Citation Nr: 23056841 Decision Date: 10/18/23 Archive Date: 10/18/23 DOCKET NO. 20-17 888 DATE: October 18, 2023 ORDER Entitlement to service connection for bilateral plantar fasciitis, claimed as bilateral heel pain, is denied. FINDING OF FACT The evidence of record persuasively weighs against finding that bilateral plantar fasciitis began during active service or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for bilateral plantar fasciitis are not 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 served on active duty in the United States Army from July 1989 until his honorable discharge in November 1989, from August 1991 until his honorable discharge in December 1991, from October 2002 until his honorable discharge in August 2003, and from March 2006 until his honorable discharge in July 2007. These matters come before the Board of Veterans' Appeals (Board) on appeal from a November 2018 rating decision of the Regional Office of the Department of Veterans Affairs (VA). The Veteran requested a Board hearing in his March 2020 VA Form 9 that was later cancelled. Service Connection VA provides compensation for a disability resulting from disease or injury incurred in or aggravated by service. This is referred to as a "service connection." 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Regulations also provide that 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). Generally, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran 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 - the so-called "nexus" requirement. Holton v Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially 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). 1. Entitlement to service connection for bilateral plantar fasciitis, claimed as bilateral heel pain. The Veteran asserts that his bilateral plantar fasciitis is due to active service. The Veteran has been diagnosed with bilateral plantar fasciitis and complains of pain in both feet. See November 2018 VA Examination. This diagnosis is supported by the VA treatment records. As a result, he has met the first element of service connection. In a 2007 post deployment health reassessment, the Veteran reported numbness or tingling in his feet that he associated with service and pain that radiated down his legs to his feet. See September and November 2007 Service Treatment Records. A June 2007 service treatment record reported right lower back and right hip pain that radiated down the leg to the foot. The Board also notes that the Veteran served in a designated imminent danger pay area, in Operation Iraqi Freedom, and engaged in combat with the enemy. His combat experience included exposure to IED explosions. See Service Treatment Records, Buddy Statements, and Private Medical Treatment Records. Under the so-called "combat presumption," where the evidence shows that a veteran engaged in combat with the enemy, his or her lay reports will be sufficient to establish the occurrence of an event or injury during combat if such reports are consistent with the circumstances, conditions, or hardships of such service. This is true even if there is no official record of the reported incident unless there is clear and convincing evidence to the contrary. 38 U.S.C. § 1154(b); 38 C.F.R. § 3.304(d). This presumption also extends to a combat veteran's reports of experiencing a permanent disability beginning at the time of injury during combat. Reeves v Shinseki, 682 F.3d 988, 998-1000 (Fed. Cir. 2012). However, "[e]ven when the statutory combat presumption applies, a veteran seeking compensation must still show the existence of a present disability and that there is a causal relationship between the present disability and the injury, disease, or aggravation of a preexisting injury or disease incurred during active duty." Id. at 999 n. 9. The Veteran's VA Form 9 and Notice of Disagreement (NOD) do not include any assertions that an injury to the heels of the feet was incurred during combat. Rather, during his 2018 VA examination the Veteran reported onset of pain in the feet and toes in 2007. There is no substantive lay explanation for how the Veteran injured his feet during service. The November 2018 VA examiner provided a negative nexus opinion and rationale. The examiner found, "Review of claims file shows c/o radiating pain across lateral right hip to front of RLE and will radiate to foot on June 12, 2007. This is due to Veteran's lumbar degenerative changes noted on June 11, 2007. Review of claims file does not show any other objective evidence of right and left foot pain during service." The Board also finds that a February 2006 service treatment record notes that the Veteran had normal feet and arches. The Board finds that the Veteran has not met the second element of service connection. There is no competent, probative medical evidence from service that the Veteran had a diagnosis of heel pain or plantar fasciitis. Furthermore, the Veteran has not stated how he injured his heels during service or how he injured his heels during combat. The absence of diagnosis or reference of the disability in service is not enough to deny the claim. The Veteran reported never receiving medical treatment for his feet in service. See November 2018 VA Examination. The Veteran reported the following: Veteran complains of bilateral heel pain. Veteran ... was never seen in service for condition. Veteran states he has had pain to his bilateral heels upon sitting, standing and walking. Veteran states he can sit for 5 minutes, stand for 5 minutes and walk for 5 minutes before bilateral heel pain develops causing him to stop and rest his heels. Veteran states he has flare up of bilateral heel pain daily up to 24 hours. Veteran states he uses shoe inserts to ease his bilateral heel pain. Veteran states he has no surgeries. See November 2018 VA Examination. The Board finds that the Veteran is competent to report his symptoms. See Jandreau v. Nicholson, 492 F. 3d 1372, 1377 (2007). However, the Veteran is not competent to provide a nexus opinion. In August 2007, the Veteran reported that he had "low back pain to right L5 described as knife like with 'razor blades' to the right heel, x1 year, no injury." See VA Treatment Records. This record and the service treatment records cited above do not refer to plantar fasciitis pain, but to lumbar pain radiating down the leg to the feet, as noted by the examiner. The Board finds that the medical evidence of record, including the examiner's opinion that the Veteran's foot pain in service was his radiating lumbar spine pain and that his plantar fasciitis was not diagnosed until 2018, is more probative than the Veteran's statements that he had heel or foot pain in service. As such, the Board finds that there has not been an incurrence of plantar fasciitis during service. The Board finds that the Veteran does have a current diagnosis of plantar fasciitis which was diagnosed in 2018, 10 years after his discharge from service. In the intervening years the Veteran has reported numerous service-connected disabilities to medical providers and did not report his plantar fasciitis until years later. Although the Veteran experienced combat during service, there are no lay statements or other evidence of record to establish how he incurred a heel injury during service. As such, the Board must deny the Veteran's claim for entitlement to service connection for plantar fasciitis. M. Tenner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. A. Johnston, 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.