FLATFOOT BILATERAL ACQUIRED

REBECCA N. POULSON · 2026 · Case ID: A26013801

DENIED

Summary

The veteran, who served in the Army from July 1982 to February 2005, including service in Saudi Arabia during the Persian Gulf War, appeals the denial of service connection for multiple conditions. The claims include pes planus, plantar fasciitis, gout, sleep apnea, toe fungus, skin rash of the upper extremities, and bilateral hearing loss. The Board found that for pes planus, plantar fasciitis, gout, sleep apnea, toe fungus, and skin rash, the veteran failed to provide evidence of a current disability or a nexus to service. While the veteran testified to current symptoms at a May 2024 hearing, he did not submit supporting medical evidence within the allowed timeframe, and the Board found no pre-decisional duty to order a VA examination due to the lack of current medical evidence at the time of the initial January 2020 decision. For bilateral hearing loss, the Board denied service connection because the January 2020 VA examination audiometric testing did not meet the regulatory thresholds for a current disability, and the veteran did not submit contradictory evidence or evidence of noise exposure during service. Service connection for all claimed conditions was denied.

Rationale

No evidence of current disability; No nexus to service; No pre-decisional duty to order VA exam

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

200228-73783

Full Decision Text

Citation Nr: A26013801
Decision Date: 02/13/26 Archive Date: 02/13/26

DOCKET NO. 200228-73783
DATE: February 13, 2026

ORDER

Service connection for pes planus is denied.

Service connection for plantar fasciitis is denied.

Service connection for gout is denied.

Service connection for sleep apnea is denied.

Service connection for toe fungus of both feet is denied.

Service connection for a skin rash of the upper extremities is denied.

Service connection for bilateral hearing loss is denied.

FINDINGS OF FACT

1. The Veteran's claimed pes planus is not related to service and did not manifest within one year of separation from service.

2. The Veteran's claimed plantar fasciitis is not related to service and did not manifest within one year of separation from service.

3. The Veteran's claimed gout is not related to service.

4. The Veteran's claimed sleep apnea is not related to service or to a service-connected disability.

5. The Veteran's toe fungus is not related to service.

6. The Veteran's skin rash is not related to service.

7. The Veteran does not have a current hearing loss disability for the purposes of VA compensation.

CONCLUSIONS OF LAW

1. The criteria for service connection for pes planus are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2025).

2. The criteria for service connection for plantar fasciitis are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2025).

3. The criteria for service connection for gout are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2025).

4. The criteria for service connection for sleep apnea are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2025).

5. The criteria for service connection for toe fungus of both feet are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2025).

6. The criteria for service connection for a skin rash of the upper extremities are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2025).

7. The criteria for service connection for bilateral hearing loss are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385 (2025).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from July 1982 to February 2005, including service in Saudi Arabia from December 1990 to May 1991.

This appeal is before the Board of Veterans' Appeals (Board) from a January 2020 rating decision of the agency of original jurisdiction (AOJ), a Department of Veterans Affairs (VA) Regional Office (RO).

In his February 2020 notice of disagreement, the Veteran elected the Hearing docket. In May 2024, the Veteran testified during a Board hearing before the undersigned Veterans Law Judge via videoconference. A transcript is included in the claims file. Therefore, the Board may only consider the evidence of record at the time of the January 2020 AOJ decision on appeal, as well as any evidence submitted by the Veteran or his representative at the May 2024 hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). No evidence was received within the 90-day period. If evidence was submitted either (1) during the
) Regional Office (RO).

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, he 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, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a supplemental claim are included with this decision.

The Board notes that at the time of his February 2020 notice of disagreement, the Veteran was represented by the Texas Veterans Commission. In April 2024, the Veteran submitted VA Form 21-22 naming Disabled American Veterans as his representative. The Board will not accept a change in representation more than 90 days following receipt of a notice of disagreement, except when an appellant demonstrates on motion that there was good cause for the delay. 38 C.F.R. § 20.1304(b). Disabled American Veterans served as his representative at his May 2024 hearing, at which they assured the Board that a subsequent motion showing good cause would be submitted. No such motion was received. However, the Board nevertheless finds there was good cause, as Disabled American Veterans represented the Veteran at his Board hearing, and the Board recognizes the April 2024 POA in favor of Disabled American Veterans.

