HALLUX VALGUS (BUNION) ACQUIRED

J. PARKER · 2025 · Case ID: A25103534

DENIED

Summary

The veteran, who served from April 1972 to April 1975 and May 1977 to September 1978, appeals the denial of service connection for bilateral hallux valgus with osteoarthrosis of the feet, bilateral ankle tendonitis, and bilateral hip arthritis. The veteran also appeals the denial of an automobile allowance or adaptive equipment. The Board found no evidence of in-service injury, disease, or symptoms related to the feet, ankles, or hips. Service treatment records and contemporaneous medical evidence did not indicate any foot, ankle, or hip issues during service, and post-service examinations showed normal findings for feet and ankles for many years after separation. While the veteran has a service-connected lumbosacral disability, medical opinions from VA examiners concluded that the current foot, ankle, and hip conditions were less likely than not related to service or aggravated by the service-connected condition, attributing them to the natural aging process. The Board found these opinions probative and persuasive against service connection. The claim for an automobile allowance or adaptive equipment was denied because the veteran's service-connected disabilities do not meet the criteria for loss or permanent loss of use of feet or hands, or other specific qualifying conditions.

Rationale

No in-service injury, disease, or event reported for left foot.; No chronic or continuous symptoms since service.; VA medical opinions found less likely than not related to service or aggravated by service-connected lumbosacral disability.; Condition attributed to normal aging process.

Special Benefit

AUTO / ADAPTIVE EQUIPMENT

Docket No.

241203-501814

Full Decision Text

Citation Nr: A25103534
Decision Date: 12/02/25 Archive Date: 12/02/25

DOCKET NO. 241203-501814
DATE: December 2, 2025

ORDER

Service connection for left foot hallux valgus with osteoarthrosis is denied.

Service connection for right foot hallux valgus with osteoarthrosis is denied.

Service connection for the left ankle is denied.

Service connection for the right ankle is denied.

Service connection for the left hip arthritis is denied.

Service connection for the right hip arthritis is denied.

Entitlement to an allowance for an automobile or other conveyance and adaptive equipment, or for adaptive equipment is denied.

FINDINGS OF FACT

1. The evidence shows current diagnoses of left and right foot hallux valgus with osteoarthrosis.

2. No left and right foot hallux valgus with osteoarthrosis injury or disease, including symptoms, manifested during service.

3. Symptoms of the left and right foot hallux valgus with osteoarthrosis were not chronic in service, were not continuous since service separation, and did not manifest to a compensable degree within one year of service separation.

4. The current left and right foot hallux valgus with osteoarthrosis are not related to service.

5. The evidence shows current diagnoses of left and right ankle tendonitis.

6. No bilateral ankle injury or disease, including symptoms, manifested during service.

7. The current left and right ankle disabilities are not related to service.

8. The evidence shows current diagnoses of trochanteric pain syndrome of the hips, degenerative arthritis of the hips, and degenerative joint disease of the sacroiliac joints with pain referred to the hips.

9. No bilateral hip injury or disease, including symptoms, manifested during service.

10. The current left and right hip disabilities are not related to service.

11. The current left and right foot hallux valgus with osteoarthrosis, left and right ankle disabilities, and left and right hip disabilities are neither caused nor worsened in severity by the service-connected lumbosacral degenerative disease post laminectomy with degenerative disease (lumbosacral disability) and radiculopathy of the left and right sciatic and left and right femoral nerves.

12. The Veteran does not have loss of use of one or both feet, or loss of use of one or both hands, permanent impairment of vision of both eyes to the required specified degree, a severe burn injury to the required specified degree, amyotrophic lateral sclerosis (ALS), or ankylosis of one or both knees or one or both hips, by reason of a service-connected disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for left foot hallux valgus with osteoarthrosis, including as secondary to the service-connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves, have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.307, 3.309, 3.310.

2. The criteria for service connection for right foot hallux valgus with osteoarthrosis, including as secondary to the service-connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves, have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.307, 3.309, 3.310.

3. The criteria for service connection for a left ankle disability, including as secondary to the service-connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

4. The criteria for service connection for a right ankle disability, including as secondary to the service-connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304,
the bilateral sciatic and femoral nerves, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

5. The criteria for service connection for left hip arthritis, including as secondary to the service-connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves, have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309, 3.310.

6. The criteria for service connection for right hip arthritis, including as secondary to the service-connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves, have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309, 3.310.

7. The eligibility criteria for financial assistance in acquiring an automobile or other conveyance or special adaptive equipment have not been met. 38 U.S.C. §§ 3901, 3902, 5107; 38 C.F.R. §§ 3.102, 3.808, 4.63.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran, who is the appellant, served on active duty from April 1972 to April 1975, and from May 1977 to September 1978.

This matter came before the Board of Veterans' Appeals (Board) on appeal from a February 2024 Department of Veterans Affairs (VA) Regional Office (RO) rating decision.

By way of procedural history, there is an extensive history of claims related to the listed disabilities, including before the Board. Most recently in September 2023, the Veteran filed a supplemental claim for service connection for the feet, ankles, and hips (previously claimed as hips and thighs) following the issuance of a supplemental statement of the case in August 2023; thereby opting into the Appeals Modernization Act (AMA) or modernized review system. Additionally, a supplemental claim was filed in January 2024 for an automobile allowance and special adaptive equipment. A February 2024 rating decision denied, in relevant part, service connection for the feet, ankles, hips, and an automobile or other conveyance, and adaptive equipment, or for adaptive equipment because evidence submitted was not new and relevant. The Board notes that new and relevant evidence was not required.

