Citation Nr: 22017653 Decision Date: 03/25/22 Archive Date: 03/25/22 DOCKET NO. 10-46 322 DATE: March 25, 2022 ORDER Entitlement to service connection for a left foot hallux valgus is granted. FINDING OF FACT Resolving all reasonable doubt in favor of the Veteran, his diagnosed left foot hallux valgus is etiologically related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for left foot hallux valgus have been met. See 38 U.S.C. §§ 1131, 1137, 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 Army from September 1983 to September 1986. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2008 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before a Veterans Law Judge (VLJ) in July 2014. The claims were Remanded for further development in February 2015. The VLJ that took the Veteran's testimony in 2014 was no longer associated with the Board. The Veteran then testified before the undersigned Veterans Law Judge in September 2020. Transcripts of both hearings are of record. The claim was once again remanded in January 2021. In compliance with the Board remand instructions an addendum opinion was provided. Further, in an April 2021 rating decision, service connection was granted for lumbosacral strain and right knee strain. Thus, these issues are no longer before the Board, as this represents a full grant of benefits sought on appeal. SERVICE CONNECTION Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(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." See Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). 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 persuasive evidence is against the claim, in which case the claim is denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the claimant. Entitlement to service connection for a left foot disability to include hallux valgus is granted. The Veteran was diagnosed with left foot hallux valgus in an October 2015 VA examination. The first element of Shedden is met. The Veteran reports that during service he had bunions that developed on both of his feet. See July 2014 Hearing Transcript. When he got out of service, he could not wear regular shoes and walked funny. Id. He further asserted that he did not have bunions prior to military service. Id. He reported having a bunionectomy in 1996 but continued to experience problems with stiffness. He emphasized that service boots during his period of service had changed, and that service members could now wear tennis shoes in some instances. Id. The Board finds that the Veteran is a credible and reliable historian as to the in-service incurrence. See Layno v. Brown, 6 Vet. App. 465 (1994); Barr v. Nicholson, 21 Vet. App. 303, 308 (2007). The second element of Shedden is met. As to the third element of Shedden, the record includes both a positive and negative nexus opinion. In an October 2015 medical opinion, the VA examiner determined that hallux valgus deformities are very common, and it is well known that it can be worsened by shoe wear. The determination was made that the Veteran's left hallux valgus condition was worsened beyond its natural history by his military service obligations. In a February 2016 medical opinion, the VA examiner determined that his claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner emphasized that the Veteran's service records do not document a chronic on-going treatment or condition for left foot. The examiner also acknowledged that another provider gave an opinion that his left foot was aggravated by service and caused by service based on the presumption that anyone in service who wore shoes would later develop foot problems. However, the examiner stated that this presumption is not supported by the majority of peer-reviewed literature. In a July 2021 medical opinion, the VA examiner found, in pertinent part, that the Veteran's left foot hallux valgus was due to a foot deformity of the first metatarsophalangeal joint due to tight shoes. The above medical opinions are no more or less probative than the other. They each contain some level of deficiency. Ultimately, the Board finds that the evidence is in relative equipoise as to whether his left foot hallux valgus is related to service. The third element of Shedden is met. Accordingly, the Board resolves all reasonable doubt in the Veteran's favor and finds that service connection for left foot hallux valgus is warranted. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Smith, 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.