Citation Nr: 21027131 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 14-22 634 DATE: May 4, 2021 ORDER Entitlement to service connection for a left ankle disability is denied. Entitlement to service connection for a right ankle disability is denied. FINDINGS OF FACT 1. The Veteran's left ankle disability was not manifest in service and is unrelated to service. 2. The Veteran's right ankle disability was not manifest in service and is unrelated to service. CONCLUSIONS OF LAW 1. The Veteran's left ankle disability was not incurred in or aggravated by service and is not attributable to service. 38 U.S.C. §§ 1110, 1112, 1113, 5103, 5103A, 5107; 38 C.F.R. §§ 3.159, 3.303. 2. The Veteran's right ankle disability was not incurred in or aggravated by service and is not attributable to service. 38 U.S.C. §§ 1110, 1112, 1113, 5103, 5103A, 5107; 38 C.F.R. §§ 3.159, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from June 2004 to September 2007, with combat service in Iraq from November 2005 to November 2006. The Veteran is in receipt of the Combat Infantryman's Badge. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared before the undersigned Veterans Law Judge (VLJ) in a videoconference hearing in September 2017. A copy of the transcript has been associated with the Veteran's electronic claims folder. In April 2020, the Board remanded the matters for additional development. The Board finds that there has been substantial compliance with the remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection Entitlement to service connection for a left and right ankle disability The Veteran contends that he is entitled to service connection for left and right ankle disabilities because he twisted his ankles during in-service marches and while running away while under attack. See Board Hearing Transcript, p.9. He testified that whenever he runs, he hears constant popping in both ankles. Id. at 10. For the reasons explained below, the Board finds that entitlement to service connection is not warranted. In order to obtain service connection under 38 U.S.C. § 1110 and 38 C.F.R. § 3.303 (a) a Veteran must satisfy a three element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service - the so- called 'nexus' requirement. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Walker v. Shinseki, 708 F.3d 1331, 1333 (Fed. Cir. 2013). As to claims made by combat veterans, VA shall accept as sufficient proof of service-connection of any disease or injury alleged to have been incurred in or aggravated by such service satisfactory lay or other evidence of service incurrence or aggravation of such injury or disease, if consistent with circumstances, conditions, or hardships of such service, notwithstanding the fact that there is no official record of such incurrence or aggravation in such service, and, to that end, shall resolve every reasonable doubt in favor of the veteran. The combat presumption may be rebutted by clear and convincing evidence to the contrary. 38 U.S.C. § 1154 (b); 38 C.F.R. § 3.304 (d). Here, there is evidence of a current disability - namely bilateral ankle strain. Service treatment records are silent for any ankle complaints. However, there is evidence that the Veteran was engaged in combat during service. The combat presumption permits the consideration of the Veteran's lay statements of proof of an in-service injury in the absence of records if there is evidence that the Veteran was involved in combat and therefore less likely that his injuries may have been officially documented. Accordingly, the Board accepts the Veteran's account of in-service bilateral ankle injuries. Having found that the Veteran has a current disability and sustained an in-service injury, the question turns to whether the two are related. The Veteran testified at the Board hearing that he just self-treated any problems he had with his ankles. See Board Hearing Transcript, p. 10. Post-service, he testified that he had minor injuries to his ankles while on duty as a border patrolman in 2016 while chasing some illegal aliens. Id. at 12. He stated that he never sought medical treatment because he was discouraged from doing so as part of military culture. In a February 2021 medical opinion, the doctor opined that it was less likely than not that the Veteran's left or right ankle disabilities were related to service. The doctor reasoned that the time between the claimed injury in service and post-service treatment was too far apart to be the same condition. He also noted that June and July 2007 medical treatment records were silent for a bilateral ankle disability and an October 2019 primary care physician note was silent for any chronic ankle pain. The doctor noted in the evidence section that he had reviewed the Veteran's electronic claims folder, including his September 2017 hearing testimony of ankle injuries sustained during combat. The Board assigns probative value to the February 2021 VA examination report. A medical opinion is most probative if it is factually accurate, fully articulated, and based on sound reasoning. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The doctor reviewed relevant evidence, including the Veteran's lay statements and his service and post-service medical treatment records. The doctor found that it was less likely than not than any potential bilateral ankle disability was related to service. It is clear that the Veteran believes that a nexus exists. Such a lay belief sometimes is sufficient. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Although symptoms of rolling of the ankle are capable of lay observation, the Board notes that the Veteran has not contended that he has suffered from these symptoms continuously since service. See Board Hearing Transcript, p.10. There is no competent evidence which links his current ankle symptoms to active service. As the preponderance of the evidence is against the claims for service connection for a left or right ankle disability, the benefit-of-the-doubt rule does not apply, and the claims must be denied. See 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Michael A. Pappas Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Baskerville, LaRita 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.