The Veteran filed a substantive appeal in December 2024 for the February 2024 rating decision for the denial of service connection for the feet, ankles, hips, and automobile conveyance or adaptive equipment. The Veteran also disagreed with a June 2023 rating decision regarding the rating for the lumbosacral disability, bilateral lower extremity restless leg syndrome, and anterior trunk scar; however, the appeal was untimely as to this decision, so these issues will not be addressed herein.

In the December 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket; therefore, the Board may only consider the evidence of record at the time of the February 2024 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

If the Veteran would like
4 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 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 claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Service Connection Legal Authority

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in service disease or injury and the current disability.

In this case, the evidence shows current diagnoses of generative osteoarthrosis of the feet and degenerative arthritis of the hips, which are considered chronic diseases under 38 C.F.R. § 3.309(a). As such, the presumptive service connection provisions under 38 C.F.R. § 3.303(b) for service connection based on "chronic" symptoms in service and "continuous" symptoms since service are applicable to this matter. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Where the evidence shows a "chronic disease" in service or "continuity of symptoms" after service, the disease shall be presumed to have been incurred in service. For the showing of "chronic" disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With chronic disease as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally, a showing of "continuity of symptoms" after service is required for service connection. 38 C.F.R. § 3.303(b).

Additionally, where a veteran served 90 days or more of active service, and certain chronic diseases become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a).

Secondary service connection may be established for a disability that is proximately due to or the result of service-connected disease or injury. In such instance, service connection shall be granted as secondary to the disability for which VA benefits were initially established. 38 C.F.R. § 3.310(a); see Harder v. Brown, 5 Vet. App. 183, 187 (1993). A veteran may also obtain compensation for the aggravation of a nonservice-connected condition by a service-connected disability. See 38 C.F.R. § 3.310(a) (2012); see Allen v. Brown, 7 Vet. App. 439, 448 (1995).

To prevail under a
service connection may be established for a disability that is proximately due to or the result of service-connected disease or injury. In such instance, service connection shall be granted as secondary to the disability for which VA benefits were initially established. 38 C.F.R. § 3.310(a); see Harder v. Brown, 5 Vet. App. 183, 187 (1993). A veteran may also obtain compensation for the aggravation of a nonservice-connected condition by a service-connected disability. See 38 C.F.R. § 3.310(a) (2012); see Allen v. Brown, 7 Vet. App. 439, 448 (1995).

To prevail under a theory of secondary service causation, the record must show (1) evidence of a current disability, (2) evidence of a service-connected disability, and (3) medical nexus evidence establishing a connection between the current disability and the service-connected disability. Wallin v. West, 11 Vet. App. 509, 512 (1998); Reiber v. Brown, 7 Vet. App. 513, 516-17 (1995). Any increase in the severity of a nonservice-connected disability that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disability, will be itself service connected. 38 C.F.R. § 3.310(b).

1. Service connection for left foot hallux valgus with osteoarthrosis is denied.

2. Service connection for right foot hallux valgus with osteoarthrosis is denied.

The Veteran contends that the left and right foot disabilities were a result of in-service physical training or in the alternative were due to the service-connected lumbosacral disability. See October 2010 statement of Veteran and October 2013 notice of disagreement.

The February 2024 rating decision made favorable findings that there were current diagnoses of left and right foot hallux valgus with osteoarthrosis as found in February 2024 x-rays. Additionally, the Veteran was service connected for the primary claimed disability of lumbosacral degenerative disease post laminectomy. Under the AMA, the Board is bound by favorable findings made by the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c). The record also shows that the Veteran is service connected for radiculopathy of the bilateral sciatic and femoral nerves.

After review of all the evidence, lay and medical, the persuasive weight of the evidence is against a finding that there was a left or right foot injury, disease, or event during service. Service treatment records from the first period of active duty (April 1972 to April 1975) show that the Veteran had neurological symptoms of decreased plantar flexion in the left foot attributed to the chronic low back pain followed by lumbosacral strain as a result of a motor vehicle accident. See July 1974 service treatment records. In September 1974, the Veteran had symptoms of decreased sensation of the left foot and the impression was herniated disc in the L4-5 region.

Prior to the second period of active service, the Veteran denied foot troubles and there were no feet issues at the entrance examination. See April 1977 report of medical history. During the second period of active duty (May 1977 to September 1978), service treatment records indicated a second motor vehicle accident and a herniated disc with lower extremity sciatica that was treated by laminectomy performed with disc excision at L3-4, and l4-5. See service treatment records April 1978. Symptoms prior to surgery included weak dorsiflexes of the right foot and left medial foot numbness. A service separation examination in May 1978 indicated only issues of the right shoulder and a herniated nucleus pulposus, L4, 5 with chronic low back and bilateral leg pain. Medical board testimony in August 1978, near the time of service separation, indicated radiating back pain to the left and right foot. Service treatment records from both periods appear to be complete.

