Citation Nr: 21026028 Decision Date: 04/29/21 Archive Date: 04/29/21 DOCKET NO. 15-14 460 ORDER Entitlement to service connection for left foot plantar fasciitis is granted. FINDINGS OF FACT 1. The Veteran was diagnosed and treated for left plantar fascial strain in service and has experienced left plantar foot pain ever since. 2. Resolving any reasonable doubt in the Veteran’s favor, his current left foot plantar fasciitis had its onset during service. CONCLUSION OF LAW Resolving all reasonable doubt in the Veteran’s favor, the criteria for service connection for left foot plantar fasciitis are met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from August 1988 to July 1993. This appeal stems from a May 2013 rating decision that denied service connection for plantar fasciitis of the left foot. The Veteran timely submitted a May 2013 notice of disagreement (NOD), a statement of the case was issued in April 2015, and the Veteran perfected his appeal in December 2015. In July 2018, the Board remanded the claim for further development. The case has since returned to the Board for further appellate consideration. SERVICE CONNECTION – APPLICABLE LAWS AND REGULATIONS Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009). The Board must analyze the credibility and probative value of the evidence, account for the evidence that it finds persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. Kahana v. Shinseki, 24 Vet. App. 428, 433 (2011). This includes weighing the credibility and probative value of lay evidence against the remaining evidence of record. See King v. Shinseki, 700 F.3d 1339 (Fed. Cir. 2012); Kahana, 24 Vet. App. at 433-34. A veteran bears the evidentiary burden to establish all elements of a service connection claim, including the nexus requirement. Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009). In making its ultimate determination, the Board must give a veteran the benefit of the doubt on any issue material to the claim when there is an approximate balance of positive and negative evidence. Id. at 1287 (quoting 38 U.S.C. § 5107(b)). Analysis The Veteran asserts that his current left foot plantar fasciitis is related to a left foot injury in service. The Veteran has a current diagnosis of left foot plantar fasciitis. See e.g., July 2019 VA examination report. The Veteran’s service treatment records show treatment in July 1989 for left foot pain, diagnosed as left plantar fascial strain. At a follow-up visit one week later, he reported feeling better, but still having slight pain on walking. There was pain on palpation. There were no reports of foot issues at a separation examination in November 1992. Post-service treatment records show complaints of left foot pain from 2012 on, including surgery for fibromas in 2015, with varying diagnoses of left plantar fibroma/fasciitis. In November 2012, a VA examiner opined that the Veteran was diagnosed with left foot plantar fibroma which was less likely than not incurred in service. The examiner reasoned that the Veteran had an acute plantar fascia strain which resolved and there was no further evidence of it in service. In support of his claim, in the May 2015 substantive appeal, the Veteran indicated that that he has suffered from the left foot injury in-service to the present time and that no treatment was allowed because of his shipboard commitments. Subsequent to the Board’s July 2018 remand, a July 2019 examiner noted that the Veteran was diagnosed with bilateral plantar fasciitis, bilateral pes planus, left foot rigidus and bilateral hammertoes. The examiner opined that all of these disabilities were less likely than not incurred in service. The examiner reasoned that there was a singular episode of a left foot plantar arch issue in 1989 with no recurrence for the remainder of his service. On review, the Board finds both VA opinions inadequate and of little probative value as they relied solely on the lack of documented post-service treatment while ignoring the Veteran’s competent assertions. The November 2012 examiner did not address the Veteran’s lay statements regarding ongoing left foot plantar pain and whether the Veteran’s current plantar fibroma was related to the left foot plantar fascial strain in service. The July 2019 examiner merely indicated the Veteran reported left foot pain and failed to give any consideration to the Veteran’s lay assertions about continuous left foot pain since service. The Board finds the Veteran’s lay statements in this case highly probative. While the Veteran is not shown to possess the necessary medical expertise to diagnose plantar fasciitis or render an opinion regarding the etiology of the current plantar fasciitis, he is competent to report that what he observed firsthand, which was left foot pain during service and thereafter. See Layno v. Brown, 6 Vet. App. 465 (1994). The Board finds no reason to doubt the credibility of these lay assertions, particularly as the VA examiner did not address the Veteran’s lay reports regarding his left foot plantar pain. (Continued on the next page)   The Board concludes that the evidence is at least in equipoise as to whether the Veteran’s left foot plantar fascitis had its onset in service. The finding that the Veteran has had left foot symptoms and pain, particularly in service and since separation from service, is supportive of the claim overall because it tends to show that the same symptoms that began in service were the basis for the later diagnosed plantar fasciitis. See Horowitz v. Brown, 5 Vet. App. 217, 221-22 (1993). Accordingly, upon further review, and resolving all reasonable doubt in favor of the Veteran, the Board finds that his left foot plantar fasciitis had its onset during active service. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Beach, 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.