Citation Nr: 23047367 Decision Date: 08/28/23 Archive Date: 08/28/23 DOCKET NO. 17-30 096 DATE: August 28, 2023 ORDER Entitlement to service connection for left plantar fascial fibromatosis is granted. FINDING OF FACT The Veteran's left plantar fascial fibromatosis is related to service. CONCLUSION OF LAW The criteria for establishing entitlement to service connection for left plantar fascial fibromatosis have been 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 Air Force from May 1985 to August 1992, April 1996 to April 1999, and May 2009 to October 2009. Prior to that, he was a cadet at the Air Force Academy from June 1981 to May 1985. He also served in the Air Force Reserves, performing periods of extended active duty, active duty for training (ACDUTRA), and inactive duty training (INACDUTRA). The Veteran retired from the Air Force Reserves in June 2013. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO), which, in pertinent part, denied entitlement to service connection for bilateral plantar fascial fibromatosis. The Veteran timely perfected an appeal. See April 2015 Notice of Disagreement; May 2017 Statement of the Case; June 2017 VA Form 9. The Board remanded the issue of entitlement to service connection for bilateral plantar fascial fibromatosis in November 2021 and July 2022. Thereafter, in December 2022, the RO grained entitlement to service connection for right foot plantar fascial fibromatosis. Accordingly, this issue is no longer on appeal. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1977) (noting that a grant of service connection extinguishes appeals before the Board). Service Connection The Veteran seeks service connection for left plantar fascial fibromatosis, which he contends started in service. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38?U.S.C. §?1110, 1131; 38?C.F.R. §?3.303 (a). Establishing service connection generally requires (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F. 3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7?Vet. App.?498, 506 (1995), aff'd per curiam, 78 F. 3d 604 (Fed. Cir. 1996) (table); 38 C.F.R. § § 3.303. Service connection may also be granted for any disease diagnosed after the military discharge, when all the evidence, including that pertinent to the period of military service, establishes that the disease was incurred during the active military service. 38 U.S.C. § § 1113 (b); 38 C.F.R. § § 3.303 (d). As an initial matter, the Veteran has been diagnosed with left plantar fascial fibromatosis. See August 2022 VA Examination Report; MTF Treatment Records. As such, the Board finds the current disability element is established. See Shedden v. Principi, 381 F.3d 1163, 1167. Service treatment records from the Veteran's service in the Air Force Academy show that the Veteran was seen on numerous occasions for bilateral foot pain. See July 1981 STR (blisters on both feet); July 1981 STR (left foot and ankle pain; sprained left ankle diagnosis); February 1982 STR (left toe problem); March 1984 STR (left ankle sprain). Active duty includes service at any time as a cadet at the United States Air Force Academy. 38 C.F.R. § 3.6 (b)(4). Service treatment records from the Veteran's second and third periods of service, from 1985 to 1992 and from April 1996 to April 1999, continue to show left foot complaints. See May 1990 STR (left foot warts); September 1997 STR (left foot pain; September 1997 STR (warts plantar surface left foot). A May 2012 service treatment record, while the Veteran was serving on a period of INACDUTRA, include complaints of persistent "lumps" on both feet as well as a diagnosis of bilateral plantar fascial fibromatosis. Accordingly, the second Shedden element has also been satisfied. See Shedden v. Principi, 381 F.3d 1163, 1167. The question then becomes whether a nexus, or relationship, between the Veteran's current disability and service has been shown. The Veteran was afforded a VA examination in August 2022. After confirming a diagnosis of left plantar fascial fibromatosis, the examiner opined that it was less likely as not related to service because the Veteran was not on active duty in 2012 when he was seen for bilateral foot pain and diagnosed with bilateral plantar fascial fibromatosis. The Board finds that this opinion is based on an inaccurate factual premise. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that the Board may reject a medical opinion based on an inaccurate factual basis). In this regard, the Veteran was treated for left foot pain on multiple occasions from 1981 to 1999. However, the examiner did not discuss any of this evidence. Accordingly, the Board affords the August 2022 VA opinion no probative weight. In an October 2022 addendum opinion, the August 2022 VA examiner opined that "a link to the service cannot be established" for the Veteran's left foot plantar fascial fibromatosis because "there are no records of left foot plantar pain while in the service (ACDUTRA)." The examiner noted the mention of painful lumps on the bilateral feet while the Veteran was on INACDUTRA in 2012. The Board finds that this opinion is based on an inaccurate factual premise, and it is therefore not entitled to any probative weight. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that the Board may reject a medical opinion based on an inaccurate factual basis). The August 2022/October 2022 VA examiner further opined that the Veteran's right foot plantar fascial fibromatosis was at least as likely as not had its onset in service because a September 1982 service treatment record showed pain on the plantar aspect of his right foot, which "was the initial start of the right foot pain/plantar fibromatosis." The examiner also noted that the Veteran was attending the Air Force Academy at the time, which is considered active duty. Based on this opinion, the RO granted entitlement to service connection for right plantar fascial fibromatosis. However, the Board finds that the rationale of this opinion, i.e., that the Veteran's complaints of right foot plantar pain during his Air Force Academy service was the start of his right foot pain/plantar fibromatosis, equally applies to the Veteran's left foot plantar fibromatosis. In this regard, service treatment records from the Air Force Academy also show reports of left foot plantar pain. Accordingly, the Board finds that this opinion is probative regarding whether the Veteran's left plantar fascial fibromatosis had its onset in service. There are no probative, contrary opinions of record. (Continued on the next page) ? Based on the foregoing and resolving all doubt in the Veteran's favor, the Board finds that entitlement to service connection for plantar fascial fibromatosis is warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Kipper, 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.