Citation Nr: 21028896 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 16-41 377 DATE: May 12, 2021 ORDER Service connection for left foot pes planus, posttraumatic arthritis, and open reduction and internal fixation of the Lisfranc joint is granted. FINDING OF FACT The Veteran's current left foot disorder, diagnosed as left foot pes planus, posttraumatic arthritis, and open reduction and internal fixation of the Lisfranc joint, is related to an injury incurred in the line of duty as a result of a motorcycle accident that occurred on September 14, 2003, while returning directly from a period of inactive duty for training (INACDUTRA). CONCLUSION OF LAW The criteria for service connection for left foot pes planus, posttraumatic arthritis, and open reduction and internal fixation of the Lisfranc joint have been met. 38 U.S.C. §§ 101(24), 1110, 5107; 38 C.F.R. §§ 3.1(d), 3.6(a), (d), (e), 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1990 to December 1994, with additional periods of service with the Naval Reserve. 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). In November 2018, the Board remanded the case for additional development and it now returns for further appellate review. Entitlement to service connection for a left foot disorder. A Veteran is a person who served in the active military, naval, or air service and who was discharged or released under conditions other "than dishonorable." 38 C.F.R. § 3.1(d). The term "active military, naval, or air service" includes: (1) active duty; (2) any period of active for training (ACDUTRA) during which the individual concerned was disabled or died from a disease or injury incurred or aggravated in the line of duty; and (3) any period of INACDUTRA during which the individual concerned was disabled or died from an injury incurred or aggravated in the line of duty. 38 U.S.C. § 101(24); 38 C.F.R. § 3.6(a). ACDUTRA includes full-time duty performed by members of the National Guard of any State or the Reserve. 38 C.F.R. § 3.6(c). INACDUTRA includes duty other than full-time duty performed by a member of the Reserve or the National of any State. 38 C.F.R. § 3.6(d). Additionally, any individual who, when authorized or required by competent authority, assumes an obligation to perform ACDUTRA or INACDUTRA, and is disabled or died from an injury or covered disease incurred while proceeding directly to or returning directly from such ACDUTRA or INACDUTRA shall be deemed to have been on ACDUTRA or INACDUTRA, as the case may be. 38 C.F.R. § 3.6(e). The Veteran contends that his current left foot disorder is related to an injury that occurred as a result of a motorcycle accident on September 14, 2003, that occurred while traveling directly from a period of INACDUTRA while he was serving in the Naval Reserve. In this regard, he submitted a Defense Finance and Accounting Service (DFAS) Leave and Earning Statement reflecting that he participated in drill in the morning and afternoon of September 14, 2003. Furthermore, a November 2003 Approval of Non-Drilling Notice of Eligibility/Line of Duty Benefits reflects that such was approved for a fracture of the tibia/fibula incurred on September 14, 2003, while the Veteran was on INACDUTRA with the Naval Reserve for two days. Furthermore, private treatment records dated on September 15, 2003, reflect that the Veteran was referred to an orthopedist from the emergency room for evaluation and treatment of an injury to his left foot sustained the prior night. In this regard, he reported that such resulted when he dropped his motorcycle on his left foot, and it was noted that X-rays reflected a possible fracture. Following additional imaging tests and a physical examination, crush injury of the left foot with probable nondisplaced fracture at the base of the second metatarsal was diagnosed. A CT scan from September 18, 2003, revealed that, in addition to the fracture at the base of the second metatarsal, there were multiple fractures, including a minimally displaced fracture at the base of the third metatarsal with possible chip avulsion fractures from the cuneiform and dorsum of the cuboid bone. The treating physician also noted that there was a possibility of a Lisfranc fracture-dislocation and serious ligamentous injury. A September 22, 2003, treatment record reflects an impression of left Lisfranc fracture/disruption and fourth metatarsal fracture. On September 28, 2003, the Veteran underwent an open reduction and internal fixation of the left Lisfranc joint. Subsequent treatment records reflect hardware removal in March 2004 and an exostectomy in November 2005. Furthermore, at a VA examination in July 2020, diagnoses of left foot pes planus, posttraumatic arthritis, and open reduction and internal fixation of the Lisfranc joint were rendered. Following a review of the record, to include an October 2019 radiology report that reflected such diagnoses and medical literature, the examiner opined that such disorders were at least as likely as not incurred in or caused by the claimed in-service injury, event, or illness. In this regard, she noted that the Veteran had posttraumatic arthritis with medial longitudinal arch collapse of the left foot resulting in fixed pes planus, and the medical literature indicated that "arthritis can affect the back of the foot or the middle of foot, both of which can result in a fallen arch." She further observed that a September 2003 CT scan of the Veteran's left foot reflected a crush injury occult fracture with evidence of diffuse soft tissue swelling and infiltration of the subcutaneous soft tissues, which were presumably secondary to edema and associated inflammatory changes related to a posttraumatic etiology, which she indicated confirmed that the inflammatory changes were due to the Veteran's accident. Consequently, the examiner concluded that the Veteran's current left disorders were at least as likely as not incurred in or caused by his September 14, 2003, motorcycle accident during service. Consequently, the Board finds that the Veteran's current left foot disorder, diagnosed as left foot pes planus, posttraumatic arthritis, and open reduction and internal fixation of the Lisfranc joint, is related to an injury incurred in the line of duty as a result of a motorcycle accident that occurred on September 14, 2003, while returning directly from a period of INACDUTRA. Thus, service connection for such disorder is warranted. 38 U.S.C. §§ 101(24), 1110, 5107; 38 C.F.R. §§ 3.1(d), 3.6(a), (d), (e), 3.102, 3.303. A. JAEGER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Koria B. Stanton, 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.