Citation Nr: 23016902 Decision Date: 03/19/23 Archive Date: 03/19/23 DOCKET NO. 17-30 299 DATE: March 19, 2023 REMANDED Entitlement to service connection for a right foot disability, to include plantar fasciitis is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from August 1979 until his honorable discharge in June 1992. These matters come before the Board of Veterans' Appeals (Board) on appeal from the February 2016 rating decision by the Regional Office of the United States Department of Veterans Affairs (VA). In October 2020, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the record on appeal. During the hearing, the undersigned held the record open for 30 days to allow for the submission of additional evidence; however, no additional evidence was added to the record within that time period. In September 2021 and June 2022, the Board remanded the case to the Regional Office for further development. Specifically, the most recent Board remand directed the Regional Office to (1) ask the Veteran to complete a VA Form 21-4142 for any private records from any provider that has diagnosed and/or treated the Veteran's right foot disability, and (2) provide the Veteran with a new VA examination. In response, in June 2022, the Regional Office obtained updated VA treatment records and sent the Veteran a subsequent development letter to obtain private treatment records. In October 2022, the Regional Office obtained a new VA examination with addendum opinions received in November 2022 and December 2022. As noted above, the Board remanded this matter in September 2021 and June 2022, most recently to include obtaining any private treatment records. The June 2022 Board remand directed the RO to ask the Veteran to complete a VA Form 21-4142 for any private provider who treated or diagnosed the Veteran with a right foot disability. The record indicates that in a June 2022 letter, the Veteran was directed to return the enclosed VA Form 21-4142 (Authorization to Disclose Information to the Department of Veterans Affairs (VA)) and VA Form 21-4142a (General Release for Medical Provider Information to the Department of Veterans Affairs (VA)) to obtain treatment records on the Veteran's behalf. However, the evidence does not reflect that the Veteran ever responded to the June 2022 correspondence. Therefore, the Veteran is hereby notified that the duty to assist is a two-way-street. Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). If the Veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information essential in obtaining the relevant evidence. Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). REMANDED Entitlement to service connection for a right foot disability, to include plantar fasciitis is remanded. Where VA provides the veteran with an examination, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The October 2022 VA examiner opined that the Veteran's right foot disabilities are less likely than not proximately due to, the result of, or aggravated beyond their natural progression by the Veteran's service-connected right knee and/or left knee disabilities because they "cannot find any medical literature to support plantar fasciitis being secondary to..." the Veteran's bilateral knee disabilities; additionally age and obesity are also other risk factors likely contributing to the Veteran's plantar fasciitis. The Board notes that within the October 2022 opinion(s), the VA examiner cited a single website source that they searched, but failed to provide a detailed rationale nor address if their the inability to locate medical literature is due to a lack of personal knowledge (the examiner does not have the knowledge or training); or a lack of knowledge in the medical community (no one could respond given medical science and the known facts); or a deficiency in the record (additional facts are required). Within the November 2022 opinion(s), the VA examiner noted that "the Veteran claimed [his pes planus] existed upon entry." However, the lack of acknowledgement that the Veteran's service treatment records reflect a diagnosis of pes planus on the entrance examination raise questions of the file review and consideration of the service treatment records, including the Veteran's entrance examination. Finally, the November 2022 opinion provides that it is more likely that the pes planus is a "factor" in the development of the Veteran's plantar fasciitis without providing a detailed rationale nor explanation on the basis of the opinion(s) provided. The December 2022 addendum opinion asserts that the Veteran's service treatment records do not support symptoms of plantar fasciitis and the record(s) are silent for plantar fasciitis up until November 2021. However, the December 2022 VA examiner does not identify the symptoms that would be present, if the disability had been present. For example, an explanation as to why the Veteran's in-service foot pain report(s) are not considered symptom(s) of plantar fasciitis would be helpful. Finally, the Board notes that the single website source (https://emedicine.medscape.com/article/86143-overview#a5) is an article that addresses a cursory overview of plantar fasciitis including etiology (1 paragraph), extrinsic risk factors (2 paragraphs), intrinsic risk factors (5 paragraphs). A quick review of the cited single website also notes that there are additional discussions available [background, anatomy, etiology, epidemiology, prognosis, etc.] that the VA examiner did not address. Furthermore, the VA examiner did not provide any source(s) for opinions pertaining to the pes planus disability. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for any period that is not already of record. 2. Ask the Veteran to complete a VA Form 21-4142 for any private provider that has diagnosed and/or treated the Veteran for a right foot disability, that is not already of record. Make two requests for the authorized records from any identified private provider that has diagnosed and/or treated the Veteran for a right foot disability, that is not already of record, unless it is clear after the first request that a second request would be futile. If the Veteran does not have any outstanding private treatment records diagnosed and/or treating any right foot disabilities, it would be appreciated if the Veteran responded that there are no additional private treatment records. 3. After the above has been completed, schedule the Veteran for a VA examination, preferably with a medical doctor, for his right foot disabilities. The examiner must review the claims file, including but not limited to a copy of this remand, service treatment records, and all prior examinations. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: For each and every identified right foot disability, is the disability at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) related to service, including but not limited to the May 1982 report of right (bilateral) foot pain. See May 31, 1982 Service Treatment Records received on April 26, 2005, page 40; see also Service Treatment Records received on April 26, 2005, page 9 [separation examination]. In providing the requested opinion, consider the Veteran's description of his in-service injury and/or symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? For each identified right foot disability, is the right foot disability at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) proximately due to a service-connected disability and/or a combination of service-connected disabilities, i.e. right and/or left knee disabilities)? For each identified right foot disability, is the right foot disability at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) aggravated, i.e., worsened beyond its natural progression, by a service-connected disability and/or a combination of service-connected disabilities, i.e. right and/or left knee disabilities)? For each identified right foot disability, is the right foot disability at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's right foot disability (1) began during active service, (2) manifested within 1-year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service? Did the Veteran's right foot pes planus clearly and unmistakably (undebatable) preexist the Veteran's service? See August 23, 1979 enlistment examination, clinical evaluation. Why do you say so? If the examiner finds that the Veteran's right foot pes planus did clearly and unmistakably preexist service, was it clearly and unmistakably not aggravated by service? If the examiner finds that the Veteran's right foot pes planus either did not clearly and unmistakably preexist service or was not clearly and unmistakably not aggravated by service, the examiner must opine whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) related to service, including May 1982 report of right (bilateral) foot pain. Did the Veteran's right foot pes planus which existed prior to service, at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) increase in severity during service? If so, was the increase in severity clearly and unmistakably (undebatable) due to the natural progress of the disease? The examiner must also specifically address the Veteran's separation examination in which no foot disability was diagnosed. The examiner must provide a detailed rationale for all opinions, including citations to any medical and/or scientific research that the examiner has relied upon. If the examiner is unable to provide an opinion, the examiner must note if the inability is due to a lack of personal knowledge (the examiner does not have the knowledge or training); or a lack of knowledge in the medical community (no one could respond given medical science and the known facts); or a deficiency in the record (additional facts are required). M. Tenner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Deemer, 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.