FLATFOOT

M. PRYCE · 2026 · Case ID: A26032868

MIXED

Summary

The veteran, who served in the U.S. Army from October 1976 to October 1982 and again from February 1991 to April 1991, appeals the propriety of a rating reduction for service-connected right foot pes planus. The Regional Office (RO) had reduced the veteran's disability rating from 10 percent to 0 percent, effective July 1, 2020. The veteran contended that the reduction was improper as her condition had not improved and sought restoration of the 10 percent rating, as well as an increased rating. The Board reviewed evidence from a December 2016 private examination, a December 2018 VA examination, and a March 2019 VA treating physician examination. The Board found that the evidence available at the time of the reduction did not support a finding of material improvement under ordinary conditions. Specifically, while some symptoms showed possible improvement, others, such as marked deformity, pain on non-weight bearing, and the need for a cane, indicated stability or worsening. The Board concluded that the reduction was improper and restored the 10 percent rating. Regarding the increased rating claim, the Board reviewed evidence up to July 1, 2020. While acknowledging the veteran's credible testimony and the presence of symptoms warranting at least a 10 percent rating, the Board found that the evidence did not meet the criteria for a 20 percent rating, which requires "marked deformity" and other severe symptoms not consistently documented. Therefore, the Board granted the restoration of the 10 percent rating but denied the increased rating beyond that.

Rationale

Reduction improper due to lack of evidence of material improvement; Evidence did not support reduction under 38 C.F.R. § 3.344; Symptoms remained stable or worsened, not improved

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

5276

Docket No.

210305-144393

Full Decision Text

Citation Nr: A26032868
Decision Date: 04/09/26 Archive Date: 04/09/26

DOCKET NO. 210305-144393
DATE: April 9, 2026

ORDER

1. The reduction of the rating for right foot pes planus from 10 percent to 0 percent, effective July 1, 2020, was improper; a 10 percent rating is restored.

2. Entitlement to a 20 percent rating for right foot pes planus is granted.

FINDING OF FACT

1. Evidence available at the time of the rating reduction for right foot pes planus did not establish that the disability showed actual improvement under the ordinary conditions of life and work.

2. For the period prior to July 1, 2020, the Veteran's right foot pes planus was manifested by symptoms such as characteristic callouses, accentuated pain, marked deformity (pronation), swelling on use, inward bowing of the achilles tendon, and pain on manipulation and use of the feet.

CONCLUSIONS OF LAW

1. The rating reduction for service-connected right foot pes planus was improper. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.105, 3.344, 4.1, 4.7, 4.115a, 4115b, Diagnostic Codes (DC) 5276.

2. The criteria for a rating of 20 percent, but no higher, for right foot pes planus have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, DC 5276.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the U.S. Army from October 1976 to October 1982 and February 1991 to April 1991.

This matter comes before the Board of Veterans' Appeals (Board) on the appeal of a September 2020 higher-level review decision by a U.S. Department of Veterans Affairs (VA) Regional Office (RO), which is the agency of original jurisdiction (AOJ).

In the March 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on August 13, 2024. A copy of the hearing transcript has been associated with the Veteran's electronic claims file.

Therefore, the Board may only consider the evidence of record at the time of the April 2020 decision, which was subsequently subject to higher-level review, as well as any evidence submitted by the Veteran or her representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision, which was subsequently subject to higher-level review and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 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[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

In the instant matter, the question before the Board, as appealed from the rating decisions in question, is the propriety of the reduction of the rating from 10 percent to noncompensable. Regarding the question of an increased rating for that disability, generally, an appeal regarding the reduction of an evaluation must address only the propriety of the reduction, and not whether the veteran is entitled to a higher evaluation. Dofflemyer v. Derwinski, 2 Vet. App. 277, 279-80 (1992). However, when filing a claim with VA, claimants are presumed to be seeking the maximum available benefit for their disability. See AB v. Brown, 6 Vet. App. 35, 38 (1993). As such, when the reduction stems from the Veteran's claim for an increased evaluation, the appeal may encompass not only the propriety of the reduction, but also the underlying increased rating claim.