In an October 2013 statement, the Veteran reported that bilateral foot conditions, originally claimed as jungle rot, were due to wearing boots in water, mud, and oil. See October 2013 notice of disagreement. In a March 2025 appellate brief, it was contended that the bilateral foot disabilities were due to the military occupational specialty (MOS) of lineman, including climbing telephone poles.

The Board has considered the Veteran's recent lay contentions and lay statement to the effect that he experienced foot injury in service
. Medical board testimony in August 1978, near the time of service separation, indicated radiating back pain to the left and right foot. Service treatment records from both periods appear to be complete.

The Board has considered the Veteran's recent lay contentions and lay statement to the effect that he experienced foot injury in service; however, wearing boots in wet conditions and climbing telephone poles do not describe a foot injury or disease. Symptoms of foot pain, as described by the Veteran, can be expected after prolonged physical activity and do not necessarily indicate a foot injury or disease.

Further, these recent lay assertions of foot problems during service are inconsistent with and outweighed by other, more contemporaneous lay and medical evidence of record, including the Veteran's own prior medical histories presented during service and for treatment purposes. The Veteran was treated on numerous occasions during service for the lumbar spine condition and neurological symptoms in the lower extremities, which are now service connected. The more contemporaneous lay and medical evidence, including the Veteran's medical histories made for treatment purposes, shows no such report of injury or history of in-service foot symptoms, disease, or injury. The absence of any in-service reports of diagnosis, findings, or reference to treatment related to the feet during active-duty service, under the facts of this case, is one factor, among other factors considered by the Board, that tends to show that the bilateral foot disabilities did not occur during service but occurred many years after service. See Buczynski v. Shinseki, 24 Vet. App. 221, 224 (2011) (the absence of a notation in a record may only be considered if it is first shown that the record is complete and also that the fact would have been recorded had it occurred); Kahana v. Shinseki, 24 Vet. App. 428, 438 (2011) (stating that VA may use silence in service treatment records as evidence contradictory to a veteran's assertions if the service treatment records appear to be complete and injury, disease, or symptom would ordinarily have been recorded had they occurred); Fed. R. Evid. 803(7).

Consistent with the finding of no injury or disease of the feet in service, a post-service VA examination related to the claim indicated that the bilateral feet were still normal in May 2011, over 30 years after service separation. Based on the foregoing, the persuasive weight of the evidence is against a left or right foot injury, disease, or event during service or continuous symptoms since service.

After review of all the evidence, lay and medical, the Board finds the persuasive weight of the evidence demonstrates that there was no relation between the bilateral foot conditions and service. In the context of no in-service foot injury or disease, and no foot abnormalities for decades after service, the evidence included medical nexus opinions that weigh against otherwise finding a direct nexus to service.

VA provided multiple examinations for the feet. In a May 2011 VA examination, there was no diagnosis for the feet. In a September 2013 examination, the diagnosis was mild bilateral hallux valgus with degenerative changes.

The September 2013 VA examiner opined that the bilateral foot disabilities were less likely than not incurred in or caused by the claimed in-service injury, event or illness. The examiner provided the rationale that the bilateral foot pain was related to degenerative joint disease of the foot and aggravation of the mild hallux valgus, and none of the signs or symptoms were caused directly or indirectly by the service-connected lumbar arthropathy. An April 2020 Board decision found the opinion inadequate for adjudication purposes for lack of rationale and remanded the issue of service connection for further development.

At a January 2021 VA examination, the Veteran reported onset of bilateral foot pain in the 1970s that worsened to include bilateral great toe pain from hallux valgus and pain with walking. The examiner opined that the bilateral foot disabilities were less likely than not incurred in or caused by the claimed in-service injury, event, or illness, providing the rationale that there was no objective evidence of related complaints or treatment during service. A June 2022 Board decision remanded the matter for a VA examiner to consider statements from an October 2013 notice of disagreement that the feet disabilities were due to wearing boots in water, mud, and oil.

In a January 2023 VA opinion
connection for further development.

In a January 2023 VA opinion, the examiner opined that the bilateral foot disabilities were less likely than not incurred in or caused by the Veteran's military service. In support of this opinion, the examiner indicated that post-service treatment records indicated that degenerative changes were noted in 2013, several years after service separation. The Veteran also had bilateral mild hallux valgus deformity indicated on x-rays. Service treatment records did not indicate the bilateral foot disabilities began or started while in the military due to trauma or injury, and there was no confirmed diagnosis during service. The examiner further indicated that the bilateral foot disabilities were consistent with the normal aging process for the Veteran considering his age.

A February 2023 addendum VA opinion also indicated that the bilateral foot disabilities were less likely than not incurred in or caused by the Veteran's military service. In addition to the reasoning from the January 2023 examination, the examiner specifically considered the Veteran's contentions that the current bilateral foot disabilities were due to wearing boots in mud, water, oil, and pain that started in the 1970s. However, the examiner maintained their reasoning.

The examiner had an accurate history, medical expertise and training, and provided a sound rationale for the medical opinion; therefore, the February 2023 VA medical opinion was of probative value to weigh against a nexus between the current bilateral foot disabilities and service.