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection requires: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

Service connection may be awarded on a secondary basis if a claimant suffers a disability that is "proximately due to or the result of a service-connected disease or injury." See 38 C.F.R. § 3.310(a); but see Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023). For "aggravation of non-service-connected disabilities" it is enough to show that a non-service-connected disability would have been less severe but-for a service-connected disability, either because there is an etiological link (to include worsening of functionality) between the two, or because the service-connected disability resulted in the inability to treat the non-service-connected disability.

VA may grant service connection for a current disability on a secondary basis with obesity as an intermediate step under 38 C.F.R. § 3.310(a), to include aggravation of a non-service-connected disability. See Walsh v. Wilkie, 32 Vet. App. 300, 304-06 (2020) (explaining service connection may be granted on a secondary basis where the claimed disability would not have occurred but for obesity caused or aggravated by a service-connected disability). To determine whether obesity is an intermediate step between a service-connected disability and the development of a current disability, the following criteria must all be satisfied: 1) the service-connected disability must have caused the claimant to become obese or aggravated his obesity; 2) the obesity or aggravation of the
basis with obesity as an intermediate step under 38 C.F.R. § 3.310(a), to include aggravation of a non-service-connected disability. See Walsh v. Wilkie, 32 Vet. App. 300, 304-06 (2020) (explaining service connection may be granted on a secondary basis where the claimed disability would not have occurred but for obesity caused or aggravated by a service-connected disability). To determine whether obesity is an intermediate step between a service-connected disability and the development of a current disability, the following criteria must all be satisfied: 1) the service-connected disability must have caused the claimant to become obese or aggravated his obesity; 2) the obesity or aggravation of the obesity, as a result of the service-connected disability, must have been a substantial factor in causing the potential secondary disability; and 3) the potential secondary disability would not have occurred but for the obesity caused by, or aggravated by, the service-connected disability. See id. at 307.

For certain chronic diseases, including arthritis and organic disease of the nervous system such as sensorineural hearing loss, a presumption of service connection arises if the disease is manifested to a degree of 10 percent within one year following discharge from service. 38 C.F.R. §§ 3.307(a)(3), 3.309(a). When a chronic disease is not shown to have manifested to a compensable degree within one year after service, under 38 C.F.R. § 3.303(b) 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. When the fact of chronicity in service is not adequately supported, a showing of continuity after discharge is required to support a claim for such diseases; however, such continuity of symptomatology may only support a claim for those chronic diseases listed under 38 C.F.R. § 3.309(a). 38 C.F.R. § 3.303(b); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

VA's duty to assist a claimant includes providing a medical examination or obtaining a medical opinion when an examination or opinion is necessary to make a decision on the claim. 38 U.S.C. § 5103A(d)(1); 38 C.F.R. § 3.159(c). In determining whether VA's duty to assist requires a VA examination or medical opinion, four factors are for consideration: (1) whether there is competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) whether there is evidence establishing that an event, injury, or disease occurred in service, or evidence establishing certain diseases manifesting during an applicable presumptive period; (3) whether there is an indication that the disability or symptoms may be associated with the veteran's service or with another service-connected disability; and (4) whether there otherwise is sufficient competent medical evidence of record to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006).

In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the claimant prevailing in either event, or whether the evidence is persuasively against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant.

