Citation Nr: 23017378
Decision Date: 03/20/23	Archive Date: 03/20/23

DOCKET NO. 16-19 508
DATE: March 20, 2023

REMANDED

Entitlement to service connection for a bilateral foot disorder, claimed as plantar fasciitis with tibial sesamoiditis (with bilateral foot polysensory neuropathy) and pes planus, to include as secondary to Achilles tendonitis is remanded.

REASONS FOR REMAND

The Veteran served on active duty from December 1981 to December 1984.

This matter comes before the Board of Veterans' Appeals on appeal from a rating decision issued by a Department of Veterans Affairs (VA) Regional Office.

By way of procedural background, the Veteran's claim was initially denied by the Board in a November 2019 decision.  The Veteran appealed that denial to the United States Court of Appeals for Veterans Claims (Court), and in September 2020, the Court granted a Joint Motion for Remand, vacating the Board's prior decision and remanding it for further development as agreed upon between the parties.  

The Board issued a remand per the instructions in the September 2020 JMR in May 2021.  In September 2021, the Board issued a new decision which again denied the Veteran's claim.  The Veteran again appealed that denial to the Court, and in November 2022, the Court again granted a JMR, vacating the Board's September 2021 decision and remanding it for further development.  

1. Entitlement to service connection for a bilateral foot disorder, claimed as plantar fasciitis with tibial sesamoiditis (with bilateral foot polysensory neuropathy) and pes planus, to include as secondary to Achilles tendonitis is remanded.

The Veteran claims service connection of a bilateral foot disorder, which was most recently diagnosed following a VA examination as pes planus with plantar fasciitis.  As was discussed in detail by the Board in its most recent decision, a June 2021 VA examiner opined that the current foot condition was less likely than not related to her active-duty service to include her previously diagnosed Achilles tendon disorders.  In doing so, the Board stated that beyond bilateral plantar fasciitis and pes planus, no other disorders were endorsed.  

Pursuant to the JMR, the parties agree that the medical evidence noted in that June 2021 examination report indicates foot symptoms consistent with neuropathy, and other evidence of record shows a diagnosis of peripheral pedal neuropathy in February 2020.  However, to the extent that the Board did not consider service connection of peripheral pedal neuropathy, but rather only discussed the bilateral pes planus and plantar fasciitis, it did not fully assess the claim on appeal.  

A claim of service connection includes a claim for any disability which may be reasonably encompassed by the reported symptoms.   See Clemons v. Shinseki, 23 Vet. App. 1 (2009).  Although a medical opinion has been obtained which assesses the physical disabilities of pes planus and plantar fasciitis, no examination has been accomplished which fully assesses the Veteran's potential neuropathic symptoms in her feet.  Neither has a medical opinion been given regarding those symptoms.  To the extent that the Veteran has an indication of a diagnosis of neuropathy of the feet, and the evidence suggests in-service foot pain and other pathology such as Achilles tendonitis, a peripheral nerve examination should be afforded the Veteran and an opinion be given regarding the etiology of such a disability, if confirmed as a diagnosis.  McLendon v. Nicholson, 20 Vet. App. 79 (2006).

The matters are REMANDED for the following action:

1. Invite the Veteran to submit any additional evidence in support of her appeal.

2. Schedule the Veteran for a peripheral nerve examination with a qualified examiner.  The complete claims file should be made available to the examiner selected to conduct the examination.  The examiner should conduct a thorough examination and state whether the Veteran has a peripheral nerve condition affecting her feet, to include peripheral pedal neuropathy, which may account for some or all of her reported foot symptoms.  If no diagnosis can be given, then an explanation should be provided which rectifies this conclusion with the evidence of such a diagnosis in February 2020.

For each diagnosed condition, the examiner is requested to state whether it is at least as likely as not related to any incident of active service, to include any in-service achilles tendonitis pain, and her complaint of foot pain the day following separation from active service.  

For each opinion offered, the examiner should provide a reasoned rationale for the conclusions reached.  

 

 

B.T. KNOPE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	M. Pryce, Counsel