Citation Nr: 21029005 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 16-07 434 DATE: May 12, 2021 REMANDED Entitlement to service connection for left hip pain, to include as due to a right knee disability is remanded. Entitlement to service connection for right hip pain, to include as due to a right knee disability is remanded. Entitlement to service connection for pes planus (flat foot) is remanded. Entitlement to service connection for bilateral lower extremity peripheral neuropathy is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1973 to December 1974. The issue on appeal was previously denied by the Board in May 2019. The Veteran appealed this decision to the Court of Appeals for Veterans Claims which, in a July 2020 Order, vacated the Board's decision and remanded the issue for additional development and readjudication. 1. Entitlement to service connection for left hip pain, to include as due to a right knee disability is remanded. 2. Entitlement to service connection for right hip pain, to include as due to a right knee disability is remanded. 3. Entitlement to service connection for pes planus (flat foot) is remanded. 4. Entitlement to service connection for bilateral lower extremity peripheral neuropathy is remanded. Any examination obtained by VA must be adequate for purposes of adjudication. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Unfortunately, in this case, further development is necessary before this appeal can be adjudicated. The Veteran contends in November 2014 correspondence that his hip conditions were aggravated by the unusual gait caused by his service connected knee and ankle conditions. Yet, the March 2015 VA examination upon which the denial was based did not address this contention. The Veteran has also submitted positive nexus materials, to include a January 1946 article addressing the effect of knee disabilities on the hips, as well as an August 2020 opinion. Unfortunately, these materials are inadequate to base an award of service connection. They contain general information and do not include a rationale based on the Veteran's particular circumstances. As for the pes planus and neuropathy of the feet, the CAVC observed that the Veteran's May 2015 VA examination did not address the Veteran's claim for direct service connection. Furthermore, neither examination discussed whether the Veteran's particular knee conditions, degenerative joint disease of the knee, status post torn medial meniscus with meniscectomy, and ankle sprain associated with status post knee replacement arthroplasty, aggravated his flatfoot or bilateral peripheral neuropathy. As the Board noted in its May 2019 Decision, the Veteran's service records do not note a chronic bilateral foot disability, either upon entrance or during service. Nonetheless, as the CAVC ordered in its, July 2020 Remand an adequate VA examination must address direct service connection, with particular attention to the Veteran's claims of foot pain in service. Finally, treatment records identified by the Veteran must be obtained. Specifically, the Veteran reported that he had been treated at the VA clinic in Marquette, Michigan, and at the VA Medical Center (VAMC) in Iron Mountain, Michigan, since January 2015. He also indicated that he was seen for his flat feet at the VAMC Milwaukee, Wisconsin. Reasonable attempts should be made to obtain these records. Accordingly, there this appeal must be returned to the RO to provide an adequate examination. Specifically, the Veteran should be provided with a new examination of the hips by a physician. The examiner must specifically address the Veteran's statements indicating that his knee and ankle disabilities aggravated his hip conditions. Furthermore, the Veteran must also be provided a VA examination of the feet by a physician. The physician examiner must state whether the Veteran's foot pain was incurred in service, related to service, or was caused or aggravated by his service-connected knee or ankle disability. Finally, records must be sought as ordered below. The matters are REMANDED for the following action: 1. Add all outstanding VA treatment records not currently associated with the Veteran's claims file. Special attention should be given to treatment records created at the VA medical clinic in Marquette, Michigan, the VAMC in Iron Mountain, Michigan from January 2015 onward, and pes planus treatment records from the VAMC in Milwaukee, Wisconsin. Document all requests for information as well as all responses in the claims file. If the Veteran has obtained treatment outside of VA, he should be afforded an opportunity to add any applicable records. The RO should also consider whether any records associated with treatment the Veteran received while working with the U.S. Fish and Wildlife Service. 2. Schedule the Veteran for a VA examination by an appropriate clinician for his bilateral hip disabilities. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: Are the Veteran's bilateral hip disabilities at least as likely as not aggravated, i.e., worsened beyond its natural progression by the Veteran's service-connected knee and ankle disabilities. In answering this question, the examiner must pay particular attention to the Veteran's particular knee diagnosis, (degenerative joint disease of the knee, status post torn medial meniscus with meniscectomy, and ankle sprain associated with status post knee replacement arthroplasty), and whether there is a nexus between it and the Veteran's hip disabilities. The examiner should also note the January 1946 article cited by the Veteran in his April 2021 Brief. 3. Schedule the Veteran for a VA examination by an appropriate clinician for his bilateral foot disabilities. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to both of the following questions for each diagnosed foot disability: (1) Is the Veteran's current foot disability at least as likely as not related to service, including the Veteran's January 1973 treatment for bilateral symptomatic flat feet? (2) Is the Veteran's foot disability at least as likely as not aggravated, i.e., worsened beyond its natural progression by the Veteran's service-connected knee and ankle disabilities? 4. In answering these questions, the examiner must pay particular attention to the Veteran's particular knee diagnosis, (degenerative joint disease of the knee, status post torn medial meniscus with meniscectomy, and ankle sprain associated with status post knee replacement arthroplasty), and whether there is a nexus between it and the Veteran's foot disabilities. B.T. KNOPE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Z. Maskatia