The Board notes that the Veteran's service treatment records are not associated with the claims file. In October 2019 and December 2019 letters, the Veteran was informed that VA had been unable to obtain his service treatment records, and that further evidence corroborating his in service injuries should be submitted if available. The Board is mindful that, in a case such as this, where service treatment records are unavailable, there is a heightened obligation to explain our findings and conclusions and to consider carefully the benefit-of-the-doubt rule. Cuevas v. Principi, 3 Vet. App. 542, 548 (1992); Pruitt v. Derwinski, 2 Vet. App. 83, 85 (1992); O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). While it is unfortunate that some of the Veteran's service treatment records are unavailable, this appeal must be decided on the evidence of record and, where possible, the Board's analysis
The Board is mindful that, in a case such as this, where service treatment records are unavailable, there is a heightened obligation to explain our findings and conclusions and to consider carefully the benefit-of-the-doubt rule. Cuevas v. Principi, 3 Vet. App. 542, 548 (1992); Pruitt v. Derwinski, 2 Vet. App. 83, 85 (1992); O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). While it is unfortunate that some of the Veteran's service treatment records are unavailable, this appeal must be decided on the evidence of record and, where possible, the Board's analysis has been undertaken with this heightened obligation in mind.

1. Entitlement to service connection for pes planus

2. Entitlement to service connection for plantar fasciitis

The Veteran claims service connection for pes planus and plantar fasciitis.

In his July 2019 claims, the Veteran claimed service connection for pes planus and plantar fasciitis. He did not further describe the disabilities or explain how they were related to service. The initial claim form was rejected as unsigned; the Veteran submitted an identical claim with signature in November 2019.

At his May 2024 hearing, the Veteran reported that he was initially told that he had flat feet in service. He stated that he had some copies of service treatment records and current treatment records that he could obtain and submit. No additional evidence, however, was received within the applicable 90-day period.

As an initial matter, the Board finds that remand is not necessary to provide the Veteran with a VA examination or opinion. There was no pre-decisional duty to provide such an examination because the evidence before the AOJ at the time of the January 2020 rating decision on appeal did not establish any current foot disabilities. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006); see 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(i); see also 38 U.S.C. § 1168 (requiring a medical opinion addressing toxic exposure risk activities (TERAs) when there is evidence of a disability). While the Veteran is competent to report his own symptoms, aside from listing the disability on the claim form itself he did not provide any evidence of a current disability. At no time did he state that the disability was current, provide a description of symptoms, or describe pain that results in functional impairment of earning capacity. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). It was not until his May 2024 hearing that he stated that his symptoms were current. Moreover, he did not provide any medical treatment records or any other evidence to establish a current disability. For these reasons, the Board finds that there was no pre-decisional duty to provide a VA examination or opinion, and remand for such is thus not warranted.

The Board finds that the evidence persuasively weighs against a finding that the Veteran's claimed pes planus and plantar fasciitis is related to service or manifested within one year of separation from service. While he is competent to report current foot pain, he is not competent to provide a diagnosis or to determine that his current symptoms are related to any symptoms he may have had in service. There is no competent medical evidence before the Board as to these conditions. At his hearing, the Veteran expressed an intent to submit medical evidence during the 90-day window following his appeal. He has not done so. Submitting such evidence with a supplemental claim would be the best avenue for him to attempt to obtain service connection. For these reasons, the Board finds that the evidence persuasively weighs against a finding that the Veteran's pes planus and plantar fasciitis is related to service or manifested within one year of separation from service. Service connection is therefore denied.

3. Entitlement to service connection for gout

The Veteran claims service connection for gout.

In his July 2019 claim, the Veteran claimed service connection for gout in his feet, hands, and other parts of his body. He did not further describe the disability or explain how it was related to service. The initial claim was rejected as unsigned; the Veteran submitted an identical claim with signature in November 2019.

3. Entitlement to service connection for gout

The Veteran claims service connection for gout.

At his May 2024 hearing, the Veteran stated that while in service he had a gout flare-up in his ankle which they initially thought was a spider bite. He stated that since then it flares every now and then with pain. He reported that his most recent gout flare in his wrists and ankle was within two or three years prior. He stated that he had some copies of service treatment records and current treatment records that he could obtain and submit. No additional evidence, however, was received within the applicable 90-day period.

