Citation Nr: 21024545 Decision Date: 04/23/21 Archive Date: 04/23/21 DOCKET NO. 16-30 088 DATE: April 23, 2021 REMANDED Entitlement to service connection for a left foot disorders, to include as secondary to a service-connected right foot condition is remanded. REASONS FOR REMAND The Veteran had honorable active duty service from July 1977 to July 1980 and November 1990 to July 1991, with additional service in the Army Reserve. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in June 2016 by a Department of Veterans Affairs (VA) Regional Office. In October 2018, and May 2020, the Board remanded the case for additional development, including an adequate opinion. In October 2020, the Veteran was afforded a new VA medical opinion. After a Supplemental Statement of the Case (SSOC), the claim is back before the Board. Although further delay is regrettable, a remand is necessary for an adequate VA opinion. A remand by the Board confers upon the claimant, as a matter of law, the right to compliance with the remand instructions, and imposes upon the VA a concomitant duty to ensure compliance with the terms of the remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Here, the Board finds that the RO did not substantially comply with the remand for the following reason. As noted in the October 2018, and May 2020 remand, the Board found that the earlier opinions were insufficient as they did not address whether the Veteran’s left foot disorders were aggravated by his service-connected right foot disability. The new opinions obtained in October 2020, continue to be inadequate for the same reason. For example, the examiner in October 2020 stated that pes planus with plantar fasciitis of the right foot and pes planus with plantar fasciitis and degenerative arthritis of the left foot are not medically related, and that one does not cause the other. However, the Board found such opinions insufficient as they did not address whether the Veteran’s left foot disorders were aggravated by his service-connected right foot disability. The Board notes that a private podiatrist opined in March 2016 that the Veteran’s service-connected right foot disability contributed to, or aggravated, his left foot disorders. See Medical Treatment Record- Non-Government Facility received April 2016. However, the podiatrist did not provide a rationale for his opinion. Therefore, the opinion was insufficient to establish service connection. In summary, the RO did not ensure that the October 2020, VA examiner provided an adequate rationale for his opinion with respect to aggravation by a service-connected impairment. Thus, the RO did not substantially comply with the remand and another medical opinion is required. See Stegall, 11 Vet. App. 268 at 271. The matters are REMANDED for the following action: 1. Update all VA treatment records as deemed necessary. 2. Then forward the record and a copy of this Remand to an appropriate VA clinician for an addendum opinion addressing the etiology of the Veteran’s left foot disorder. The need for an examination of the Veteran is left to the discretion of the clinician selected to write the opinion. Following a review of the record, the examiner should address the following inquiries: (a.) Is it at least as likely as not (i.e., a 50 percent probability or greater) that the Veteran’s osteoarthritis of the left foot had its onset in, or is otherwise related to, his military service, to include his June 1989 hard landing and trauma to both ankles? (b.) Then also answer, is it at least as likely as not (50 percent probability or greater) that the Veteran’s left foot pes planus, plantar fasciitis, and/or osteoarthritis were either: i. Caused by the service-connected right foot disability, or ii. aggravated by (i.e., worsened beyond the normal progression of the disease) the Veteran’s service-connected right foot disability? In addressing whether the Veteran’s service-connected right foot disability, was a source of aggravation of the Veteran’s left foot pes planus, plantar fasciitis, and/or osteoarthritis, the examiner must attempt to establish a baseline level of severity of the left foot pes planus, plantar fasciitis, and/or osteoarthritis prior to aggravation by the service-connected disability, if any can be determined. The clinician should address the March 2016 private opinion that the Veteran’s service-connected right foot disability contributed to, or aggravated, his left foot disorders. 2. A complete rationale must be provided for all opinions offered. If an opinion cannot be offered without resort to mere speculation, the examiner must fully explain why this is the case and identify what additional evidence, if any, would allow for a more definitive opinion. 3. If any benefit sought on appeal is not granted, the Veteran and his representative should be provided a Supplemental Statement of the Case (SSOC) and afforded the requisite opportunity to respond before the case is returned to the Board. Sarah Campbell Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Associate Counsel, C. Parnell 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.