidence. Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990); Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001). Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Mitchell, 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.