The Board finds that the evidence persuasively weighs against a finding that the Veteran's claimed gout is related to service. While he is competent to report current prior diagnoses and symptoms, he is not competent to determine that his current symptoms are related to a TERA or any gout he may have had in service. There is no competent medical evidence before the Board as to his gout. At his hearing, the Veteran expressed an intent to submit medical evidence during the 90-day window following his appeal. He has not done so. Submitting such evidence with a supplemental claim would be the best avenue for him to attempt to obtain service connection. For these reasons, the Board finds that the evidence persuasively weighs against a finding that the Veteran's gout is related to service, and service connection is therefore denied.

4. Entitlement to service connection for sleep apnea

The Veteran claims service connection for sleep apnea.

In his July 2019 claim, the Veteran claimed service connection for sleep apnea. He did not further describe the disability or explain how it was related to service.

At his May 2024 hearing the Veteran stated that in service he was treated at Ireland Army Hospital for being tired. He stated that he was told that it was about his blood levels, but at that time he did not know anything about excessive snoring. He reported that his wife started complaining about his snoring around 2009. He then stated that because of his service-connected knees, he was unable to work out and gained a lot of weight, causing his sleep apnea to accelerate. Sleep apnea was diagnosed around 2014, and he was currently using a continuous positive airway pressure machine (CPAP). He stated that he had a current diagnosis of sleep apnea but did not undergo a sleep study while in service. He reported that his private physician was preparing an opinion to be submitted. No additional evidence, however, was received within the applicable 90-day period.

As an initial matter, the Board finds that remand is not necessary to provide the Veteran with a VA examination or opinion. There was no pre-decisional duty to provide such an examination because the evidence before the AOJ at the time of the January 2020 rating decision on appeal did not establish any current sleep apnea disability. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006); see 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(i); see also 38 U.S.C. § 1168 (requiring a medical opinion addressing TERAs when there is evidence of a disability). While the Veteran is competent to report his own symptoms, aside from listing the disability on the claim form itself he did not provide any evidence of a current disability. At no time did he state that the disability was current, provide a description of symptoms, or describe pain that results in functional impairment of earning capacity. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). It was not until his May 2024 hearing that he stated that he was currently diagnosed with and treated for sleep apnea. This was also the first point at which he raised the possibility that sleep apnea was secondary to his service-connected disabilities with obesity as an intermediate step. Moreover, he did not provide any medical treatment records or any other evidence to establish a current disability. For these reasons, the Board finds that there was no pre-decisional duty to provide a VA examination or opinion, and remand for such is thus not warranted.

The Board finds that the evidence persuasively weighs against a finding that the Veteran's claimed sleep apnea is related to service or to a service-connected disability. While he is competent to report current prior diagnoses and symptoms, he is not competent to determine that current sleep apnea arose in service, is related to a TERA, or is secondary to his service-connected disabilities with obesity as an intermediate step. There is no competent medical evidence before the Board as to his sleep apnea. At his hearing, the Veteran expressed an intent to submit medical evidence during the 90-day window following his appeal. He has not done so. Submitting such evidence with a supplemental claim would be the best avenue for him to attempt to obtain service connection. For these reasons, the Board finds that the evidence persuasively weighs against a finding that the Veteran's sleep apnea is related to service or to a service-connected disability. Service connection is therefore denied.

5. Entitlement to service connection for toe fungus of both feet

6. Entitlement to service connection for a skin rash of the upper extremities

The Veteran claims service connection for toe fungus and a skin rash.

In his July 2019 claim, the Veteran claimed service connection for toe fungus and a skin rash of the upper extremities. He did not further describe the disabilities or explain how they were related to service.

At his May 2024 hearing, the Veteran reported that a skin rash of the upper extremities began in 1997 or 1998 after he was stationed in Korea. He stated that since then it flared up in cycles. He also reported that his toe fungus began while in service after the Gulf War. He stated that he had some copies of service treatment records and current treatment records that he could obtain and submit. No additional evidence, however, was received during the applicable 90-day period.