The Board concludes that, while the Veteran has current disabilities of osteoarthrosis of the left and right foot that are chronic diseases listed under 38 C.F.R. § 3.309(a), the persuasive weight of the lay and medical evidence shows that symptoms of osteoarthrosis were not chronic in service, were not continuous since service, and did not manifest to a compensable degree within one year of service separation in April 1975 and September 1978; therefore, the criteria for "chronic disease" presumptive service connection are not met. 38 U.S.C. §§ 101(3), 1110, 1112, 1131, 1137; 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). As discussed above, neither service treatment records or the service periodic health assessments throughout active service indicated any history, findings, or diagnosis for the left and right foot. A VA examination in September 2013, 35 years after service separation, indicated degenerative changes in the feet.

The persuasive weight of the lay and medical evidence also demonstrates that there was no relation between the bilateral foot hallux valgus with osteoarthrosis and the service-connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves. In a January 2021 VA examination, the examiner opined that the bilateral foot disabilities were less likely than not aggravated by the service-connected disabilities, including lumbar spine laminectomy with degenerative disease, bursitis of the right shoulder, arthritis of the left shoulder, and degenerative disc and joint disease of the cervical spine. The examiner provided the rationale that a September 2013 examination demonstrated intermittent foot pain with no prior surgical procedures, and this fell within the projected natural history of the condition and does not represent aggravation. A June 2022 Board decision remanded the matter for additional clarification as to the aggravation opinions.

In a January 2023 VA opinion, the examiner opined that the bilateral foot disabilities were less likely than not proximately due to or the result of the service- connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves. The examiner explained that the bilateral foot disabilities were part of the normal aging process for the veteran as per the Veteran's age.

In a January 2023 VA opinion, the examiner opined that the bilateral foot disabilities were not aggravated by the lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves. In support of this opinion, the examiner explained that bilateral foot disabilities were part of the normal aging process over the years which included degenerative arthritis and
opinion, the examiner opined that the bilateral foot disabilities were less likely than not proximately due to or the result of the service- connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves. The examiner explained that the bilateral foot disabilities were part of the normal aging process for the veteran as per the Veteran's age.

The January 2023 VA examiner had an accurate history, medical expertise and training, and provided a sound rationale for the medical opinions; therefore, the January 2023 VA medical opinions were of probative value to weigh against service connection on a secondary basis.

For the reasons described above, the Board finds that the persuasive weight of the lay and medical evidence is against service connection for the left and right foot disabilities under any theory; therefore, the appeals must be denied.

3. Service connection for the left ankle is denied.

4. Service connection for the right ankle is denied.

The Veteran contends that the left and right ankle disabilities were a result of falling down during formation in service in 1974 or in the alternative were due to the service-connected lumbosacral disability. See October 2010 statement of Veteran and October 2013 notice of disagreement.

The February 2024 rating decision made the favorable finding that the Veteran was service connected for the primary claimed disability of lumbosacral degenerative disease post laminectomy. Under the AMA, the Board is bound by favorable findings made by the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c).

The record shows current diagnoses of left and right ankle tendonitis. See January 2023 VA examination.

After review of all the evidence, lay and medical, the persuasive weight of the evidence is against a finding that there was a left or right ankle injury, disease, or event during service. Service treatment records from the first period of active duty (April 1972 to April 1975) indicate no reports of relevant injury, symptoms, complaints, findings, diagnosis, or treatment in service for the ankles, and an April 1975 separation examination indicated only musculoskeletal issues of back pain. Prior to the second period of active service, the Veteran denied arthritis, bone or joint deformity, and lameness in a medical history from April 1977, and there were no musculoskeletal issues at the entrance examination in April 1977. Service treatment records from the second period of active duty (May 1977 to September 1978) indicate no reports of relevant injury, symptoms, complaints, findings, diagnosis, or treatment in service for the ankles, and a service separation examination in May 1978 indicated only issues of the right shoulder and lumbar spine. Service treatment records from both periods appear to be complete.

In an October 2013 statement, the Veteran reported the left and right ankle disabilities were a result of falling down during formation in service in 1974. In a March 2025 appellate brief, it was contended that the bilateral ankle disabilities were due to the Veteran's MOS of lineman.

The Board has considered the Veteran's recent lay contentions and lay statement to the effect that he experienced ankle injury in service during a fall, that he injured himself climbing telephone poles, and that he has had pain since the 1970s; however, the Veteran has not identified symptoms that he experienced during the fall in 1974. Additionally, climbing telephone poles does not describe a foot injury or disease. Symptoms of ankle pain, as described by the Veteran, can be expected after prolonged physical activity and do not necessarily indicate an ankle injury or disease.

These recent lay assertions are inconsistent with and outweighed by other, more contemporaneous lay and medical evidence of record, including the Veteran's own prior medical histories presented during service and for treatment purposes. The Veteran was treated on numerous occasions for a lumbar spine condition and neurological symptoms in the lower extremities. The more contemporaneous lay and medical evidence, including the Veteran's medical histories made for treatment purposes, shows no such report of in-service ankle symptoms, disease, or injury. The absence of any in-service reports of diagnosis, findings, or reference to treatment related to the ankles during active-duty service, under the facts of this case, is one factor, among other factors considered by the Board, that tends to show that the bilateral ankle
recent lay assertions are inconsistent with and outweighed by other, more contemporaneous lay and medical evidence of record, including the Veteran's own prior medical histories presented during service and for treatment purposes. The Veteran was treated on numerous occasions for a lumbar spine condition and neurological symptoms in the lower extremities. The more contemporaneous lay and medical evidence, including the Veteran's medical histories made for treatment purposes, shows no such report of in-service ankle symptoms, disease, or injury. The absence of any in-service reports of diagnosis, findings, or reference to treatment related to the ankles during active-duty service, under the facts of this case, is one factor, among other factors considered by the Board, that tends to show that the bilateral ankle disabilities did not occur during service but occurred many years after service. See Buczynski, 24 Vet. App. at 224; Kahana, 24 Vet. App. at 438; Fed. R. Evid. 803(7).

