Citation Nr: 21024352 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 16-28 421 DATE: April 22, 2021 ORDER Entitlement to service connection for left foot numbness and tingling is granted. FINDING OF FACT The Veteran’s left foot numbness and tingling started during active service and continued to present. CONCLUSION OF LAW The criteria to establish service connection for left foot numbness and tingling have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 2006 to April 2011. The Veteran appealed a May 2012 rating decision by the Agency of Original Jurisdiction (AOJ). In November 2018, the Board of Veterans’ Appeals (Board) remanded the Veteran’s claim to the AOJ for further action consistent with the Board’s remand directives. The claim is back before the Board for further appellate proceedings. The Board finds there has been substantial compliance with its remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The November 2018 Board decision additionally remanded the issue of service-connection for temporomandibular joint dysfunction (TMJ). A June 2020 rating decision granted service connection for TMJ. The Veteran has not expressed further disagreement with the June 2020 rating decision. As such, the issue regarding TMJ is no longer on appeal. A veteran is entitled to the Department of Veteran Affairs (VA) disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1110. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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, the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). In Saunders v. Wilkie, the Federal Circuit held that pain alone can constitute a disability if it causes functional impairment. 886 F.3d 1356, 1365-68 (Fed. Cir. 2018). The Federal Circuit further explained that to establish a disability, “the [V]eteran will need to show that his pain reaches the level of a functional impairment of earning capacity.” Id. at 1367-68. Here, the November 2019 VA examiner did not diagnose the Veteran with a current left foot disability. However, the VA examiner noted numbness and tingling that bothers the Veteran during prolonged standing and sitting, sharp pain in the middle of the arch if she stands too long, and that her foot gives her a hard time when standing all day as a preschool teacher. The Board considers the Veteran’s pain amounts to such disabling functional impairment as contemplated in Saunders. The Veteran related her left foot condition to an in-service left knee patellar re-alignment in 2008. See November 2019 VA examination report. The November 2019 VA examiner noted an onset date of 2009 and that shortly after the patellar re-alignment procedure the Veteran had an onset of numbness and tingling in her toes. The Veteran competently stated in her June 2016 VA Form 9 that she was diagnosed and treated during service for this condition and that she currently has the condition today. The Board finds the Veteran’s assertions credible. The Veteran’s separation examination noted foot numbness and tingling after a fall. See February 2011 service treatment records (STRs). Overall, the Veteran entered service without any left foot condition. The Veteran had an in-service injury to her knee. The Veteran competently stated she had left foot numbness and tingling since the knee re-alignment and that it has continued to present. This is noted in the Veteran’s separation STRs. The Board finds the Veteran’s statements credible. The Board finds that the evidence is at least in equipoise as to whether the Veteran’s left foot condition had its onset in service. Resolving reasonable doubt in the Veteran’s favor, the Board finds that the Veteran’s left foot condition originated during service and has continued to present. (Continued on the next page)   Accordingly, service connection for left foot numbness and tingling is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Zheng, 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.