As an initial matter, the Board finds that remand is not necessary to provide the Veteran with a VA examination or opinion. There was no pre-decisional duty to provide such an examination because the evidence before the AOJ at the time of the January 2020 rating decision on appeal did not establish any current skin disabilities. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006); see 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(i); see also 38 U.S.C. § 1168 (requiring a medical opinion addressing toxic exposure risk activities (TERAs) when there is evidence of a disability). While the Veteran is competent to report his
the Veteran with a VA examination or opinion. There was no pre-decisional duty to provide such an examination because the evidence before the AOJ at the time of the January 2020 rating decision on appeal did not establish any current skin disabilities. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006); see 38 U.S.C. § 5103A(d)(2); 38 C.F.R. § 3.159(c)(4)(i); see also 38 U.S.C. § 1168 (requiring a medical opinion addressing toxic exposure risk activities (TERAs) when there is evidence of a disability). While the Veteran is competent to report his own symptoms, aside from listing the disability on the claim form itself he did not provide any evidence of a current disability. At no time did he state that the disability was current, provide a description of symptoms, or describe pain that results in functional impairment of earning capacity. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). It was not until his May 2024 hearing that he stated that his symptoms were current. Moreover, he did not provide any medical treatment records or any other evidence to establish a current disability. For these reasons, the Board finds that there was no pre-decisional duty to provide a VA examination or opinion, and remand for such is thus not warranted.

The Board finds that the evidence persuasively weighs against a finding that the Veteran's claimed toe fungus and skin rash is related to service. While he is competent to report current skin symptoms, he is not competent to provide a diagnosis or to determine that his current symptoms are related to a TERA or to any symptoms he may have had in service. There is no competent medical evidence before the Board as to these conditions. At his hearing, the Veteran expressed an intent to submit medical evidence during the 90-day window following his appeal. He has not done so. Submitting such evidence with a supplemental claim would be the best avenue for him to attempt to obtain service connection. For these reasons, the Board finds that the evidence persuasively weighs against a finding that the Veteran's toe fungus and skin rash is related to service, and service connection is therefore denied.

7. Entitlement to service connection for bilateral hearing loss

The Veteran claims service connection for bilateral hearing loss.

For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies of 500, 1000, 2000, 3000 and 4000 Hertz is 40 decibels or greater; or when the thresholds for at least three of these frequencies are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. See 38 C.F.R. § 3.385.

In his July 2019 claim, the Veteran claimed service connection for hearing loss. He did not further describe the disability or explain how it was related to service.

The Veteran underwent a VA examination in January 2020. He reported difficulty hearing in noisy environments and group situations. He was unsure of the date of onset. Pure tone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 15 15 10 15 15

LEFT 10 10 10 30 25

Speech audiometry revealed speech recognition ability of 100 percent in each ear. He was diagnosed with normal hearing in the right ear and left ear sensorineural hearing with the caveat that such diagnosis may not meet the definition of a disability under 38 C.F.R. § 3.385.

At his May 2024 hearing, the Veteran attributed his claimed hearing loss to exposure to noise in service as a master gunner. He stated that he had some copies of service treatment records and current treatment records that he could obtain and submit. No additional evidence, however, was received during the applicable 90-day period.

The Board finds that the evidence persuasively weighs against a finding of current hearing loss disability for VA compensation purposes. While the Veteran is competent to report his own hearing loss symptoms, VA regulations require hearing loss to meet certain thresholds on objective testing to qualify as a current disability for compensation purposes. At his January 2020 VA examination, his audiometric testing did not show current hearing loss under 38 C.F.R. § 3.385. Specifically, he did not have any pure tone thresholds at 40 decibels or greater and had only one threshold at 26 decibels or greater. Speech recognition scores were likewise well above 94 percent. There is no objective audiometric evidence to contradict these findings. Where the evidence does not support a finding of current disability upon which to predicate a grant of service connection, there can be no valid claim for that benefit. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). As such, the Board finds that the evidence persuasively weighs against a finding of a current disability and service connection must therefore be denied.

Rebecca N. Poulson

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board J. Gallagher, 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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