PLANTAR FASCIITIS

Summary

The Veteran, a Veteran who served from January 1965 to October 1969, including service in Vietnam, appeals the denial of service connection for right foot plantar fasciitis and a right hip condition, both claimed on a secondary basis. The Board reviewed the evidence, including VA examinations and a private medical opinion. For plantar fasciitis, the Board noted a prior VA opinion was incomplete regarding nexus to the service-connected ankle. Subsequent VA opinions were also insufficient to establish a baseline or rule out aggravation. However, considering the Veteran's reduced ankle dorsiflexion and obesity linked to his service-connected ankle, the Board applied the benefit of the doubt and granted service connection for plantar fasciitis. For the right hip condition, the Board acknowledged favorable findings for diagnosed hip osteoarthritis, bursitis, and gluteal tendinopathy, and the service connection for the primary right ankle disability. While a VA examiner opined the hip condition was intrinsic and less likely than not aggravated by the ankle, a private medical opinion and the Veteran's testimony suggested a link due to altered gait and alignment. The Board found the evidence in approximate balance and, applying the benefit of the doubt, granted secondary service connection for the right hip condition. Both conditions were granted service connection on a secondary basis.

Rationale

Favorable findings for plantar fasciitis diagnosis and service-connected ankle injury.; Incomplete/insufficient VA opinions on nexus to service-connected ankle.; Private opinion and Veteran testimony suggested link via altered gait/alignment.; Benefit of the doubt applied due to approximate balance of evidence.

Full Decision Text

Citation Nr: A25085668
Decision Date: 10/03/25	Archive Date: 10/03/25

DOCKET NO. 250219-517491
DATE: October 3, 2025

ORDER

Service connection for right foot plantar fasciitis is granted. 

Service connection for right hip condition is granted. 

FINDINGS OF FACT

1. Affording the Veteran the benefit of the doubt, his right foot plantar fasciitis is due to his service-connected right ankle disability. 

2. Affording the Veteran the benefit of the doubt, his right hip condition is due to his service-connected right ankle disability. 

CONCLUSIONS OF LAW

1. The criteria for service connection for right foot plantar fasciitis are met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

2. The criteria for service connection for a right hip condition are met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from January 1965 to October 1969. His medals include the Vietnam Service Medal with 2 bronze stars and the Republic of Vietnam Campaign Medal. 

This matter is before the Board of Veterans' Appeals (Board) on appeal from a January 2025 rating decision issued by a Regional Office (RO). 

In a February 2026 Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran selected the Hearing docket. On February 19, 2025, the Veteran withdrew the hearing request.

Therefore, the Board may only consider the evidence of record at the time of the January 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Regarding procedural history, the Board previously remanded the claims in May 2024 for additional records and addendum medical opinions. Following further development, the Veteran appealed from the subsequent January 2025 rating decision.

Service Connection

Generally, service connection will be granted if the evidence demonstrates that current disability resulted from an injury suffered or disease contracted in active military service, even if the disability was initially diagnosed after service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish service connection, a claimant must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the in-service disease or injury, the so-called "nexus" requirement. See 38 U.S.C. § 1110; 38 C.F.R. §3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

To establish entitlement to service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) probative evidence establishing a nexus (i.e., link) between the service-connected disability and the current disability. 38 C.F.R. § 3.310(a) and (b); Wallin v. West, 11 Vet. App. 509, 512 (1998).

Right Foot Plantar Fasciitis

The Veteran contends that he is entitled to service connection for right foot plantar fasciitis, to include as on a secondary basis. 

The rating decision on appeal made favorable findings that the Veteran has
. 2004).

To establish entitlement to service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) probative evidence establishing a nexus (i.e., link) between the service-connected disability and the current disability. 38 C.F.R. § 3.310(a) and (b); Wallin v. West, 11 Vet. App. 509, 512 (1998).

Right Foot Plantar Fasciitis

The Veteran contends that he is entitled to service connection for right foot plantar fasciitis, to include as on a secondary basis. 

The rating decision on appeal made favorable findings that the Veteran has been diagnosed with plantar fasciitis, that the Veteran's service treatment records show treatment for a right foot and ankle injury, and that his claimed primary disability, residuals of a right ankle fracture to include post-traumatic arthritis, is service connected. The Board is bound by favorable findings of the AOJ. 38 C.F.R. § 3.104(c). As the first two elements of secondary service connection have been met, the only issue that remains is the nexus element of secondary service connection.

During the evidence submission window following his hearing withdrawal, the Veteran's representative argued that the long-term effects of military training on the body are well-documented and submitted the abstract from an article regarding the occupational load carriage of soldiers and associated injuries; while the abstract mentioned foot pain, it did not link carrying heavy loads with plantar fasciitis.

