Citation Nr: 21042443 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 18-14 118 DATE: July 13, 2021 ORDER Entitlement to service connection for bilateral pes planus, bilateral Morton's neuromas with metatarsalgia status post neurectomy, bilateral hammer toes, left foot Charcot's deformity, Mueller-Weiss syndrome, and bilateral neuropathy associated with bilateral foot injuries is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, he has bilateral pes planus, bilateral Morton's neuromas with metatarsalgia status post neurectomy, bilateral hammer toes, left foot Charcot's deformity, Mueller-Weiss syndrome, and bilateral neuropathy that are at least as likely as not related to bilateral foot injuries incurred in service. CONCLUSION OF LAW The criteria for service connection for bilateral pes planus, bilateral Morton's neuromas with metatarsalgia status post neurectomy, bilateral hammer toes, left foot Charcot's deformity, Mueller-Weiss syndrome, and bilateral neuropathy associated with bilateral foot injuries are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had honorable active military service from July 1981 to June 1985. Additionally, he served with the Army National Guard of Washington from September 1987 to September 1997 during which he served three periods of active duty for special work in the Counterdrug Task Force program from June 1991 to June 1992, June 1992 to August 1993 and August 1993 to February 1994. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a Department of Veterans Affairs (VA) Regional Office (RO)'s August 2016 rating decision. The Veteran testified at a virtual hearing before the undersigned in July 2020. A copy of that hearing is associated with the claims file. 1. Entitlement to service connection for bilateral pes planus (also claimed as bilateral foot condition) The Veteran contends that he injured both of his feet (broke them) during his initial period of active duty from 1981 to 1985, that he has continued to have problems with pain and then numbness in them since service, and that his current foot problems (claimed as pes planus) are a result of the in-service injuries. Resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran has current bilateral foot disabilities that are related to his active 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). April 2016 and June 2019 Disability Benefits Questionnaires completed by the Veteran's private physician show that he has multiple problems with his feet with current diagnoses of bilateral pens planus, bilateral Morton's neuromas with metatarsalgia, hammer toes, left foot Charcot's deformity, Muller-Weiss syndrome and bilateral foot fractures. Thus, the question becomes whether the Veteran's current foot problems are related to his active military service. On this question there is probative evidence, including opinions, in favor of and against the claim. The Veteran's service treatment records do not demonstrate that the Veteran sustained bilateral foot fractures on active duty or that he had any chronic foot problem although they do indicate he sustained a soft tissue injury to the left heel in May 1984. The January 2018 VA examiner also stated that the Veteran's service records indicate he sustained a left toe fracture in 1981, but the record he refers to could not be found. The evidence against the claim includes a January 2018 VA examination and medical opinion. Upon examination, as to diagnoses, the examiner found that the Veteran has pes planus but only in the left foot, Morton's neuroma bilaterally, toe fracture (which the examiner stated he believed involved the left foot although the records did not specify), and bilateral degenerative arthritis. However, the examiner stated that he did not find that the Veteran has pes planus of the right foot as corroborated by X-rays taken the day of the examination. The examiner also stated that the Veteran does not have hammer toes but has webbing between the third and fourth toes bilaterally that leads to them being slightly bent. He further commented that, although the Veteran had Morton's neuromas of the bilateral feet, they were surgically excised in 2008 and he has not had any recurrence of them. He also found that the Veteran has degenerative arthritis of the bilateral feet as shown on X-rays taken at the time of the examination. In addition, the VA examiner provided a medical opinion that it is not at least as likely as not that the Veteran's current foot conditions were incurred in or caused by the claimed in-service foot injuries. The VA examiner's rationale for this opinion is that there is no evidence of any chronic foot complaints until 2008 when the Veteran developed Morton's neuroma in both feet and had them removed. After that, he reports he developed chronic foot pain and neuropathy. The examiner considered it significant that there were no complaints of or treatment for a chronic foot condition in the Veteran's service treatment records and in fact the Veteran specifically denied having any foot issues multiple times after the left toe fracture in 1981. He thought the Veteran's report of having had untreated foot fractures during service that continued to bother him highly unlikely given the lack of evidence of any chronic foot problem until 2008 and because it can be assumed that the Veteran would have had complaints in service if he had but the records are devoid of any complaints of or treatment until 2008. The evidence in favor of the claim includes the DBQs from the Veteran's private physician and a July 2020 written statement in which this private physician opined that it is more probably than not that the military injury (fracture) the Veteran experienced in October 1981 is the cause of his bilateral foot pain with associated neuropathy, developed neuromas, pes planus, left foot Charcot's deformity and Mueller-Wiess Syndrome. This private physician also opined that it is more probable than not that, from the original injury, the Veteran developed Morton's neuroma and hammer toes. This opinion was based upon the physician's review of the Veteran's medical records. In addition, the Veteran submitted a statement from his brother in July 2020 in which his brother states he observed the Veteran's feet were injured in the fall of 1981 when he came home on leave. The brother stated that the Veteran could hardly walk and has had problems with his feet ever since. The Board further acknowledges the Veteran's assertions regarding the VA examiner's attitude and behavior at the VA examination and that he felt the examiner was against him from the beginning. Upon review of the record, the Board finds that it cannot afford more probative value to any particular piece of evidence and that, in taking an evidence as a whole, the favorable and unfavorable evidence is at least in equipoise as to whether the Veteran's current bilateral foot conditions as diagnosed had their onset in service or are otherwise related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for bilateral pes planus, bilateral Morton's neuromas with metatarsalgia status post neurectomy, bilateral hammer toes, left foot Charcot's deformity, Mueller-Weiss syndrome, and bilateral neuropathy associated with bilateral foot injuries in service is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. M. C. GRAHAM Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S.M. Kreitlow 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.