The Veteran does not represent that there are service treatment records, VA medical records, private treatment records, or lay statements of any injury or disease of the ankles during active duty. The lay and medical evidence generated contempora-neous to service, which showed no in-service left or right ankle injury or disease and no symptoms, is likely to reflect accurately the Veteran's physical condition, so is of probative value and weighs persuasively against a finding of injury or disease during service.

Consistent with no injury or disease of the ankles in service, a post-service VA examination related to the claim indicated that the ankles were normal in May 2011, over thirty years after service separation. Based on the foregoing, the persuasive weight of the evidence is against a left or right ankle injury, disease, or event during service.

The persuasive weight of the evidence also demonstrates that there was no relation between the current bilateral ankle disabilities and service. VA provided multiple VA examinations for the ankles. In a May 2011 VA examination, there was no diagnosis for the ankles. In a September 2013 examination, the examiner opine that the bilateral ankle disabilities were less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner indicated that the ankles were asymptomatic and x-rays were normal, except for possible signs of trauma to the right ankle. The examiner opined that none of the joint signs and symptoms were caused directly or indirectly by the Veteran's service-connected lumbar spine disability. An April 2020 Board decision found the opinion inadequate for adjudication purposes for lack of rationale and remanded the issue of service connection for further development.

In a January 2021 VA examination, the Veteran reported onset of bilateral ankle pain in the 1970s that worsened to include pain to the medial aspect with standing and walking. The examiner opined that the bilateral ankle disabilities were less likely than not incurred in or caused by the claimed in-service injury, event, or illness, providing the rationale that there was no objective evidence of related complaints or treatment during service. A June 2022 Board decision remanded the matter for a VA examiner to consider statements from an October 2013 notice of disagreement that the bilateral ankle disabilities were due to falling down in formation in 1974.

In a January 2023 VA opinion, the examiner opined that the bilateral ankle disabilities were less likely than not incurred in or caused by the Veteran's military service. In support of this opinion, the examiner indicated no medical record evidence or statements that indicated the bilateral ankle disabilities existed in service. The Veteran did not report injury or trauma in service. The examiner further indicated that review of medical records indicated the bilateral foot disabilities were consistent with the normal aging process for the Veteran considering his age.

A February 2023 addendum VA opinion also indicated that the bilateral ankle disabilities were less likely than not incurred in or caused by the Veteran's military service. In addition to the reasoning from the January 2023 examination, the examiner specifically considered the Veteran's contentions that the current bilateral ankle disabilities were due to falling down during formation in 1974 and pain that started in the 1970s. However, the examiner maintained their reasoning.

After review of all the evidence, lay and medical, the Board finds the persuasive weight of the evidence demonstrates that there was no relation between the bilateral ankle disabilities and the service-connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves, either causation or aggravation. In a January 2021 VA examination, the examiner opined that the left ankle disability was less likely than not proximately due to or the result of the service-connected lumbar spine laminectomy with degenerative disease, bursitis of the right shoulder, arthritis of the left shoulders, and degenerative disc and joint disease of the cervical spine. The examiner provided the rationale that there was no evidence from orthopedic literature 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." Additionally, if there was "shortening of the injured limb resulting in length discrepancy of more than 5cm so that the individuals gait pattern has been altered to the extent that clinically there is an obvious Trendelenburg gait." The examiner further explained that it was not uncommon for two joints to share properties in the same person, but disease does not spread to another; therefore, the left ankle disability was due to something intrinsic to the ankle and not the service-connected disabilities. The examiner did not provide an opinion for the right ankle.

In a January 2021 VA examination, the examiner opined that the left and right ankle disabilities were less likely than not aggravated by the service-connected lumbar spine laminectomy with degenerative disease, bursitis of the right shoulder, arthritis of the left shoulders, and degenerative disc and joint disease of the cervical spine. The examiner provided the rationale that a September 2013 examination demonstrated no active symptoms related to the ankles, and this fell within the projected natural history of the condition and did not represent aggravation. A June 2022 Board decision remanded the matter for additional clarification as to the aggravation opinion.

In a January 2023 VA opinion, the examiner opined that the bilateral ankle disabilities were less likely than not proximately due to or the result of the service- connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves. The examiner explained that the bilateral foot disabilities were part of the normal aging process for the veteran as per the Veteran's age.

In a January 2023 VA opinion, the examiner opined that the bilateral ankle disabilities were not aggravated by the lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves. In support of this opinion, the examiner explained that the bilateral ankle disabilities were part of the normal aging process over the years which included degenerative arthritis and/or pain with decreased range of motion.

For the reasons described above, the Board finds that the persuasive weight of the lay and medical evidence is against service connection for left and right ankle disabilities; therefore, the appeals must be denied.

