ANKLE IMPAIRMENT OF

DAVID H. ROBERTSON · 2025 · Case ID: 25013896

DENIED

Summary

The Veteran, an Army veteran who served from July 1988 to January 1992, appeals the denial of service connection for a left ankle disability, claimed both directly and secondarily to service-connected pes planus and other conditions. The Veteran experienced in-service left ankle injuries in July and September 1988, but the Board found these were solitary complaints without chronic symptoms or continuity of symptomatology after service. The first post-service report of left ankle symptoms was in February 2009, approximately 17 years after separation. The Board found the Veteran's lay statements regarding symptom onset inconsistent with the medical evidence, particularly the lack of contemporaneous treatment for the left ankle after the initial injuries and the absence of left ankle complaints on separation examinations. The Board also reviewed and rejected a private medical opinion, finding it based on an inaccurate factual premise regarding the Veteran's pre-service condition. Multiple VA examinations were conducted, with examiners consistently opining that the left ankle disability was less likely than not related to service or aggravated by service-connected conditions, citing the lack of in-service chronicity and a post-service left foot drop requiring fusion as the more likely etiology. The Board denied service connection for the left ankle disability, finding the criteria for direct and secondary service connection were not met.

Rationale

No chronic in-service symptoms; No continuity of symptomatology after service; No etiologically related to service; Not aggravated by service-connected conditions

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

10-18 557

Full Decision Text

Citation Nr: 25013896
Decision Date: 11/12/25 Archive Date: 11/12/25

DOCKET NO. 10-18 557
DATE: November 12, 2025

ORDER

Entitlement to service connection for a left ankle disability due to any of the following service-connected disabilities, including bilateral pes planus, right knee, left knee, lumbosacral spine, radiculopathy of the sciatic nerve in the right lower extremity, and radiculopathy of the sciatic nerve in the left lower extremity, is denied.

FINDINGS OF FACT

1. The Veteran has a current left ankle disability diagnosed as strain, post fusion of the ankle and subtalar joint, tibiotalocalcaneal arthrodesis revision, tibiotalocalcaneal fusion, tendonitis, and ankylosis.

2. Symptoms of ankylosis in the left ankle were not chronic in service, did not manifest to a compensable degree within one year after service separation, and were not continuous after service separation.

3. The Veteran experienced in-service left ankle injuries in July 1988 and September 1988.

4. The left ankle disability did not have its onset in service and is not otherwise etiologically related to service.

5. The left ankle disability was not caused or aggravated by the service-connected pes planus, right knee, left knee, lumbosacral spine, radiculopathy of the sciatic nerve in the right lower extremity, and radiculopathy of the sciatic nerve in the left lower extremity.

CONCLUSION OF LAW

The criteria for service connection for the left ankle disability due to any of the following service-connected disabilities, including pes planus, right knee, left knee, lumbosacral spine, radiculopathy of the sciatic nerve in the right lower extremity, and radiculopathy of the sciatic nerve in the left lower extremity, have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The Veteran served in the United States Army July 1988 to January 1992.

This matter was previously before the Board in August 2025. The Board remanded the issue in order to obtain secondary service connection opinions. An opinion was issued in September 2025. A Supplemental Statement of the Case (SSOC) was issued in September 2025. This matter is now before the Board.

Duties to Notify and Assist

The Board finds that the duties to notify and assist the Veteran in this case have been fulfilled. Neither the Veteran nor the representative has raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015).

Legal Authority for Service Connection

Generally, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

As the Veteran has been diagnosed with ankylosis, which is a qualifying chronic disease pursuant to 38 C.F.R. § 3.309(a), he is eligible for presumptive service connection under 38 C.F.R. § 3.303(b).

Service connection may be established on a presumptive basis for chronic diseases listed under 38 C.F.R. § 3.309 (a) if chronic symptoms of the disease were shown in service; the disease was manifested to a compensable degree with a presumptive period, one year after service separation; or continuous symptoms of the disease were manifested since service. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a); see also Walker v. Shinseki, 708 F. 3d 1131 (Fed. Cir. 2013).
.F.R. § 3.303(b).