In the present case,
appeal regarding the reduction of an evaluation must address only the propriety of the reduction, and not whether the veteran is entitled to a higher evaluation. Dofflemyer v. Derwinski, 2 Vet. App. 277, 279-80 (1992). However, when filing a claim with VA, claimants are presumed to be seeking the maximum available benefit for their disability. See AB v. Brown, 6 Vet. App. 35, 38 (1993). As such, when the reduction stems from the Veteran's claim for an increased evaluation, the appeal may encompass not only the propriety of the reduction, but also the underlying increased rating claim.

In the present case, the reductions stemmed from the Veteran's November 28, 2018, increased rating claim for right foot pes planus. As such, the increased rating claim for that disability is also before the Board.

1. Whether the reduction of the rating for right foot pes planus from 10 percent to noncompensable effective July 1, 2020, was proper

The Veteran contends that the previous 10 percent rating for service-connected right foot pes planus, which was effective December 5, 2016, should not have been decreased to 0 percent, effective July 1, 2020, and should be restored to a 10 percent evaluation. The Veteran asserts that her right foot pes planus did not, in fact, improve, and that the reduction was improper. The Board agrees.

When the propriety of a rating reduction is at issue, the focus is on the actions of the RO in effectuating the reduction, both in terms of compliance with the special due process considerations applicable to reductions, and in terms of whether the evidence at the time of the decision reducing the evaluation supported the reduction. In most cases, violations of the set of due process considerations applicable to rating reductions, or failure of the evidence to meet the standards for reducing an evaluation, render the underlying reduction void ab initio, rather than merely voidable. The burden is on VA to justify a reduction in a rating. See Brown v. Brown, 5 Vet. App. 413 (1993) (finding that the Board is required to establish, by a preponderance of the evidence and in compliance with 38 C.F.R. § 3.344, that a rating reduction is warranted).

Where the reduction in evaluation of a service-connected disability or employability status is considered warranted and the lower evaluation would result in a reduction or discontinuance of compensation payments currently being made, a rating proposing the reduction or discontinuance will be prepared setting forth all material facts and reasons. The beneficiary will be notified at his or her latest address of record of the contemplated action and furnished detailed reasons therefor, and will be given 60 days for the presentation of additional evidence to show that compensation payments should be continued at their present level. Unless otherwise provided in paragraph (i) of this section, if additional evidence is not received within that period, final rating action will be taken and the award will be reduced or discontinued effective the last day of the month in which a 60-day period from the date of notice to the beneficiary of the final rating action expires. 38 C.F.R. § 3.105(e).

As an initial matter, the RO issued the Veteran a rating decision in February 2019, which proposed the rating reduction in question from 10 percent to noncompensable. The rating reduction on appeal was effectuated in an April 2020 rating decision, with an effective date of July 1, 2020. Therefore, the reduction itself complied with the due process requirements necessary for the reduction. 38 C.F.R. § 3.105(e).

38 C.F.R. § 3.344 (a) provides that a disability cannot be reduced without evidence of sustained material improvement under the ordinary conditions of life as shown by full and complete examinations. Likewise, a reduction in disability evaluation is warranted if the evidence shows "that an improvement in disability has actually occurred," and that the "improvement actually reflects an improvement in the veteran's ability to function under the ordinary conditions of life and work." See Brown v. Brown, 5 Vet. App. 413, 421 (1993). Pursuant to 38 C.F.R. § 3.344(c), when a disability rating is less than five years old, has not become stabilized, and is likely to improve, a reexamination disclosing improvement will warrant a reduction in rating. Whether or not a disability has improved cannot be determined without reference to prior records detailing the history of that condition. See Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991).
and that the "improvement actually reflects an improvement in the veteran's ability to function under the ordinary conditions of life and work." See Brown v. Brown, 5 Vet. App. 413, 421 (1993). Pursuant to 38 C.F.R. § 3.344(c), when a disability rating is less than five years old, has not become stabilized, and is likely to improve, a reexamination disclosing improvement will warrant a reduction in rating. Whether or not a disability has improved cannot be determined without reference to prior records detailing the history of that condition. See Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991).

