Citation Nr: 21042806 Decision Date: 07/14/21 Archive Date: 07/13/21 DOCKET NO. 18-44 255 DATE: July 14, 2021 REMANDED The issue of service connection for left foot arthritis is remanded. REASONS FOR REMAND The Veteran had active duty in the United States Army from July 1959 to August 1991 as a chief warrant officer and helicopter pilot with service in the Republic of Vietnam and in Southwest Asia. This matter comes before the Board of Veterans' Appeals (Board) from a June 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) which denied the claim of service connection for left foot arthritis and continued the previous denial of service connection for right foot arthritis. The Veteran submitted a Notice of Disagreement (NOD) in July 2018 and only appealed the claim of service connection for left foot arthritis. Thus, the application to reopen the previously denied claim of service connection for right foot arthritis is not before the Board. 38 U.S.C. § 7105 ("Notices of disagreement ... shall identify the specific determination with which the claimant disagrees"). A Statement of the Case (SOC) was issued in August 2018. The Veteran perfected an appeal by submitting a timely VA Form 9 in September 2018 insisting that his left foot arthritis was due to his service. There was no mention of his claim of service connection for right foot arthritis. The Veteran appeared in a May 2021 hearing. A transcript of that hearing has been associated with the record. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.902(c). 38 U.S.C. § 7107(b). The issue of service connection for left foot arthritis is remanded. The Veteran contends that his current left foot arthritis was caused by constant exposure to cold while piloting helicopters in service. The Veteran also contends that he has had symptoms continuously since service. In April 2018, the Veteran was afforded a VA examination for his left foot arthritis. The Veteran reported that at discharge he thought that his feet were "ok except for the fungal infection." He believed that his arthritis was directly related to all the training exercises and wearing combat boots for 32 years. The examiner opined, however, that the Veteran's left foot arthritis was less likely than not caused by his service as the "Veteran was discharged from military service in 1991 with no report of a foot pain or history of injury" and as it is "now 26 later with minimal [degenerative joint disease] of the feet." Outside of the lack of contemporaneous treatment records and passage of time between discharge and diagnosis, there were no other rationale offered to support the opinion, and there was no discussion of the Veteran's contention of his arthritis being caused by his exposure to cold. The Board finds the April 2018 VA examination to be inadequate. First, the examiner effectively engaged in an improper credibility determination by relying on the absence of documented medical treatment records over the Veteran's lay statements of continuous symptoms since service. Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) ("[T]he Board cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence"); see also Sizemore v. Principi, 18 Vet. App. 264, 271 (2004) (noting that credibility determination is not a medical matter and therefore a matter for the Board). The examiner also did not explain the significance of "minimal" degenerative joint disease of the feet in relation to the passage of time since discharge. Specifically, it is unclear if there is a degree of degenerative joint disease that could suggest a relationship with the Veteran's active service, as contrary to the examiner's rationale, the imaging study cited in the April 2018 VA examination notes that the Veteran had "mild" degenerative joint disease at the first metatarsophalangeal joint with "minimal changes elsewhere in the left foot." See Nieves-Rodrigues v. Peake, 22 Vet. App. 295 (2008). VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121 (1991). When VA obtains an evaluation, the evaluation must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Lastly, as the examiner did not address all the Veteran's contentions, the examination is inadequate. See Moore v. Derwinski, 1 Vet. App. 401, 404 (1991) ("the Board must include in its decisions 'the precise basis for that decision ... [and] the Board's response to the various arguments advanced by the claimant.'" (alterations in original) (quoting Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990))). The matter is REMANDED for the following action: Obtain an addendum VA medical opinion regarding the Veteran's left foot arthritis. Specifically, the examiner must opine whether it is at least as likely as not (50 percent or greater probability) that left foot arthritis was caused by service, to include exposure to cold and wearing combat boots for his 32 years of service. A rationale for all opinions is to be provided. Specifically, the examiner should discuss the nature of the Veteran's left foot arthritis, to include its likely cause if it is not the Veteran's service. Medical factors relevant in formulating the opinion should be identified and discussed, including the respective weight assigned by the examiner. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). The need for another examination is left to the discretion of the examiner offering the addendum opinion. J.W. FRANCIS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board H. S. Yun, 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.