The Veteran was afforded an initial February 2023 VA examination, in which he reported an onset of pain to his right foot in 2021, when he experienced a burning pain to the bottom of his right ankle and foot after injuring his ankle while attempting to get out of bed. An MRI showed a chronically torn AFTL, peroneal tenosynovitis, and achilles and plantar fascia tendinosis with a large plantar calcaneal spur. The examination further reported a chronically torn ATFL as sequela of prior ankle strain, an intact but thickened CFL, deltoid, and syndesmotic ligaments. The examiner opined that the Veteran's right foot plantar fasciitis was a separate entity from the residuals of the Veteran's right ankle fracture. However, this opinion was incomplete, as it did not address whether the Veteran's right foot disability was aggravated by his service-connected right foot disability. 

In August 2024, the Veteran was afforded an additional VA opinion. The examiner opined that he could not describe the baseline level of severity of the Veteran's right foot prior to the impact of his service-connected right ankle. He specified that medical evidence was not sufficient to support a determination of a baseline level of severity. The examiner further opined that plantar fasciitis involved changes to the plantar fascia at the medial tuberosity of the calcaneum which results in foot pain; possible risk factors for plantar fasciitis included obesity and reduced ankle dorsiflexion. 

The Veteran had previously been afforded an April 2022 VA examination for his service-connected right ankle disability, which recorded reduced ankle dorsiflexion. Furthermore, in November 2023, the Veteran submitted a private medical opinion which noted that the Veteran had gained almost 100 pounds since his enlistment, likely due to his service-connected right ankle and was obese - specifically, he was unable to run or exercise due to chronic pain and limited mobility. 

Therefore, affording the Veteran the benefit of the doubt, the Board finds that the Veteran's reduced ankle dorsiflexion and obesity caused by his service-connected right ankle disability contributed to the development of plantar fasciitis. See Lynch v. McDonough, 21 F.4th 776, 780-81 (Fed. Cir. 2021). Accordingly, service connection for plantar fasciitis is granted. 

Right Hip Condition

The Veteran contends that he is entitled to service connection for right hip condition, to include as on a secondary basis. 

The rating decision on appeal made favorable findings that the Veteran had been diagnosed with right hip osteoarthritis, bursitis, and gluteal tendinopathy. Additionally, his claimed primary disability - residuals of a right ankle fracture to include post-traumatic arthritis - is service connected. The Board is bound by favorable findings of the AOJ. 38 C.F.R. § 3.104(c). As the first two elements of secondary service connection have been met, the only issue that remains is the nexus element of service connection.

The Veteran was initially afforded a February 2023 VA examination, in which he reported that his right hip began to hurt beginning in approximately 2018 as his right ankle worsened. The examiner opined that there was no clear evidence
 favorable findings that the Veteran had been diagnosed with right hip osteoarthritis, bursitis, and gluteal tendinopathy. Additionally, his claimed primary disability - residuals of a right ankle fracture to include post-traumatic arthritis - is service connected. The Board is bound by favorable findings of the AOJ. 38 C.F.R. § 3.104(c). As the first two elements of secondary service connection have been met, the only issue that remains is the nexus element of service connection.

The Veteran was initially afforded a February 2023 VA examination, in which he reported that his right hip began to hurt beginning in approximately 2018 as his right ankle worsened. The examiner opined that there was no clear evidence from review of orthopedic literature to suggest that an injury to one joint would have any significant impact on another or opposite uninjured joint or limb, unless the injury resulted in a major muscle or nerve damage causing partial or complete paralysis or shortening of the injured limb resulting in length discrepancy of more than 5 centimeters with an obvious Trendelenburg gait; however, this level of severity was not supported by the record. 

The Veteran submitted a private medical opinion in November 2023, which generally addressed the relationship between the Veteran's ankle and back, but also stated that the Veteran had been walking on his poor ankle for 56 years, which affected his alignment, foot and general posture, and gait. She elaborated that the spine, hip, and knee are anatomically connected and pain and discomfort in the hip frequently arises due to degenerative changes of these structures. This opinion is competent, credible, and afforded probative weight. 

In his November 2023 Board hearing regarding his previous appeal, the Veteran reported that he feels like a hot poker goes through his ankle and straight up through his leg and into his back; whatever happens in his ankle goes straight up, and he has experienced that through the years. 

The Veteran was afforded additional VA opinions in August 2024, in which the examiner opined that he was unable to describe the baseline of the Veteran's hip condition to determine aggravation; the examiner opined that there was no clear evidence from orthopedic literature to suggest that an injury to one joint would have any significant impact on another or opposite uninjured joint or limb unless the injury resulted in major muscle or nerve damage causing partial or complete paralysis. Rather, the condition of the hip was due to something intrinsic to the hip and not the ankle, and the Veteran's right hip osteoarthritis was less likely than not aggravated beyond its natural progression by residuals of the Veteran's service-connected ankle disability. This opinion is competent, credible, and afforded probative weight

The evidence of records contains medical opinions that are competent, credible, and afforded probative weight, that provide both positive and negative secondary service connection nexus opinions. Accordingly, the Board finds that the evidence is in approximate balance as to whether the Veteran's service-connected right ankle disability caused or aggravated his right hip condition. Resolving reasonable doubt in favor of the Veteran, secondary service connection is granted. See Lynch v. McDonough, 21 F.4th 776, 780-81 (Fed. Cir. 2021).

 

 

JOHN Z. JONES

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	L. Resor, Associate 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.