Citation Nr: 21025430 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 15-04 073A DATE: April 28, 2021 REMANDED Entitlement to service connection for a left foot disability is remanded. Entitlement to service connection for a right hip disability, to include as secondary to the service-connected right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1969 to October 1973 and from May 1975 to May 1979. These matters come before the Board of Veterans’ Appeals (Board) on appeal from rating decisions by the Department of Veterans’ Affairs (VA) Regional Office (RO). In January 2019, the Veteran testified at videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. These matters were previously remanded by the Board in May 2019 and October 2020. 1. Entitlement to service connection for a left foot disability is remanded. The Veteran contends that during service, in 1976, he sustained a minor abrasion to his left foot after his left foot slid forward and under the end of a door resulting to trauma to not only his third and fourth toes but to his entire left forefoot. He contends that his Morton’s neuroma is related to the 1976 injury to his left foot. Pursuant to the October 2020 Board remand, an addendum opinion was obtained in January 2021. The examiner provided a negative nexus opinion. The examiner explained that the Veteran sustained a minor abrasion of the left foot during service in the late 1970s; however, there is no plausible pathophysiologic mechanism that would explain the development of a left foot Morton’s neuroma 35 years after the injury reported while on active duty. Furthermore, the examiner opined that there is no plausible pathophysiologic mechanism discussed in the medical literature and known principles that would explain such a causal relationship between these conditions. In February 2021, the Veteran submitted a statement clarifying the facts of his case and clarified that the January 2021 VA examiner’s statement regarding the plausibility of a left foot Morton’s neuroma developing 35 years after service. Specifically, the Veteran stated that this was inaccurate because he had pain and suffering for the 35 years after his initial 1976 injury until he underwent surgery in 2011 to remove the Morton’s neuroma and still has recurring pain which he receives treatment for. In light of the above, the Board finds an addendum opinion should be obtained upon remand. 2. Entitlement to service connection for a right hip disability, to include as secondary to the service-connected right knee disability is remanded. Pursuant to the October 2020 Board remand, an opinion as to whether the Veteran’s right hip disability was related to service or to his service-connected right knee disability was to be obtained. An addendum opinion was obtained in January 2021. The examiner opined that the right hip disability was less than likely related to service, or alternatively, caused or aggravated by his service-connected right knee disability because there was no evidence in the Veteran’s service treatment records and subsequent medical records indicating that the right knee surgery performed in 1976 while on active duty directly or indirectly caused hip pain. The examiner noted that the Veteran has stated in recent examinations that he is not claiming hip pain, but rather is claiming lumbar spine derangement associated with sciatic neuritis that radiates to the right hip and right lower extremity. However, the Board finds the opinion is insufficient as the examiner failed to provide the requested opinion as instructed by the Board in its October 2020 remand. Accordingly, remand is required for an addendum opinion to fully comply with the Board’s October 2020 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding veterans are entitled to compliance with Board remand instructions). Updated treatment records should be obtained as well. The matters are REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for his claimed disabilities. After securing any necessary releases, the AOJ should request any relevant records identified. In addition, obtain updated VA treatment records. If any requested records are unavailable, the Veteran and his representative should be notified of such. 2. After records development is completed, send the Veteran’s claims file to a VA podiatrist, if available, to obtain an addendum opinion as to whether the Veteran’s left foot disability is possibly related to service. If a new examination is required in order to respond to the request, such should be scheduled. Following review of the claims file, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any current disability of the left foot arose during service or is otherwise related to service, to include the 1976 in-service injury to the left foot. Please explain why or why not, to include addressing the significance of the September 2001 private treatment for the left foot, the Veteran’s lay statements (to include his contention that he has had left foot pain since his initial 1976 in-service injury to the left foot), the statement submitted by the Veteran’s wife regarding his left foot symptomology and service treatment records showing treatment for the left foot in August 1976. Additionally, the examiner should consider the Veteran’s statement accompanying his February 24, 2021 VA Form 21-4138, Statement in Support of Claim. 3. Send the Veteran’s claims file to the January 2021 VA hip examiner, if available, to obtain an addendum opinion as to whether the Veteran’s claimed right hip disability, to include right hip pain and right hip degenerative joint disease is related to service or his service-connected right knee disability. If a new examination is required in order to respond to the request, such should be scheduled. Following review of the claims file, the examiner should provide an opinion as to the following: (a.) Is at least as likely as not (50 percent probability or greater) that any current disability of the right hip, to include right hip pain and right hip degenerative joint disease arose during service or is otherwise related to service? The examiner is also requested to consider any reported pain that yields functional loss of the right hip and, if pain causing functional loss of the right hip is found to be present, the examiner should opine as to its etiology in accord with the holding of Saunders v. Wilkie, 885 F.3d. 1356 (Fed. Cir. 2018). Please explain why or why not, to include addressing the significance of the Veteran’s lay statements and medical records showing complaints of right hip/SI pain. (b.) If not related to service, is it at least as likely as not (50 percent probability or greater) that the right hip condition, to include right hip pain and right hip degenerative joint disease was caused by the service-connected right knee disability? Please explain why or why not, to include addressing the Veteran’s lay assertions and medical evidence of record. (c.) If not caused by the service-connected right knee disability, is it at least as likely as not that the Veteran’s right hip condition, to include right hip pain and right hip degenerative joint disease is worsened beyond natural progression (aggravated) by his service-connected right knee disability? Please explain why or why not, to include addressing the Veteran’s lay assertions and medical evidence of record. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Medina, 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.