13-10 917
13-10 917
| Board of Vet. App. | Jun 15, 2017Background
- Veteran served on active duty Apr 1967–Mar 1974; filed fully developed claims in Sept 2013 and amended to add low back in Feb 2014; testified at VA hearing Sept 2016.
- Service connection already granted for diabetic peripheral neuropathy of the bilateral lower extremities (Sept 2007).
- Veteran alleges bilateral foot disability caused by being run over by a jeep in Vietnam and that low back disability is service‑connected or secondary to gait changes from neuropathy.
- VA obtained examinations (Aug 2015) and addendum opinions (Nov 2015, Mar 2017); Board found exams adequate for the direct‑connection issues but ordered remand for a new secondary‑connection opinion for the low back.
- Board found current diagnoses of bilateral foot conditions (metatarsalgia/plantar fasciitis/arthritis) and low back degenerative disease, but concluded service records show no chronic in‑service foot or low back problems apart from isolated wart/toenail treatments and a single 1973 back complaint.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Service connection — bilateral foot disability | Foot injury occurred in service (run over by jeep); or secondary to diabetic peripheral neuropathy | Service treatment records largely normal; exams show neuropathy/arthritis but no in‑service chronic foot disease | Denied — no nexus to service or to diabetic neuropathy |
| Service connection — low back (direct) | Low back condition began in service (treated stateside, x‑rays) | Service records show only one acute back visit; separation exam normal; no chronic in‑service care | Denied — lack of chronic in‑service evidence or nexus |
| Service connection — low back (secondary to diabetic peripheral neuropathy) | Low back caused or aggravated by gait changes from neuropathy | March 2017 exam failed to address secondary theory adequately | Remanded — for a new/additional opinion addressing causation and aggravation |
| Service connection — sciatic/radiculopathy (secondary to low back) | Radiculopathy secondary to low back disease | Claim is intertwined with low back secondary theory; needs resolution of low back secondary claim first | Remanded as inextricably intertwined with the low back secondary claim |
Key Cases Cited
- Locklear v. Shinseki, 24 Vet. App. 311 (2011) (VA may bifurcate claims and adjudicate separate theories independently)
- Tyrues v. Shinseki, 23 Vet. App. 166 (2009) (bifurcation of claims permissible)
- Nieves‑Rodriguez v. Peake, 22 Vet. App. 295 (2008) (requirements for adequate medical opinions)
- Kahana v. Shinseki, 24 Vet. App. 428 (2011) (service treatment records completeness and probative silence analysis)
- Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (lack of contemporaneous records not an absolute bar to lay testimony)
- Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) (continuity of symptomatology limited to conditions listed in 38 C.F.R. § 3.309)
- Jandreau v. Nicholson, 492 F.3d 1372 (2007) (limits of lay competence to provide medical etiology opinions)
- Stegall v. West, 11 Vet. App. 268 (1998) (remand compliance; Board must ensure remand directives are followed)