Citation Nr: 21026253 Decision Date: 04/30/21 Archive Date: 04/30/21 DOCKET NO. 16-25 528 DATE: April 30, 2021 ORDER Entitlement to service connection for a left foot disability is denied. FINDING OF FACT The Veteran’s left foot disability is not secondary to a service-connected shin splints and is not otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for a left foot disability are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1989 to September 1989. She also had National Guard Duty service. In March 2019, the Veteran testified before the undersigned during a videoconference hearing. A transcript of the hearing is included in the electronic claims file. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the claim for additional development in January 2021. There has been substantial compliance with the Board's remand directives as they pertain to the issue decided herein, and adjudication of the appeal may proceed. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The Veteran is contending that her left foot disorder is due to service, or in the alternative, is related to her service-connected shin splints. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. Evaluating the claim on a direct basis, the first element is satisfied because the Veteran has been diagnosed with heel spurs and plantar fasciitis of her left foot. The Board also finds that the second element, in-service injury, has also been met. The Veteran had a fall in service and while records do not show that she injured her left foot at that time, the Board finds her testimony of having sustained an injury credible. Therefore, the second element is met. Regarding the third element, nexus, the evidence of record does not support the claim. The December 2015 VA examiner, after physical examination and review of the claims file, opined that it was less likely than not incurred in or caused by her military service. The rationale was because the Veteran’s left foot plantar fasciitis is a condition of inflammation to the plantar fascia on the bottom of the foot which wasn’t diagnosed until 2013, which the Board notes was more than 20 years after discharge from service. Following examination in March 2020, another VA examiner reached the same conclusion that the Veteran’s left foot disability was not related to service. The examiner pointed out that there was no mention of any plantar issues in the service treatment records with the only foot issue documented being an ingrown nail that was surgically treated. Given the negative opinions, the Board finds that the third element is not met. Therefore, service connection for a left foot disorder on a direct basis is not warranted. As discussed above, the Veteran has also asserted that her left foot disorder is secondary to her service-connected shin splints. Upon review, the Board finds that the Veteran’s left foot disability cannot be service connected via a secondary basis, even though the first two elements are met: the Veteran has a left foot disability and multiple service-connected disabilities, including shin splints in her left leg. However, the December 2015 VA examiner opined that the Veteran’s left foot plantar fasciitis was unrelated to her shin splints. The March 2020 VA examiner likewise determined that it was less likely than not that plantar fasciitis was an associated problem with shin splints while an addendum in January 2021 also opined that the Veteran’s left foot plantar fasciitis was less likely than not proximately due to or aggravated by the service-connected left knee patellofemoral syndrome with shin splints. The rationale provided was that plantar fascia cover the bottom of the foot overlying the metatarsal bones and intrinsic muscles and that knee issues and/or shin splints do not impact mechanically the bottom of the foot even if gait is altered, thus making it less likely than not that plantar fasciitis is related or worsened by the Veteran’s service-connected disabilities. Neither the Veteran nor her representative have provided or identified any medical evidence which contradicts the opinions of the VA examiners on either a direct or secondary basis. The Board acknowledges the claims made by the Veteran during the hearing that VA examiners and private doctors do not render accurate opinions and/or diagnoses if an individual is not immediately seen after an accident occurred. While not taking issue with the Veteran’s claim, the Board nonetheless finds that the fact remains that there is no evidence of record showing that the Veteran’s left foot disability is related to her military service or, in the alternative, caused or aggravated by her service-connected shin splints. Without such evidence, the claim must be denied. The Board acknowledges the Veteran's own assertions in support of her claim. However, as a layperson without the appropriate medical training and expertise, the Veteran has not demonstrated the competency to opine as to the etiologies in this matter. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Considering the pertinent evidence in light of the governing legal authority, the Board finds that the preponderance of the evidence is against the claim. The probative evidence does not show that the current disability is related to the Veteran’s active military service or a service-connected disability. In reaching this decision the Board considered the doctrine of reasonable doubt, however, the doctrine is not for application and service connection must be denied. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Chalker, Phillip 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.