5. The claim for service connection for left hip arthritis is denied.

6. The claim for service connection for right hip arthritis is denied.

The Veteran contends that the left and right hip disabilities began in service due to work as a lineman or are secondary to the service-connected lumbosacral disability. See October 2010 statement of Veteran (indicating hip disabilities are secondary to lumbosacral disability) and March 2025 appellate brief (indicating bilateral hip disabilities due to work as lineman).

The February 2024 rating decision made a favorable finding that the Veteran was service connected for the primary claimed disability of lumbosacral degenerative disease post laminectomy. Under the AMA, the Board is bound by favorable findings made by the AOJ in the absence of evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c).

The record shows that the Veteran was diagnosed with trochanteric pain syndrome of the hips, degenerative arthritis of the hips, and degenerative joint disease of the sacroiliac joints with pain referred to the hips. See January 202
) and March 2025 appellate brief (indicating bilateral hip disabilities due to work as lineman).

After review of all the evidence, lay and medical, the persuasive weight of the evidence is against a finding that there was a left or right hip injury, disease, or event during service. Service treatment records for the first period of active duty (April 1972 to April 1975) indicate no reports of relevant injury, symptoms, complaints, findings, diagnosis, or treatment in service for the left or right hips. August 1974 service treatment records indicated full range of motion in the hips. An April 1975 separation indicated only musculoskeletal issues of back pain.

VA treatment records from May 1976, between the first and second period of active duty, indicated sharp pains in the lower back with extension into the buttock, thigh areas, and tingling in the toes of both feet. See also February 1976 VA treatment records (indicating normal range of motion in hips but reported pain at limit of motion in hip joint). X-rays taken in May 1976 indicated a normal lumbar spine, pelvis, and hips.

Prior to the second period of active service (May 1977 to September 1978), the Veteran denied arthritis, bone or joint deformity, and lameness in a medical history in April 1977, and there were no musculoskeletal issues at the entrance examination in April 1977. Service treatment records from the second period of active duty indicate no reports of relevant injury, symptoms, complaints, findings, diagnosis, or treatment in service for the hips. A service separation examination in May 1978 indicated only issues of the right shoulder and a herniated nucleus pulposus, L4, 5 with chronic low back and bilateral leg pain. Service treatment records from both periods appear to be complete.

Post-service VA treatment records in March 1979 indicated a diagnosis of bursitis in the bilateral hips with full range of motion.

In a March 2025 appellate brief, it was contended that the bilateral hip disabilities were due to the MOS of lineman, including climbing telephone poles.

The Board has considered the Veteran's recent lay contentions and lay statement to the effect that he experienced hip symptoms in service; however, these recent lay assertions are inconsistent with and outweighed by other, more contemporaneous lay and medical evidence of record, including the Veteran's own prior medical histories presented during service and for treatment purposes, that do not report a history of hip injury or disease in service or of continued symptoms since service. The Veteran was treated on numerous occasions for the lumbar spine condition and neurological symptoms in the lower extremities, which are now service connected. The more contemporaneous lay and medical evidence, including the Veteran's medical histories made for treatment purposes, shows no such report of in-service hip symptoms, disease, or injury. The absence of any in-service reports of symptoms, complaints, findings, diagnosis, or reference to treatment related to the hips during active-duty service, under the facts of this case, is one factor, among other factors considered by the Board, that tends to show that the bilateral hip disabilities did not occur during service but occurred after service. See Buczynski at 224; Kahana at 438; Fed. R. Evid. 803(7).

Consistent with no injury or disease of the hips in service, the post-service x-rays of the hips in May 1976 indicated that the hips were normal. Additionally, treatment for bilateral hip bursitis occurred after service in 1979. Based on the foregoing, the persuasive weight of the evidence is against a left or right hip injury, disease, or event during service.

After review of all the evidence, lay and medical, the Board finds the persuasive weight of the evidence demonstrates that there was no relation between the bilateral hip disabilities and service. VA provided multiple examinations for the hips. In a May 2011 VA examination, there was no diagnosis for the hips. In a September 2013 examination, the Veteran was diagnosed with partial ankylosis of the upper
the post-service x-rays of the hips in May 1976 indicated that the hips were normal. Additionally, treatment for bilateral hip bursitis occurred after service in 1979. Based on the foregoing, the persuasive weight of the evidence is against a left or right hip injury, disease, or event during service.

After review of all the evidence, lay and medical, the Board finds the persuasive weight of the evidence demonstrates that there was no relation between the bilateral hip disabilities and service. VA provided multiple examinations for the hips. In a May 2011 VA examination, there was no diagnosis for the hips. In a September 2013 examination, the Veteran was diagnosed with partial ankylosis of the upper sacroiliac joint of either side of the pelvis from a 2009 x-ray; however, the pelvis and hips were normal, and the examiner indicated that the bilateral hip pain was referred pain from the back and sacroiliac joints. No opinion was provided, and an April 2020 Board decision remanded the issue of service connection for further development.

In a January 2021 VA examination, the diagnoses were trochanteric pain syndrome of the hips. The Veteran reported hip pain with onset in the 1970s that worsened to include pain with bending, standing up straight, lifting, and carrying. The examiner opined that the bilateral hip disabilities were less likely than not incurred in or caused by the claimed in-service injury, event, or illness, providing the rationale that there was no objective evidence of related complaints or treatment during service. A June 2022 Board decision remanded the matter for a VA examiner to consider statements from an October 2013 notice of disagreement that the bilateral hip problems began during service as evidenced by service treatment records.