The Veteran's pes planus is rated pursuant to Diagnostic Code 5276, which rates for acquired flatfoot. Under DC 5276, a noncompensable rating is assigned for mild symptoms, described as "symptoms relieved by built-up shoe or arch support." A 10 percent rating is warranted for moderate pes planus (flat foot) with weight-bearing line over or medial to the great toe, inward bowing of the tendo-Achillis, pain on manipulation and use of the feet, bilateral or unilateral. A 20 percent rating is warranted for severe unilateral pes planus manifested by objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, and characteristic callosities. A 30 percent rating is warranted for severe unilateral pes planus manifested by objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, and characteristic callosities. A maximum 50 percent rating is warranted for pronounced bilateral pes planus manifested by marked pronation, extreme tenderness of plantar surface of the feet, marked inward displacement and severe spasm of the tendo-Achillis on manipulation, not improved by orthopedic shoes or appliances. 38 C.F.R. § 4.71a, DC 5276.

Turning to the relevant evidence of record, the Veteran's 10 percent rating in effect prior to the reduction was primarily based on a December 2016 private foot conditions evaluation. The Veteran's right foot pes planus was characterized by objective evidence of pain on use, pain on manipulation of the feet, flare-ups resulting in difficulty with prolonged walking, standing and driving, swelling on use, extreme tenderness of plantar surfaces that is improved with arch supports, decreased longitudinal arch height in feet on weight-bearing, and metatarsalgia. The Veteran's functional loss stems from pain on weight-bearing, swelling, disturbance of locomotion, interference with standing.

The Veteran filed her claim for an increased rating on November 28, 2018, and on December 7, 2018, she was afforded a VA examination in connection with that claim. At that time, the Veteran reported that she has increased foot pain and arthritis in her right MCP joint. The Veteran reported sharp pain in the joint area and has flare-ups resulting in pain with prolonged standing. The Veteran's right foot pes planus was characterized by objective evidence of pain on use accentuated, pain on manipulation accentuated, swelling on use, decreased longitudinal arch height on weight-bearing, pain on weight-bearing, pain on non-weight bearing, marked deformity of both feet, relief with arch supports, mild to moderate hallus valgus, weakness and pain to her arch area upon repeated use. She constantly used a cane for ambulation.

In February 2019, the RO issued a rating decision proposing a reduction of rating for her right foot pes planus. The following month, the Veteran submitted a new medical examination and opinion in support of her claim, completed by her VA treating physician. The examination report indicated that the Veteran described pressure and pain to the soles of both feet, especially after standing for long periods of time. Flares made it difficult to walk and she had to stay off her feet to get some relief. She was unable to engage in prolonged walking due to pain. Pain on use and on manipulation of the foot was noted. Pain was accentuated on manipulation and use. There was evidence of swelling on use. She exhibited characteristic callouses. She required the use of arch supports. She did not have extreme tenderness of the plantar surface. She had decreased longitudinal arch height but did not have marked deformity or marked pronation of the foot. The weight bearing line did not fall over or medial to the great toe. She did not have inward bowing of the achilles tendon. There were no marked inward displacement or severe spasms of the achilles tendon. She did not exhibit Morton's neuroma or metatarsalgia. Functional loss
. Pain on use and on manipulation of the foot was noted. Pain was accentuated on manipulation and use. There was evidence of swelling on use. She exhibited characteristic callouses. She required the use of arch supports. She did not have extreme tenderness of the plantar surface. She had decreased longitudinal arch height but did not have marked deformity or marked pronation of the foot. The weight bearing line did not fall over or medial to the great toe. She did not have inward bowing of the achilles tendon. There were no marked inward displacement or severe spasms of the achilles tendon. She did not exhibit Morton's neuroma or metatarsalgia. Functional loss was limited to interference with standing and pain on prolonged walking. No other functional losses were identified. She regularly used a cane to ambulate.

In his opinion statement, the VA clinician indicated that the Veteran's medical records had been reviewed. He stated that that he treated the Veteran at the Atlanta VAMC Women's Wellness Clinic for pes planus. The VA clinician stated that a review of the Veteran's medical records shows that the Veteran's right foot pain and discomfort "has not significantly improved with time despite current treatment with therapy and medication."