Secondary service connection may be granted for a disability that is proximately due to, or aggravated by, a service-connected disease or injury. 38 C.F.R. § 3.310. Establishing service connection on a secondary basis requires medical evidence sufficient to show that a current disability exists and that the current disability was either caused or aggravated by a service-connected disability. 38 C.F.R. § 3.310(a); Allen v. Brown, 7 Vet. App. 439 (1995).

The determination as to whether the requirements for service connection are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. 38 U.S.C. § 7104 (a); Baldwin v. West, 13 Vet. App. 1 (1999). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of the matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021).

The Veteran proffers two theories of service connection. First, the Veteran explains that he injured the left ankle in service, was diagnosed with tendonitis, and received a profile. He believes that the current left ankle disability is related to these in-service injuries. See July 2023 Transcript. Second, the Veteran explained that he is entitled to secondary service connection, contending that the left ankle disability was caused by the flatfeet disorder that was symptomatic in service. See November 2019 Private Treatment Records.

The Board finds that the Veteran has a current left ankle disability diagnosed as

strain, post fusion of the ankle and subtalar joint, tibiotalocalcaneal arthrodesis

revision, tibiotalocalcaneal fusion, tendonitis, and ankylosis. See June 2015 VA Examination; March 2016 VA Examination; September 2025 VA Examination.

The Board concedes that the Veteran experienced in-service left ankle injuries in July 1988 and September 1988. According to July 1988 service treatment records, the Veteran complained of left ankle pain lasting two days without any report of trauma. The military medical examiner diagnosed the Veteran with a mild sprain and treated the injury conservatively. In September 1988, the Veteran complained of bilateral ankle pain secondary to the bilateral pes planus; the military medical examiner notes redness and tenderness on palpation.

The persuasive weight of the evidence is against finding that symptoms of ankylosis in the left ankle were chronic in service. While the Veteran sought in-service treatment for left ankle symptoms in July 1988 and September 1988, these reports were solitary in nature; the Veteran did not seek follow-up treatment after either report. The Veteran claims that he was put on physical profiles for the ankles, indicating that symptoms were chronic. However, none of the physical profiles in the service treatment records are for a left ankle condition. An August 1991 physical profile was issued for bilateral pes planus and an October 1991 physical profile was issued for chronic pain in both feet. Additionally, the Reports of Medical Examination and Medical history, conducted after the July 1988 and September 1988 left ankle injuries, do not contain any evidence of left ankle symptoms. See December 1989 Report of Medical Examination (The lower extremities and feet were in normal condition); August 1991 Report of Medical Examination (The lower extremities and feet were in normal condition, except for a notation of plantar fasciitis); August 1991 Report of
symptoms were chronic. However, none of the physical profiles in the service treatment records are for a left ankle condition. An August 1991 physical profile was issued for bilateral pes planus and an October 1991 physical profile was issued for chronic pain in both feet. Additionally, the Reports of Medical Examination and Medical history, conducted after the July 1988 and September 1988 left ankle injuries, do not contain any evidence of left ankle symptoms. See December 1989 Report of Medical Examination (The lower extremities and feet were in normal condition); August 1991 Report of Medical Examination (The lower extremities and feet were in normal condition, except for a notation of plantar fasciitis); August 1991 Report of Medical History (The Veteran did not report any left ankle symptoms). As such, symptoms of ankylosis in the left ankle were not chronic in service.

The persuasive weight of the evidence is against finding that symptoms of ankylosis in the left ankle manifested to a compensable degree within one year after service separation or were continuous after service separation. The Veteran separated from service in January 1992. The first report of ankle symptoms were in February 2009, approximately seventeen years after service separation. There is no continuity of symptomatology after service separation in any medical records or contemporaneous lay statements. See February 2009 Statement in Support of Claim; Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (lengthy period of absence of medical complaints for condition can be considered as a factor in resolving claim).

