Citation Nr: 21028337 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 04-31 995A DATE: May 11, 2021 ORDER Service connection for bilateral foot tendonitis is denied. Service connection for bilateral ankle disorder is denied. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has had a foot disorder at any time during or approximate to the pendency of the claim. 2. The preponderance of the evidence is against finding that the Veteran has an ankle disorder, subsequently diagnosed as Achilles tendinitis, that began during active service, or is otherwise related to an in-service injury of being assaulted during bootcamp. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral foot tendonitis are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for bilateral ankle disorder, diagnosed as Achilles tendinitis, are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active military duty from March 1975 to March 1977. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2002 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Oakland, California. Since that time, jurisdiction was transferred to the RO in Portland, Oregon. The Veteran testified at a videoconference hearing before the undersigned Veteran Law Judge (VLJ) in May 2016 and a transcript of the hearing is of record. The appeal has been previously remanded for further development in March 2016, August 2016, and March 2017. Following the March 2017 Board remand, a July 2019 rating decision granted the Veteran's service connection claims for traumatic brain injury and post-traumatic stress disorder. As this grant represents a full grant of the benefits sought, these issues are no longer on appeal. See Grantham v. Brown, 114 F.3d. 1156 (Fed. Cir. 1997). Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 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). 1. Bilateral foot tendonitis The Veteran seeks service connection for bilateral tendonitis of the feet due to being assaulted during service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current diagnosis of a foot disorder and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The April 2017 and July 2019 VA examiners evaluated the Veteran and determined he did not have any foot disorders. While the July 2019 VA examiner found Achilles tendinitis, she associated that diagnosis with the Veteran's claimed ankle disorder as discussed in the section below. The Board finds the opinions of the VA examiners are adequate as the examiners considered the Veteran's contentions and based their medical opinions on an accurate medical history as post-service medical treatment records are absent for treatment of a specified foot disorder. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). While the Veteran contends that his feet were injured during an assault, STRs do not reflect any complaints or treatment of foot problems and the February 1977 separation examination showed "normal" feet. Moreover, review of the Veteran's post-service treatment records are silent as to any complaints or ongoing treatment of a foot disorder. While the Veteran believes he has a foot disorder from service, he is not competent to provide a medical opinion in this case as he has not been shown to possess the requisite training or credentials needed to render a competent opinion as to a current diagnosis. 38 C.F.R. § 3.159(a)(2); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). As such, his lay opinions do not constitute competent medical evidence and lacks probative value. Feet disorders are medically complex disorders that require specialized training for a determination as to diagnosis and causation. Consequently, the Board gives more probative weight to the competent post-service medical treatment records reflecting no presence of a foot disorder and the opinion of the April 2017 and July 2019 VA examiners who confirmed there was no current foot disability and no functional limitations due to foot pain. Based on the forgoing, the Board finds that the most probative evidence of record is the April 2017 and July 2019 VA examinations as they are the most thorough assessment of the Veteran's feet. Consequently, the Board adopts the opinion of the VA examiners, who ultimately found there was no foot disorder. The Veteran has not presented or identified any contrary medical opinion that supports his claim. VA adjudicators are not free to ignore or disregard the medical conclusions of a VA physician, and are not permitted to substitute their own judgment on a medical matter. Colvin v. Derwinski, 1 Vet. App. 171 (1991); Willis v. Derwinski, 1 Vet. App. 66 (1991). In sum, the Board finds that the preponderance of the evidence is against this service connection claim, and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 2. Bilateral ankle disorder The Veteran seeks service connection for ankle swelling due to being assaulted during service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current diagnosis of Achilles tendonitis, the preponderance of the evidence weighs against finding that the Veteran's Achilles tendonitis began during service or is otherwise related to an in-service injury, event, or disease. The July 2019 VA examiner opined that there was no medical evidence that chronic ankle problems and pain started in service, and thus it was less likely than not that the Veteran's bilateral chronic Achilles tendonitis was etiologically related to service. The Veteran was diagnosed with Achilles tendonitis during the July 2019 VA examination. Further review of his post-service medical records is absent for any ongoing complaints or treatment of ankle disorders, with the exception for a few acute ankle injuries in June 2016 and July 2016, for which he went to the ER. Additionally, at the April 2017 VA examination the examiner found no diagnoses, pathologies, or symptoms pertaining to the ankles; on examination, the Veteran's ankles were normal and there was no evidence during the examination of pain or painful movement. While the Veteran contends that his ankles were injured during an assault, STRs do not reflect any complaints or treatment of ankle problems. The February 1977 separation examination showed "normal" lower extremities. As indicated above, review of the evidence as a whole indicates that the Veteran was not diagnosed with an ankle disorder until July 2019, decades after his separation from service. The fact that Achilles tendinitis was not shown for such a prolonged period after his period of active service weighs against a claim that it was related to service. See Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (explaining that the Board may consider "evidence of a prolonged period without medical complaint," along with other factors in resolving a claim). The Veteran is competent to report his symptoms of heel pain. See Layno v. Brown, 6 Vet. App. 465 (1994). However, the Veteran is not competent to report the etiological cause of this pain. He has not been shown to possess the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. 38 C.F.R. § 3.159(a)(2); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). As such, his lay opinions, to include his contentions that he had an in-service ankle injury do not constitute competent medical evidence and lacks probative value. The Board finds the issue of the etiological cause of Achilles tendinitis occurring many years after service to be a medically complex question, as it requires knowledge of interaction between multiple body systems. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the opinion of the July 2019 VA examiner. The Veteran has not presented or identified any contrary medical opinion that supports his claim. VA adjudicators are not free to ignore or disregard the medical conclusions of a VA physician, and are not permitted to substitute their own judgment on a medical matter. Colvin v. Derwinski, 1 Vet. App. 171 (1991); Willis v. Derwinski, 1 Vet. App. 66 (1991). In sum, the Board finds that the preponderance of the evidence is against this service connection claim, and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Nathaniel J. Doan Veterans Law Judge Board of Veterans' Appeals Attorney for the Board AD 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.