Citation Nr: 21028858 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 16-32 178 DATE: May 12, 2021 REMANDED Entitlement to service connection for right foot disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1967 to August 1969, to include service in Korea. This matter comes before the Board on appeal from an August 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In October 2019, the Board reopened and remanded the claim of entitlement to service connection for a right foot disability for additional development. The matter has been returned for appellate review. Entitlement to service connection for right foot disability is remanded. The Veteran contends that service connection is warranted, as his current right foot disability is the result of a forced helicopter landing during active duty service. The Veteran's service treatment records (STRs) contain multiple notations dated in February 1969, which indicate the Veteran was hospitalized on February 2, 1969 after a forced landing of a helicopter. These notes indicate the Veteran complained of weakness, blindness, diarrhea, frequency and burning with voiding, hematuria and pyuria, watery stools, nausea associated with slight abdominal distress, "chills" but no fever, slight burning on urination with no frequency, lightheadedness, and malaise for several days prior to the helicopter landing. During his hospitalization, the Veteran underwent multiple tests and x-rays, which were essentially normal. The diagnoses were episodes of syncope of unknown etiology, viral gastroenteritis, and vasovagal reaction with syncope. A review of the STRs does not indicate that the Veteran complained of any right foot injury as a result of the helicopter landing. In fact, physical examinations of the Veteran's extremities were normal, except for one notation which indicated the Veteran had slight left lower quadrant tenderness. In February 2020, the Veteran underwent a VA foot conditions examination. The examiner diagnosed the Veteran with right foot injury (deformity and partial resection of middle phalanx of right 5th toe) and right foot degenerative arthritis. After reviewing the file and examining the Veteran, the examiner found it was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. Specifically, the examiner noted that after a review of the available records, there was a lack of sufficient evidence to show that the Veteran sustained a right foot injury or condition while in military service. However, the opinion does not address the Veteran's reports of continuity of right foot pain and symptoms. The Federal Circuit has held that a medical opinion which relies on the absence of contemporaneous medical evidence, and fails to consider whether lay statements present sufficient support of the etiology of the claimed disability, is inadequate. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006). When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Thus, the Board finds that a new medical opinion with respect to the nature and etiology of the Veteran's right foot disabilities should be obtained. The Board notes the Veteran submitted a buddy statement in January 2014, indicating the Veteran "likely qualifies as a 100% disabled person due to injuries he sustained during his military service in Korea." To the extent that this statement constitutes a nexus opinion, the Board affords it little probative value, the Veteran's buddy is admittedly not a medical professional and is not competent to offer an opinion as to the etiology of the Veteran's right foot disability. Further, the "opinion" is conclusory and speculative. The matters are REMANDED for the following action: Obtain a medical opinion as to the following from an appropriate clinician or clinicians. The claims file must be made available to the clinician rendering the requested opinions. Is it at least as likely as not that the Veteran's diagnosed right foot disabilities, to include deformity and partial resection of middle phalanx of right 5th toe and/or degenerative arthritis had its onset in service or is otherwise related to the Veteran's active service, to include as a result of the documented February 1969 forced helicopter landing therein? In providing the requested opinion, the clinician should review the relevant evidence of record, to include the Veteran's June 2016 testimony regarding continuity of symptomology of the right foot since the in-service helicopter landing, including chronic pain and discomfort. The examiner is informed that the Federal Circuit has held that a medical opinion which relies on the absence of contemporaneous medical evidence, and fails to consider whether lay statements present sufficient support of the etiology of the claimed disability, is inadequate. (Continued on the next page) Please provide a clear rationale for all opinions rendered, and a discussion of the facts and medical principles involved. A. J. Spector Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A.N., 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.