In a January 2023 VA examination, the Veteran reported that the bilateral hip pain began in the 1980s. The Veteran was diagnosed with degenerative arthritis of the bilateral hips. In a January 2023 VA opinion, the examiner opined that the bilateral hip disabilities were less likely than not incurred in or caused by the Veteran's military service. In support of this opinion, the examiner indicated the Veteran stated that hip disabilities began in the 1980s, which was after service. Medical records did not indicate any trauma or injury during service. The examiner further indicated that the bilateral hip disabilities were consistent with the normal aging process for the Veteran considering his age.

A February 2023 addendum VA opinion also indicated that the bilateral hip disabilities were less likely than not incurred in or caused by the Veteran's military service. In addition to the reasoning from the January 2023 examination, the examiner specifically considered the Veteran's contentions that pain started in the 1970s. However, the examiner maintained their reasoning.

The Board concludes that, while the Veteran has degenerative arthritis of the left and right hip that is a chronic disease listed under 38 C.F.R. § 3.309(a), the persuasive weight of the lay and medical evidence shows that symptoms of arthritis were not chronic in service, were not continuous since service, and did not manifest to a compensable degree within one year of service separation in April 1975 and September 1978; therefore, the criteria for "chronic disease" presumptive service connection are not met. 38 U.S.C. §§ 101(3), 1110, 1112, 1131, 1137; 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). As discussed above, neither service treatment records or the service periodic health assessments throughout active service indicated any history, findings, or diagnosis for the left or right hip. VA treatment records show the Veteran had complaints for the left and right hip between the first and second period of active service in February 1976; however, the Veteran had x-rays at the time that indicated normal hips. While the Veteran was seen for hip issues within one year of discharge from the second period of active service, he was diagnosed with bursitis of the hips, which is not a chronic disease. VA treatment records from 2009, over 30 years after service, indicated referred pain to the hips from diagnosed partial ankylosis of the upper sacroiliac joint of either side of the pelvis. Degenerative arthritis of the hips was indicated in 2013, which was 35 years after active-duty service.

After review of all the evidence, lay and medical
between the first and second period of active service in February 1976; however, the Veteran had x-rays at the time that indicated normal hips. While the Veteran was seen for hip issues within one year of discharge from the second period of active service, he was diagnosed with bursitis of the hips, which is not a chronic disease. VA treatment records from 2009, over 30 years after service, indicated referred pain to the hips from diagnosed partial ankylosis of the upper sacroiliac joint of either side of the pelvis. Degenerative arthritis of the hips was indicated in 2013, which was 35 years after active-duty service.

After review of all the evidence, lay and medical, the Board finds the persuasive weight of the evidence demonstrates that there was no relation, causation or aggravation, between the bilateral hip disabilities and service-connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves. In a January 2021 VA examination, the examiner opined that the left and right hip disabilities were less likely than not aggravated by the service-connected lumbar spine laminectomy with degenerative disease, bursitis of the right shoulder, arthritis of the left shoulder, and degenerative disc and joint disease of the cervical spine. The examiner provided the rationale that February 2014 treatment records demonstrated mild hip pain with normal radiographic imaging, and this fell within the projected natural treatment of the conditions and does not represent aggravation. A June 2022 Board decision remanded the matter for additional clarification as to the aggravation opinions.

In a January 2023 VA opinion, the examiner opined that the bilateral hip disabilities were less likely than not proximately due to or the result of the service- connected lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves. The examiner explained that the bilateral hip disabilities were part of the normal aging process for the veteran as per the Veteran's age.

In a January 2023 VA opinion, the examiner opined that the bilateral hip disabilities were not aggravated by the lumbosacral disability with radiculopathy of the bilateral sciatic and femoral nerves. In support of this opinion, the examiner explained that the bilateral hip disabilities were part of the normal aging process over the years which included degenerative arthritis and/or pain with decreased range of motion.

For the reasons described above, the Board finds that the persuasive weight of the lay and medical evidence is against service connection for left and right hip disabilities; therefore, the appeals must be denied.

7. Entitlement to an allowance for an automobile or other conveyance, and adaptive equipment, or for adaptive equipment is denied.

Financial assistance may be provided to an eligible person in acquiring an automobile or other conveyance and adaptive equipment, or automobile adaptive equipment only. 38 U.S.C. § 3902(a)-(b). Eligibility for financial assistance in the purchase of a vehicle or other conveyance and adaptive equipment is warranted where one of the following exists as the result of injury or disease incurred or aggravated during active service: (1) loss or permanent loss of use of one or both feet; (2) loss or permanent loss of use of one or both hands; (3) permanent impairment of vision of both eyes, meaning central visual acuity of 20/200 or less in the better eye, with corrective glasses, or central visual acuity of more than 20/200 if there is a field defect in which the peripheral field has contracted to such an extent that the widest diameter of visual field subtends an angular distance no greater than 20 degrees in the better eye; (4) severe burn injury precluding effective operation of an automobile; (5) amyotrophic lateral sclerosis; or, (6) for adaptive equipment only, ankylosis of one or both knees or one or both hips. 38 C.F.R. § 3.808.