Upon review, the Board finds that the evidence of record available at the time of the February 2019 and April 2020 rating decisions did not support a finding of actual improvement under the ordinary conditions of life and work. Comparing the December 2016 private foot examination findings with the December 2018 VA examination findings instrumental in the February 2019 proposed reduction, there is a difference in finding that the Veteran had extreme tenderness of plantar surfaces in 2016; however, the Veteran had new symptoms of marked deformity of both feet, mild/moderate hallus valgus, pain on non-weight bearing, and used a cane to ambulate. Further, the examination report completed by her VA treating physician, submitted in March 2019, contemporary to the proposed rating reduction also showed symptoms explicitly providing for a 10 percent rating or higher under the rating criteria such as characteristic callouses, accentuated pain, swelling, and pain on manipulation and use of the feet.

Although the findings on the above VA examinations show possible improvement in some symptoms and an increase in severity in other symptoms, these treatment records reflect findings more consistent with pes planus symptoms that have remained relatively stable, or consistent, if not worthy of a higher rating during the period in question. They do not persuasively show an overall improvement in symptoms or an overall improvement in the Veteran's ability to function under the ordinary conditions of life and work but rather exhibited new or worsening symptoms. For these reasons the Board finds that an actual increase in severity was not established at the time of the reduction, and restoration of the 10 percent disability rating for the Veteran's right foot disability is warranted.

Accordingly, the Board finds the rating reduction from 10 percent to 0 percent for the Veteran's right foot pes planus to be improper and grants restoration of the 10 percent rating effective July 1, 2020. 38 C.F.R. §§ 3.105(e), 3.344. To this extent, the Veteran's appeal is granted.

2. Entitlement to a rating in excess of 10 percent for right foot pes planus

As discussed above, the Board has determined the rating reduction in question for right foot pes planus was improper and has restored the original 10 percent rating in effect during the appeal period. The Veteran also seeks a higher rating for service-connected right foot pes planus due to increased pain and limitation of function during the period on appeal.

As noted above, the Veteran filed her claim for an increased rating on November 28, 2018. As a result of that request, the RO proposed to reduce the rating in February 2019, and in April 2020 issued the rating decision which instituted that reduction, effective July 1, 2020. She requested Higher Level Review, and in September 2020, the RO issued the rating decision now on appeal, which reviewed the claim based on the evidence of record at the time of the April 2020 rating decision. As such, the Board will review the ratings on appeal through July 1, 2020, the final date considered in the April 2020 rating decision.

Disability evaluations are determined by the application of a schedule of ratings, which is based on average impairment of earning capacity caused by the given disability. Separate diagnostic codes identify the various disabilities. 38 C.F.R. § 1155; 38 C.F.R. Part 4.

Disability ratings are determined by the application of a schedule of ratings, which is based on the average impairment of earning capacity. 38
the rating decision now on appeal, which reviewed the claim based on the evidence of record at the time of the April 2020 rating decision. As such, the Board will review the ratings on appeal through July 1, 2020, the final date considered in the April 2020 rating decision.

Disability ratings are determined by the application of a schedule of ratings, which is based on the average impairment of earning capacity. 38 U.S.C. § 1155 ; 38 C.F.R. § 4.1. The Veteran's entire history is reviewed when making disability evaluations. See generally, Schafrath v. Derwinski, 1 Vet. App. 589 (1991); 38 C.F.R. § 4.1. Where, as in the case of the issue on appeal in this matter, entitlement to compensation has already been established, it is the present level of disability that is of primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). Consideration of the medical evidence since the date of the claim for increase and consideration of the appropriateness of staged ratings are required. See Fenderson v. West, 12 Vet. App. 119 (1999). "Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned." 38 C.F.R. § 4.7

VA is responsible for determining whether the evidence persuasively favors one side or another. 38 C.F.R. § 4.3. When there is an approximate or nearly equal balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the Veteran and the claim will be granted on the merits. 38 U.S.C. §5107(b). When the evidence persuasively favors against the claims of the Veteran, the benefit of the doubt doctrine is inapplicable, and the claim will be denied on its merits. 38 U.S.C. §5107; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

