Citation Nr: 21026916 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 16-58 687 DATE: May 4, 2021 ORDER Entitlement to service connection for a foot disorder other than pes planus, to include peripheral neuropathy, is denied. FINDINGS OF FACT 1. The Veteran is not diagnosed with a foot disorder other than pes planus or peripheral neuropathy. 2. The preponderance of the evidence is against a finding that the Veteran's foot disorder, to include peripheral neuropathy, began during active service or is otherwise related to an in-service event or injury. CONCLUSION OF LAW The criteria for service connection for a foot disorder other than pes planus, to include peripheral neuropathy, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from May 1963 to October 1963. This matter comes before the Board of Veterans' Appeals (Board) from December 2015 and September 2016 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO) in Providence, Rhode Island. In February 2018, a video hearing was held before the undersigned Veterans Law Judge. A transcript of that hearing is of record. This claim was previously before the Board in March 2018 and May 2020, at which time the Board, inter alia, remanded this issue for additional development. The requested development was substantially completed; however, the issue was most recently before the Board in December 2018 and remanded because a Supplemental Statement of the Case (SSOC) was not issued. A SSOC was issued in January 2021 further denying the Veteran's claim. Now, the issue is properly before the Board for further appellate consideration. Entitlement to service connection for a foot disorder other than pes planus, to include peripheral neuropathy. In this post-remand case, the Veteran seeks service connection for a foot disorder other than pes planus diagnosed as peripheral neuropathy. By way of history, this issue was previously addressed and remanded by the Board in May 2020. Specifically, the issue of entitlement to service connection for bilateral pes planus and an unspecified bilateral foot disorder were remanded. The Veteran was granted service connection for bilateral pes planus in a July 2020 rating decision by the RO. However, the issue of entitlement to service connection for a bilateral foot disorder other than pes planus, diagnosed as peripheral neuropathy was denied. The issue was before the Board in December 2020 but remanded in order for a SSOC to be issued. A SSOC further denying the Veteran's claim was issued in January 2021. In order to establish service connection for a claimed disability, the following three elements must be satisfied: (1) the existence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (nexus) between the present disability and the disease or injury incurred or aggravated during service. Hickson v. West, 12 Vet. App. 246 (1999). Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection. 38 C.F.R. § 3.303(b), Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be granted for any disease diagnosed after discharge from service when all of the evidence, including lay evidence, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Lay statements may serve to support a claim for service connection by supporting the occurrence of lay-observable events or the present of disability or symptoms of disability subject to lay observation. 38 U.S.C. § 1153(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Although lay persons are considered competent to provide opinions on some medical issues, some medical issues fall outside of the realm of common knowledge of a lay person. Kahana v. Shinseki, 24 Vet. App .428 (2011). To begin, according to Providence VA medical center (VAMC) treatment records, the Veteran is currently diagnosed with idiopathic peripheral neuropathy. Specifically, the Veteran complains of pain on the right lumbar area and across the lower back with radiation down both legs with a burning sensation in both feet. The Veteran was afforded a VA examination in September 2019. He was diagnosed with bilateral peripheral neuropathy of the lower extremities; however, the examiner did not find any evidence of a current foot disorder other than pes planus. Furthermore, the Veteran was afforded an additional VA examination in October 2020. The examiner only found evidence of bilateral pes planus. The Veteran described the symptoms as "burning pain in both feet." Therefore, the Board finds adequate evidence of a current disability, to include peripheral neuropathy, for purposes of service connection. As it pertains to an in-service event or injury, the Board previously found the Veteran to be credible in his contentions regarding wearing improperly fitting footwear and his in-service concussion. Therefore, the Board finds adequate evidence satisfying the second element necessary for service connection. With regard to the final element necessary for service connection, a nexus, the Board finds the preponderance of the evidence is against finding the Veteran's peripheral neuropathy began during active service or is otherwise related to an in-service event or injury. An addendum opinion was obtained in August 2020 regarding the etiology of the Veteran's peripheral neuropathy as his medical record indicates he is diagnosed and treated for low back pain with radicular pain that requires Gabapentin therapy for treatment. The Veteran and his representative argue that his "foot condition secondarily contributed to a lower back condition, which was an intermediate step to a bilateral lower extremity neuropathy." However, the issue currently presented before the Board is not entitlement to service connection for a lower back disability. Additionally, the Veteran's representative is not competent to provide medical findings as those are medical findings made by an examiner with medical expertise and are outside the realm of common knowledge of a lay person. See Kahana, 24 Vet. App. at 428; see also Jandreau, 492 F.3d at 1372. The VA examiner opined that an MRI of his lumbar spine in January 2020 revealed degenerative disc disease with multilevel central stenosis which is moderate to severe and most marked at L2-3. The examiner opined that his degenerative disc disease is more likely the cause of his bilateral foot numbness and not an in-service concussion or improperly fitting boots. Furthermore, the October 2020 VA examiner did not find evidence of another localized foot disorder other than pes planus. The VA examiner did find, however, that during his examination the Veteran did have arches in both feet while sitting and during weight bearing. The Board notes the issue presented is not of pes planus but of other disabilities of the feet to include neuropathy. The Veteran does not have any other disability of the feet and an etiological opinion states his peripheral neuropathy is more likely than not the result of his degenerative disc disease for which the Veteran is currently not service connected. Therefore, given the negative nexus opinion, the Board must unfortunately find that the preponderance of the evidence is against a finding that the Veteran has a current foot disability other than pes planus, to include bilateral peripheral neuropathy of the lower extremities, that began during active service or is otherwise related to his concussion or improperly fitting shoes. Michael J. Skaltsounis Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. DeBoer, 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.