Citation Nr: 21031138 Decision Date: 05/20/21 Archive Date: 05/20/21 DOCKET NO. 17-22 163 DATE: May 20, 2021 ORDER Entitlement to service connection for a left foot disability is granted. FINDING OF FACT The evidence of record favors a finding that the Veteran's left foot disability, diagnosed as a foot injury and malunion/nonunion of the tarsal/metatarsal bones, is related to an injury that occurred during a period of active duty for training (ACDUTRA). CONCLUSION OF LAW The criteria for service connection for a left foot disability are met. 38 U.S.C. §§ 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Army Reserves with a period of ACDUTRA from May 1988 to September 1988. Service Connection The Veteran claims entitlement to service connection for a left foot disability. During her March 2021 hearing before the undersigned Veterans Law Judge, she stated that she injured her left foot during basic training when she was rushing downstairs and felt pain when she stepped from the stairs to the floor. See March 2021 Hearing Transcript, p. 3. She stated that she did not want to get a medical discharge, so she pushed through the pain without seeking treatment, and that she eventually sought treatment in March or April 1989. Id. at pp. 3-4. For the reasons explained below, the Board concludes that the Veteran's current left foot disability, diagnosed as a foot injury and malunion/nonunion of the tarsal/metatarsal bones, is at least as likely as not related to her military service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, in order to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. The term "active military, naval, or air service" includes: (1) active duty; (2) any period of 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 inactive duty from training during which the individual concerned was disabled or died from an injury incurred or aggravated in the line of duty, or from an acute myocardial infarction, a cardiac arrest, or a cerebrovascular accident which occurred during such training. 38 U.S.C. § 101(2), (24) (2018); 38 C.F.R. § 3.6(a) (2020). Regarding the first element of service connection, the presence of a current disability, the Board acknowledges that the objective medical evidence of record reflects diagnoses of left foot injury and malunion/nonunion of the tarsal/metatarsal bones. See April 2017 VA Form 21-0960M-6, Foot Conditions, Including Flatfoot (Pes Planus) Disability Benefits Questionnaire (DBQ). Next, regarding an in-service disease or injury, the Board finds this element is also met. Although the Veteran's service treatment records are silent as to any complaints of, or treatment for, any foot-related disorder, the Board notes that she is competent to report in-service injuries and symptoms of pain in left foot, and that these symptoms have continued since then. See Layno v. Brown, 6 Vet. App. 465, 470 (1994); 38 C.F.R. § 3.159(a)(2) (2020). Moreover, the Board notes that her reports of injuring her left foot during her period of ACDUTRA have been consistent since March 1989, when she reported injuring her left foot during basic training in June 1988. Accordingly, the Board finds that the Veteran's lay statements concerning her in-service injury and symptoms are competent and credible evidence of an in-service injury or disease. Thus, the question becomes whether the Veteran's current left foot disability is related to her military service. On this question, the Board finds that, after resolving all reasonable doubt in the Veteran's favor, her current left foot disability is due to her military service. In a March 1989 letter, the Veteran requested medical treatment through the United States Army for a fractured sesamoid bone in the left foot after injuring the foot during basic training in June 1988. A January 1990 letter from the Veteran's private treatment provider noted that she had been treated since April 1989 for a fractured fibular sesamoid bone of the left foot metatarsophalangeal joint. A November 1990 private treatment record noted that the Veteran was placed in a biomechanical orthotic device to control a painful sesamoid condition of the left foot. A May 2013 private treatment record noted that the Veteran had been treated successfully since late 1990 with a biomechanical orthotic device to control a painful sesamoid condition of her left foot. In a September 2015 letter, the Veteran's private treatment provider concluded that the Veteran's left foot injury and subsequent nonunion fracture of the sesamoid bone in the left foot was the direct result of her in-service injury. The treatment provider noted that she was originally treated in 1989 after she suffered an injury during her tenure with the Army. The treatment provider noted that, despite conservative measures, her condition was unresponsive, and she suffered from persistent pain. The treatment provider went on to say that it was obvious form the mechanism of injury that the subsequent pathological podiatric problems began in March 1989 during her military service, and that the area was acutely subject to posttraumatic complications that could be maintained, but never completely resolved. In support of her claim, the Veteran submitted an April 2017 DBQ completed by her private treatment provider who noted that the Veteran's left foot disability was originally diagnosed in January 1989 after suffering a fracture of the sesamoid bone during basic training that did not heal and was now a painful nonunion in the left foot. VA did not obtain a medical opinion addressing the etiology of her claimed left foot disorder, and there are no other probative opinions of record linking left foot disorder to any other source. Given the Veteran's competent and credible lay statements concerning her left foot injury during ACDUTRA and the onset of left foot symptoms, as well as the September 2015 opinion from the Veteran's private treatment provider attributing her current left foot disability to her in-service injury, the Board finds that the evidence favors a finding that her left foot disability is related to her military service. (CONTINUED ON NEXT PAGE) Accordingly, service connection for a left foot disability is granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. V. Chiappetta Veterans Law Judge Board of Veterans' Appeals Attorney for the Board James R. Springer, 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.