Citation Nr: 21042664 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 17-00 564 DATE: July 13, 2021 REMANDED Entitlement to service connection for bilateral pes planus is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1984 to November 1987. The Board previously remanded this case in December 2018 for further development. After reviewing the evidence of record, the Board finds additional development is needed. 1. Entitlement to service connection for bilateral pes planus. Service connection generally requires the existence of a present disability, the in-service incurrence or aggravation of a disease or injury, and a causal relationship between the present disability and the disease or injury incurred or aggravated during service. 38 C.F.R. § 3.303(a); Shedden v. Principi, 381 F.3d 1163, 1167 (2004). Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). The Veteran's private medical treatment records, as well as a prior VA examination of January 2017, reflect that she has been diagnosed with bilateral pes planus. See January 2017 VA Examination Report at 1; see also May 2013 Medical Treatment Records at 11. However, the Veteran's private medical records do not express an opinion as to the etiology of this condition. Further, the Board previously found that the January 2017 VA examiner's opinion on this point was inadequate because it relied on an absence of documentation of in-service treatment. The Board therefore remanded this case for an addendum medical opinion, which was provided in April 2019. The April 2019 examiner indicated that he reviewed the Veteran's claims file, as directed by the Board. The April 2019 examiner's opinion, however, appears to restate the 2019 examiner's opinion which has been determined to be inadequate and provides indication that cramps on their own are not a disability for compensation purposes. This, however, does not provide a rationale regarding whether the Veteran's in-service symptoms of foot cramps and continuous symptoms since that time at least as likely as not supports the Veteran's contentions that her current pes planus had onset during, or is etiologically related to, her period of active service. As such, the Board finds that a new VA medical opinion must be obtained to address the issue on appeal. This matter is therefore REMANDED for the following action: Schedule an examination to determine the etiology of the Veteran's pes planus. The examiner must report review of the claims file. The examiner is asked to opine as to the following: a) Whether it is at least as likely as not (50 percent or greater probability) that bilateral pes planus was incurred in, or otherwise caused by, the Veteran's active service. The Board calls the examiner's attention to the Veteran's contention during the January 2017 VA examination that she had nightly cramps in her feet during her active duty service and that these have continued to the present, as well as her other lay reports of continuity of symptoms since her active duty service. The examiner should be aware that the absence of treatment for a foot condition in the Veteran's service treatment records, alone, does not preclude a positive nexus opinion. A complete rationale for all opinions must be provided. In providing the requested opinions, the examiner must address the Veteran's lay assertions. Lay statements of record cannot be disregarded solely due to lack of contemporaneous medical evidence. If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and the examiner must provide a rationale for this determination. Patrick M. Johnson Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Blore, 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.