Citation Nr: 21042437 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 10-26 187 DATE: July 13, 2021 REMANDED Entitlement to service connection for a bilateral foot disability, to include arthritis, bone spurs, and neuromas is remanded. Entitlement to a total disability rating based on individual unemployability TDIU is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1968 to July 1969. This matter initially came before the Board of Veterans' Appeals (Board) on appeal from April 2012 and October 2008 rating decisions issued by the Agency of Original Jurisdiction (AOJ). The appeal was remanded in October 2015 and January 2020 for further development. The claim was most recently remanded to obtain an adequate medical opinion as to the etiology of the Veteran's bilateral foot disabilities. A new medical opinion was associated with the file in February 2020. However, the Board finds that the medical opinion is inadequate. Thus, the Board determines that there has not been substantial compliance with the January 2020 remand directives and further remand is required. See Stegall v. West, 11 Vet. App. 268 (1998) (holding that remand not required where there was substantial compliance with remand directives). 1. Entitlement to service connection for a bilateral foot disability, to include arthritis, bone spurs, and neuromas is remanded. The Veteran contends that his disabilities of the bilateral feet are caused or aggravated by his service-connected ankle conditions. Specifically, the Veteran argues that he has limited circulation to his feet as a result of his service-connected aseptic necrosis which results in pain and aggravation of his disabilities. Private treatment records from November 2003 confirm that the Veteran complained of chronic pain in both feet as the result of a 1969 injury which interrupted circulation to both feet. Additionally, the Veteran reported that he has been prescribed support hose to reduce chronic pain and swelling in his ankles and feet. Pursuant to the Board's January 2020 remand, the Veteran was provided a new VA examination in February 2020 to determine the nature of the Veteran's feet conditions and their relationship to his service-connected disabilities. The Veteran was diagnosed with arthritis, heel spurs and neuromas. The examiner opined that it was less likely than not that the Veteran's diagnosed conditions were related to his service-connected disabilities. Although the opinions provided are facially valid, the examiner did not address the Veteran's contention that loss of circulation due to his aseptic necrosis impacted his bilateral feet. Accordingly, further remand is necessary to ensure compliance with the January 2020 remand directives. A VA examiner should provide an addendum opinion that adequately addresses the lay evidence of record and all theories of entitlement. 2. Entitlement to a TDIU is remanded. Finally, because a decision on the issue of service connection for a bilateral foot disability could significantly impact a decision on the issue of TDIU, the issues are inextricably intertwined. A remand for the claim for TDIU is required. The matters are REMANDED for the following action: 1. The AOJ should forward the entire claims file in electronic records to the February 2020 VA examiner, if that examiner is unavailable, then to a suitably qualified VA examiner. The examiner should review the claims folder and acknowledge such review. If additional examination is indicated, it should be scheduled in accordance with applicable procedures and all indicated studies should be performed. The examiner should provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's bilateral foot disability, to include arthritis, bone spurs, and neuromas is caused or aggravated by the Veteran's service connected ankle disabilities and any associated treatment. The examiner should address the Veteran's service treatment records, post-service medical records, and lay statements. Specifically, the examiner must comment on the Veteran's contention that his service-connected aseptic necrosis has interrupted circulation to his feet. All opinions must be accompanied by a clear rationale. If the examiner opines that any of the above questions cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. 2. After ensuring compliance with these objectives, the AOJ should readjudicate the remanded claims, to include the claim for a TDIU. If either benefit sought on appeal is not granted, the Veteran should be provided a supplemental statement of the case and an appropriate time period for response. GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Sherman 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.