Citation Nr: 22014693 Decision Date: 03/14/22 Archive Date: 03/14/22 DOCKET NO. 16-46 714A DATE: March 14, 2022 ORDER Entitlement to service connection for a bilateral foot condition other than pes planus, to include hallux valgus, hammertoes, callosities, and osteoarthritis, is granted. FINDING OF FACT The probative medical evidence of record reveals that the Veteran's bilateral foot condition was caused by and/or incurred in military service. CONCLUSION OF LAW The criteria for entitlement to service connection for a bilateral foot condition have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from February 1973 to October 1973. This matter is before the Board of Veterans' Appeals (Board) on appeal from a September 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Board previously remanded this matter in September 2019 and June 2021 for additional development. That development having been completed, this claim is once again before the Board. It is further noted that the issue of entitlement to service connection for pes planus was also previously before the Board. However, while on remand, the RO granted the Veteran's pes planus claim in full; thus, that issue is no longer on appeal. As such, no further discussion regarding entitlement to service connection for pes planus shall ensue in the decision that follows. The decision below is limited to a foot disability other than pes planus. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. Generally, to establish service connection the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) 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, 1166-67 (Fed. Cir. 2004). In each case where a Veteran is seeking service connection for any disability, due consideration shall be given to the places, types, and circumstances of such service as shown by the service record, the official history of each organization in which the Veteran served, his or her treatment records, and all pertinent medical and lay evidence. See 38 U.S.C. § 1154(a). In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and recurrent symptoms. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge). Lay evidence can also be competent and sufficient evidence of a diagnosis or to establish etiology if (1) the layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). When considering whether lay evidence is competent the Board must determine, on a case by case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the weight of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Veteran contends that he currently suffers from a bilateral foot condition, other than pes planus, that is the result of military service. The Veteran has stated that he developed foot problems in service due to the marching, walking, running, and physical training required during boot camp. A review of the Veteran's service treatment records show that only bilateral pes planus was documented on the Veteran's January 1973 entrance examination; nonetheless, he was found fit for duty. In February 1973, the Veteran sought treatment on at least three occasions for foot pain caused by corns and/or callouses. On his September 1973 separation examination, the Veteran specifically denied foot trouble. A review of the Veteran's post-service outpatient treatment records show that he underwent surgery to correct hammertoes and remove corns from both feet in July 1980. He continues to receive regular treatment from a VA podiatrist for the above mentioned foot problems and associated pain in his feet. The Veteran was provided with a VA examination in August 2015. In addition to pes planus, the examiner identified past treatment for hammertoes and calluses, as well as current osteoarthritis. However, he only provided an opinion for the pes planus and did not further discuss the remaining foot conditions. The Veteran underwent a VA foot conditions examination in January 2020. The VA examiner only noted the Veteran's diagnoses of hammertoes and osteoarthritis apart from his pes planus on the examination report. The VA examiner opined that they were less likely than not incurred in or caused by service. In making this finding, the examiner stated that there is only one service treatment record, dated February 24, 1973, wherein the Veteran presented for care with complaint of "bad foot," before concluding that there was no evidence of continuity of care and/or treatment for any foot disorder. No further explanation was provided. The Veteran was provided with an additional VA examination in September 2021. The Veteran was diagnosed with hallux valgus, hammertoes, callosities, and arthritis, apart from pes planus. The examiner opined that these conditions were at least as likely as not caused by or incurred in military service. In support, the examiner explained that the Veteran's pre-existing pes planus when combined with an in-service right ankle injury and prolonged marching, walking, running, and physical training required during boot camp all served to exacerbate the Veteran's bilateral foot conditions, leading to the development of hammertoes, hallux valgus, calluses, and arthritis. Because of the interplay between these conditions and the constant stress placed on the feet during training, the medical literature supports that the later development of hammertoes, hallux valgus, calluses, and arthritis as a result these biomechanical processes were likely. Having reviewed the complete record, the Board finds that service connection for a bilateral foot condition, other than pes planus, including hammertoes, hallux valgus, calluses, and arthritis, is warranted. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for a bilateral foot disability, other than pes planus, is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. (CONTINUED ON NEXT PAGE) A. ADAMSON Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Dodd, Ryan 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.