Congress established the program authorizing funding for automobiles and adaptive equipment for veterans with certain service-connected disabilities. 38 U.S.C. §§ 3901-3904. Pursuant to the authority established in 38 U.S.C. § 3902, VA promulgated 38 C.F.R. § 3.808, which reiterates the 38 U.S.C. § 3901(a) requirement that entitlement to automobile and adaptive equipment is warranted for the loss or permanent loss of use of one or both feet or one or both hands. 38 C.F.R. § 3.808 (b)(i)-(ii). The regulation does not further define the phrase loss or permanent loss of use. Under the applicable eligibility criteria for financial assistance in the purchase of an automobile or other conveyance and adaptive equipment, found in 38 U.S.C. § 3901 and 38 C.F.R. § 3.808, the appellant must show that they lost a foot or hand or permanently lost the use of a foot or hand as a result of service-connected disability.

Loss of use is used in several places in the Rating Schedule. 38 C.F.R. Part 4. In the context of special monthly compensation under 38 C.F.R. § 3.350(a)(2)(i), loss of use of a hand or a foot will be held to exist when no effective function remains other than that which would be equally well served by an amputation stump at the site of election below elbow or knee with use of a suitable prosthetic appliance.

A less restrictive definition is written into 38 U.S.C. § 2101 and 38 C.F.R. § 3.809 regarding specially adapted housing. That regulation specifies that loss of use was defined by the adjacent modifier, such as to preclude locomotion without the aid of braces, crutches, canes, or a wheelchair. Jensen v. Shulkin, 29 Vet. App. 66 (2017).

However, that modifier is absent from 38 U.S.C. § 3901 and 38 C.F.R. § 3.808, and had Congress or the Secretary of VA wished for such a definition to apply to these sections, it presumably would have been included; therefore, loss of use under 38 C.F.R. § 3.808 will be taken to mean actual loss of functional use of the body part, with any need of assistive devices being relevant to, but not dispositive of the question of whether the veteran has permanent loss of use.

The Veteran requests an automobile conveyance or adaptive equipment. In a March 2025 appellate brief, it was asserted that the bilateral restless leg syndrome was causing loss of use of the feet, and the Veteran used a wheelchair for mobility purposes.

After review of all the evidence of record, the Board finds that the criteria for financial assistance in acquiring an automobile or other conveyance or special adaptive equipment have not been met. During the time period relevant to this appeal, the Veteran has established service connection for: lumbosacral degenerative disc disease, cervical degenerative disc disease, bilateral lower extremity sciatic radiculopathy, bilateral lower extremity femoral radiculopathy, bilateral upper extremity ulnar radiculopathy, right shoulder bursitis, left shoulder arthritis, scarring of the anterior trunk, scar of the transurethral resection of the bladder, scar of the right upper extremity, major depressive disorder with insomnia, urinary incontinence, tension headaches, erectile disfunction, and hypertension. The Veteran also received special monthly compensation related to the need for aid and attendance.

Service connection is not established for disabilities involving visual impairment, burn injuries, or amyotrophic lateral sclerosis. As addressed previously herein, the Veteran is not service connected for a right or left hip disability.

A VA examination for housebound status was completed in June 2023 wherein the examiner indicated there was an antalgic gate with ambulation in a stooped posture, short stride, and shuffle of two to three steps that favored the right leg. Weight bearing was limited by the bilateral lower extremity radiculopathy, cervical disability and lumbar disability, including with lifting, pushing, pulling, standing, walking long periods, driving long distances, and sitting at a desk for long periods due to pain and weakness in the back and numbness/tingling and paresthesias. Although the record showed restrictions to the use of the lower extremities generally, the ability to walk tends to show that the Veteran does not have loss of use of one or both feet.

In the June 2023 VA examination
examiner indicated there was an antalgic gate with ambulation in a stooped posture, short stride, and shuffle of two to three steps that favored the right leg. Weight bearing was limited by the bilateral lower extremity radiculopathy, cervical disability and lumbar disability, including with lifting, pushing, pulling, standing, walking long periods, driving long distances, and sitting at a desk for long periods due to pain and weakness in the back and numbness/tingling and paresthesias. Although the record showed restrictions to the use of the lower extremities generally, the ability to walk tends to show that the Veteran does not have loss of use of one or both feet.

In the June 2023 VA examination for housebound status, it was indicated that the Veteran had use of the hands to grip, for fine movements, and to feed himself. Although the record showed restrictions to the use of the upper extremities generally, the abilities to use the hands for these activities tends to show that the Veteran does not have loss of use of one or both hands.

A June 2023 VA examination for the peripheral nerve conditions, including restless leg syndrome, indicated the use of both a wheelchair and walker for ambulation. The examiner indicated that there was not functional impairment of the upper or lower extremities such that no effective function remains other than that which would be equally well served by an amputation with prosthesis.

None of the service-connected disabilities results in or are manifested by the loss, or permanent loss of use, of at least one foot or a hand, or permanent impairment of vision in both eyes, a severe burn injury to the required specified degree, ALS, or (for adaptive equipment eligibility only) ankylosis of one or both knees or one or both hips. For these reasons, automobile allowance or specially adapted equipment is not warranted, and the appeal must be denied.

J. PARKER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board E. Beilsmith, 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.

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