While the Veteran is competent to report experiencing symptoms of ankylosis since service, the Board must also consider whether his statements are credible. In determining whether statements made by a Veteran are credible, the Board may consider internal consistency, facial plausibility, consistency with other evidence, and statements made during treatment. See Macarubbo v. Gober, 10 Vet. App. 388 (1997). The Veteran's statements regarding the date of onset of his ankylosis symptoms are inconsistent. While he currently reports that he experienced left ankle pain since service, he did not report left ankle symptoms at separation examination in August 1991. Then, the first post-service report of left ankle symptoms was in February 2009, made for the purpose of compensation. The Board therefore finds statements made to VA in connection with securing VA disability compensation are less probative than the medical evidence contemporaneous with service. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006); see also Caluza v. Brown, 7 Vet. App. 498 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996); White v. Illinois, 502 U.S. 346, 355-56 (1991); Rucker v. Brown, 10 Vet. App. 67, 73 (1997). (The Board may consider a lack of contemporaneous medical evidence, interest or bias, whether the statements were made in furtherance of treatment, and the lapse of time in recollecting events attested to as factors in determining the credibility of lay evidence.)

The Board finds that the left ankle disability did not have its onset in service and is not otherwise etiologically related to service, including the July 1988 and September 1988 in-service injuries.

The Veteran submitted to a VA examination in June 2015. The VA examiner opined that the left ankle disorder was less likely than not incurred in or caused by the claimed in-service injury, event or illness. The VA examiner reasoned that the August 1991 Medical Board Examination was silent for left ankle complaints. See August 1991 Medical Board Examination (The military medical examiner found that the lower extremities were in normal condition and noted that the feet exhibited plantar fascitis); August 1991 Report of Medical History (The Veteran reported foot trouble but no specific ankle issues). The VA examiner also noted that the first left ankle symptoms of record were recorded approximately 17 years after service separation.

In November 2019 private treatment records, the private examiner opined that the left ankle disability was caused by the "service demands on his pes plano valgus deformities of the feet." The private examiner reasoned that, despite evidence to the contrary on the service entrance examination, the Veteran had a pre-existing flatfoot disability that was aggravated by service (i.e. increased activity and poor footwear). The private examiner explained that the Medical Evaluation Board confirmed that the flatfoot disability (plantar fasciitis) existed prior to service. Contra. August 1991 Medical Board Examination (The military medical examiner found that the flatfeet did not exist prior to service).

The Board finds that
record were recorded approximately 17 years after service separation.

The Board finds that the November 2019 private opinion is not probative. According to the service treatment records, the Medical Evaluation Board Proceeding found that the plantar fasciitis did not exist prior to service, contrary to the private examiner's assertion. See October 1991 Medical Evaluation Board Proceeding. As such, the private 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).

The Board finds that the left ankle disability was not caused or aggravated by the service-connected bilateral pes planus, right knee limitation of flexion, left knee limitation of flexion, lumbosacral strain with arthritis, radiculopathy in the right lower extremity, and radiculopathy in the left lower extremity.

VA issued an opinion in January 2025. The VA examiner opined that the left ankle disorder is less likely than not (likelihood is less than approximately balanced or nearly equal) proximately due to or the result of the Veteran's service-connected pes planus disability. As a baseline level of severity of the left ankle disorder could not be determined, the VA examiner opined that, regardless of an established baseline, the Veteran's left ankle disability was not at least as likely as not aggravated beyond its natural progression by the service-connected bilateral pes planus. The VA examiner reasoned that the left ankle disorder and pes planus are not medically related. The VA examiner noted that the Veteran had acute left ankle sprain in service, which resolved, and the Veteran reported that it improved after discharge. There is no evidence in the medical records that the left ankle disability was due to or aggravated beyond its natural progression by the service-connected pes planus. Instead, the left ankle disability was caused by a non-service-related left foot drop condition that required a left ankle fusion in 2008, 16 years after service. The VA examiner explained that "foot drop" is caused by a neurological condition in the spine and there is no medical correlation in foot drop and pes planus.

