Citation Nr: 21039738 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 17-16 506 DATE: July 1, 2021 ORDER Entitlement to service connection for a left ankle disability is granted. Entitlement to service connection for a right ankle disability is granted. FINDINGS OF FACT 1. Resolving all reasonable doubt in the Veteran's favor, the evidence is in equipoise as to whether the Veteran's current left ankle disability is related to service. 2. Resolving all reasonable doubt in the Veteran's favor, the Veteran's right ankle disability is related to his service-connected left ankle disability. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a left ankle disability have been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for a right ankle disability have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1973 to July 1976 and from August 1990 to February 1991. This matter comes before the Board of Veterans' Appeals (Board) from a September 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In March 2020, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record. The case was last before the Board in September 2020 and has returned to the Board for further appellate review. Service Connection 1. Entitlement to service connection for a left ankle disability 2. Entitlement to service connection for a right ankle disability The Veteran seeks service connection for a left ankle disability and right ankle disability. Specifically, the Veteran asserts that his current left ankle disability was caused by an ankle injury he suffered during service, and that his right ankle disability is secondary to his left ankle disability. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Generally, to prove service connection there must be: (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). Where a veteran served continuously for 90 days or more during active service and certain chronic diseases, including arthritis, become manifest to a degree of 10 percent within one year from date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. Service connection may also be established for a disability which is proximately due to or the result of a service-connected disability. 38 C.F.R. § 3.310(a). Further, a disability which is aggravated by a service-connected disability may be service-connected to the degree that the aggravation is shown. Allen v. Brown, 7 Vet. App. 439 (1995). However, VA will not concede that a nonservice-connected disease or injury was aggravated by a service-connected disease or injury unless the baseline level of severity of the nonservice-connected disease or injury is established by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the nonservice- connected disease or injury. 38 C.F.R. § 3.310. With regard to the Veteran's claimed left ankle disability, the Board finds that the Veteran has been diagnosed with degenerative arthritis of the left ankle, as shown by VA treatment records. Thus, the question for the Board is whether the Veteran's current left ankle disability is related to service. Service treatment records reveal the Veteran was diagnosed with a sprained left ankle after he injured his ankle while playing basketball in September 1990. The Veteran subsequently underwent physical therapy and a November 1990 service treatment record indicates that his left ankle sprain was resolved. Thereafter, post-service VA treatment records show no complaints of or treatment for a left ankle disability until 2010, when the Veteran reported that his ankle locks up on him and will pop. In January 2021, the Veteran underwent a VA examination at which time the examiner indicated that the Veteran had a diagnosis of bilateral ankle old healed medial malleolar avulsion chip fracture, but found that he did not have a diagnosis of degenerative or traumatic arthritis. The examiner opined that the Veteran's claimed left ankle disability was less likely than not incurred in or caused by service. In rendering this opinion, the examiner noted there is no evidence of a left ankle fracture during service or that the Veteran's condition was chronic or reoccurring in nature to result in a persistent disability pattern. In October 2020, Dr. M.G., found that the Veteran had diagnoses of bilateral ankle degenerative arthritis, a left anterior talofibular ligament (ATFL) tear, and partial thickness tendon tear of the right ATFL. Dr. M.G. opined that the Veteran's left ankle arthritis is at least as likely as not due to the Veteran's left ankle injury which occurred during service. In support of his opinion, Dr. M.G. explained that chronic strain on the left ankle can cause the development of degenerative arthritis. Dr. M.G. also opined that the Veteran's left ATFL tear is at least as likely as not due to the degenerative arthritis of the left ankle as worsening of degenerative arthritis can cause a tear of the ATFL. Furthermore, Dr. M.G. explained that due to the Veteran's left ankle condition the Veteran favors his left ankle while walking, putting more weight on the right ankle which caused chronic strain of the right side. As such, he opined that the degenerative arthritis of the Veteran's right ankle is at least as likely as not due to his chronic left ankle disability. The Board notes that Dr. M.G indicated that his opinions were based on review of the Veteran's service and VA treatment records. Upon review of the evidence of record, the Board finds that the evidence is at least in equipoise as to whether Veteran's current left ankle disability is related to service, and whether the Veteran's right ankle disability is related to his now service-connected left ankle disability. Accordingly, resolving all doubt in the Veteran's favor, service connection for a left ankle disability on a direct basis and for a right ankle disability on a secondary basis is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. K. A. BANFIELD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Lance, 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.