Foot (incl. plantar fasciitis, flat feet) decisions — 2013

The Board has determined that new and material evidence has been received to reopen the Veteran's claims for service connection for right foot plantar fasciitis and left foot Morton's neuroma. After a review of the evidence, including VA examination reports, the Board finds there is at least an approximate balance of positive and negative evidence regarding whether these conditions are related to active service.

The Veteran's appeal is being remanded to the RO for further development, including scheduling a VA examination and readjudicating his claim based on all applicable diagnostic codes. The Veteran seeks an increased rating for his service-connected residuals of left tibia fracture with plantar fasciitis and gastrocnemius soleus complex.

The Board found that the Veteran's service-connected bilateral pes planus disability is characterized by subjective complaints of pain, with flare-ups of increased pain and swelling after prolonged standing. The objective evidence shows that the Veteran has an apropulsive gait which reflects compensated abnormal pronation. He is able to demonstrate dorsiflexion to five degrees and plantar flexion to 40 degrees without pain. There is no tenderness to the tendo Achilles but there is pain on palpation at the talar navicular joint along the plantar fascia and at the insertion of tibiales posterior. The Veteran treats his bilateral pes planus disability with medication and orthotics, which provide relief.

The Board has determined that the July 2008 VA examination is inadequate and requires a new examination to determine if the Veteran's current lumbar spine and bilateral foot disabilities are etiologically related to his active service. The appeal will be remanded for further development.

The Veteran's bilateral plantar fasciitis is not productive of a moderately severe or severe bilateral foot disability, and therefore, the claim for an initial rating in excess of 10 percent has been denied.

The Board has remanded the case for additional development, including obtaining medical records and conducting a VA examination to determine the nature and etiology of any diagnosed disabilities.

The Veteran's service-connected bilateral pes planus is currently rated at 30 percent, which reflects the severity of his condition as severe with objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, and characteristic callosities. The disability does not meet or approximate the criteria for a higher rating under any applicable diagnostic code.

The Board denied the Veteran's claims for increased ratings for his service-connected right knee chondromalacia patella, left knee effusion, and bilateral sensorineural hearing loss. The Veteran's lumbar strain/myositis, left shoulder degenerative joint disease with impingement, and plantar fascia fibromatosis were all rated as 20 percent disabling.

The Veteran's claim for a TDIU was denied as his service-connected disabilities did not make him unemployable prior to May 22, 2008.,There was no clear and unmistakable error in the July 1988 rating decision assigning a single 10 percent disability rating for left knee disability.

The Board found that the Veteran's bilateral pes planus did not worsen during service and denied his claim for service connection. The back disorder was also denied as there is no evidence of a current disability related to service.

The Veteran's pes planus of the right foot was incurred in service and is related to his active military service.

The Veteran's service connection claim for bilateral foot fungus is pending, while his service connection claim for bilateral pes planus has been granted.

The Veteran's bilateral pes planus was evaluated at a 30 percent rating since August 2, 2001. The Board found that the condition did not warrant an evaluation in excess of this amount.

The Veteran's unauthorized medical services provided by Citrus Memorial Hospital on April 27, 2009 were not reimbursable as the treatment was for a service-connected psychiatric disorder and did not meet the criteria for emergency care.

The Board denied service connection for bilateral foot disorders including pes planus and hallux valgus, finding that the Veteran's feet were in sound condition upon entry into his second period of active service. The evidence did not support a showing of an injury or disease incurred during service.

The Veteran's bilateral pes planus has been rated at 30 percent since May 31, 2006, based on severe bilateral flatfoot with inward bowing of the tendo achillis, accentuated pain on use and manipulation, characteristic callosities, and swelling on use.

The Board finds that the Veteran's current bilateral pes planus pre-existed service but was aggravated therein. The low back disorder is less likely than not related to his bilateral foot disability.

The Board has remanded the case due to an inadequate VA examination in December 2007, which did not address whether the Veteran's bilateral pes planus was aggravated by service. A new VA examination is required.

The Veteran's service-connected bilateral foot disability is manifested by complaints of pain, weakness, stiffness, swelling, heat, redness, fatigability, lack of endurance of the feet, arthritis of the MTP joint, and the need to wear special shoes. However, there is no objective evidence of severe or pronounced disability, marked deformity (such as pronation or abduction), characteristic callosities, swelling on use, accentuated pain on manipulation and use, or incapacitating episodes.

The Board found that the Veteran's foot disability was not incurred in or aggravated by active military service and may not be presumed to have been so incurred or aggravated. The VA examiner opined that the Veteran's mild pes planus and hallux valgus were most likely the result of age-related degenerative change.