In March 2025, VA issued several negative secondary service connection opinions. The VA examiner opined that the left ankle disability was less likely than not (likelihood is less than approximately balanced or nearly equal) proximately due to or the result of the Veteran's service-connected disabilities associated with the right knee, left knee, lumbosacral spine, sciatica in the right lower extremity, and sciatic in the left lower extremity. The VA examiner provided the same reasoning for all of these opinions: while the Veteran was diagnosed with left achilles tendonitis in June 2015, he underwent knee amputations through the tibia and fibula in 2016 and, therefore, no longer suffered from a left ankle disorder. The VA examiner noted that a baseline level of severity of the left ankle disorder could not be determined. The VA examiner opined that, regardless of an established baseline, the Veteran's left ankle disorder was not at least as likely as not aggravated beyond its natural progression by the service-connected right knee, left knee, lumbosacral spine, sciatica in the right lower extremity, and sciatic in the left lower extremity because, again, the Veteran no longer suffered from a left ankle disorder.

In a May 2025 Board remand, the Board found that these March 2025 VA examination opinions were inadequate. The VA examination opinions were based on an inadequate factual premise, that there is no current disability; however, the Veteran has already established a current disability during the period on appeal. See Reonal v. Brown, supra. VA issued additional addendum opinions in May 2025, but, again, the opinions were based on the reasoning that the Veteran did not have a current left ankle disability as he had an amputation in 2016.

In August 2025, the Board remanded the issue again, finding that the VA addendums opinion were inadequate as they did not comply with the May 2025 Board remand directives.

Pursuant
, the Board found that these March 2025 VA examination opinions were inadequate. The VA examination opinions were based on an inadequate factual premise, that there is no current disability; however, the Veteran has already established a current disability during the period on appeal. See Reonal v. Brown, supra. VA issued additional addendum opinions in May 2025, but, again, the opinions were based on the reasoning that the Veteran did not have a current left ankle disability as he had an amputation in 2016.

In August 2025, the Board remanded the issue again, finding that the VA addendums opinion were inadequate as they did not comply with the May 2025 Board remand directives.

Pursuant to the August 2025 Board remand, VA issued additional addendum opinions in September 2025. Again, a baseline level of severity of the left ankle disorder could not be determined. The VA examiner opined that, regardless of an established baseline, the Veteran's left ankle disability was not at least as likely as not aggravated beyond its natural progression by the service-connected right knee, lumbosacral spine, sciatica in the right lower extremity, and sciatica in the lower extremity disabilities. The VA examiner explained that, after a thorough review of medical literature, the service-connected disabilities were not related to the left ankle disability. Instead, the VA examiner explained that since there was no in-service chronicity of symptomatology or continuous symptoms after service discharge, a post-service event, illness, or injury is a more likely etiology. The VA examiner also opined that the Veteran's left ankle disability was not at least as likely as not aggravated beyond its natural progression by the service-connected left knee disability. The VA examiner reasoned that the disabilities are not medically related and, again, as there was no in-service chronicity of symptomatology or continuous symptoms after service discharge, a post-service event, illness, or injury is a more likely etiology. The VA examiner explained that, "while there is evidence that unilateral knee pathology (such as osteoarthritis or malalignment) can result in compensatory biomechanical changes and altered joint loading in the contralateral lower limb-including the contralateral ankle-these changes may predispose to abnormal mechanics or, over time, to degenerative changes such as osteoarthritis, but not to ankylosis." The VA examiner clarified that "ankylosis refers to pathological joint fusion, typically resulting from chronic inflammatory arthropathy, trauma, or surgical intervention, and is not a recognized sequela of contralateral joint immobility or compensation alone."

Based on the foregoing, the Board finds that the criteria for service connection for the left ankle disability due to any of the following service-connected disabilities, including bilateral pes planus, right knee, left knee, lumbosacral spine, radiculopathy of the sciatic nerve in the right lower extremity, and radiculopathy of the sciatic nerve in the left lower extremity, have not been met; thus, the issue must be denied.

David H. Robertson

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Costantino, Danielle K.

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.

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