As discussed above, the Veteran's pes planus is rated pursuant to Diagnostic Code 5276, which rates for acquired flatfoot. Under DC 5276, a 10 percent rating is warranted for moderate pes planus (flat foot) with weight-bearing line over or medial to the great toe, inward bowing of the tendo-Achillis, pain on manipulation and use of the feet, bilateral or unilateral. A 20 percent rating is warranted for severe unilateral pes planus manifested by objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, and characteristic callosities. A 30 percent rating is warranted for severe unilateral pes planus manifested by objective evidence of marked deformity (pronation, abduction, etc.), pain on manipulation and use accentuated, indication of swelling on use, and characteristic callosities. A maximum 50 percent rating is warranted for pronounced bilateral pes planus manifested by marked pronation, extreme tenderness of plantar surface of the feet, marked inward displacement and severe spasm of the tendo-Achillis on manipulation, not improved by orthopedic shoes or appliances. 38 C.F.R. § 4.71a, DC 5276.

The Board notes that DC 5276 uses the phrase "marked" when discussing both severe and pronounced pes planus. In the absence of an express definition, words are given their ordinary meaning. Prokarym v. McDonald, 27 Vet. App. 307, 310 (2015) (citing Terry v. Principi, 340 F.3d 1378, 1382-83 (Fed. Cir. 2003)); see also Johnson v. Wilkie, 30 Vet. App. 245, 255 (2018). The Board finds that the phrase "marked" is defined as "having a distinctive or emphasized character." Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/marked (last accessed March 31, 2026). Additionally, "pronounced" is
Prokarym v. McDonald, 27 Vet. App. 307, 310 (2015) (citing Terry v. Principi, 340 F.3d 1378, 1382-83 (Fed. Cir. 2003)); see also Johnson v. Wilkie, 30 Vet. App. 245, 255 (2018). The Board finds that the phrase "marked" is defined as "having a distinctive or emphasized character." Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/marked (last accessed March 31, 2026). Additionally, "pronounced" is defined as a degree greater than "severe" under DC 5276. Prokarym, 27 Vet. App. at 311.

A disability of the musculoskeletal system is primarily the inability, due to damage or infection in parts of the system, to perform the normal working movements of the body with normal excursion, strength, speed, coordination and endurance. Functional loss may be due to the absence or deformity of structures or other pathology, or it may be due to pain, supported by adequate pathology and evidenced by the visible behavior in undertaking the motion. Weakness is as important as limitation of motion, and a part that becomes painful on use must be regarded as seriously disabled. 38 C.F.R. § 4.40. With respect to joints, in particular, the factors of disability reside in reductions in normal excursion of movements in different planes. Inquiry will be directed to more or less than normal movement, weakened movement, excess fatigability, incoordination, pain on movement, swelling, deformity or atrophy of disuse. 38 C.F.R. § 4.45. Although pain may cause functional loss, pain itself does not constitute functional loss. Rather, pain must affect some aspect of "the normal working movements of the body," such as "excursion, strength, speed, coordination, and endurance," in order to constitute functional loss. Mitchell v. Shinseki, 25 Vet. App. 32, 38-43 (2011) (quoting 38 C.F.R. § 4.40); see also DeLuca v. Brown, 8 Vet. App. 202, 206-207 (1995).

The Veteran also submitted a new medical examination and opinion in March 2019 in support of her claim, completed by her VA treating physician. The examination report indicated that the Veteran described pressure and pain to the soles of both feet, especially after standing for long periods of time. Flares made it difficult to walk and she had to stay off her feet to get some relief. She was unable to engage in prolonged walking due to pain. Pain on use and on manipulation of the foot was noted. Pain was accentuated on manipulation and use. There was evidence of swelling on use. She exhibited characteristic callouses. She required the use of arch supports. She did not have extreme tenderness of the plantar surface. She had decreased longitudinal arch height but did not have marked deformity or marked pronation of the foot. The weight bearing line did not fall over or medial to the great toe. She did not have inward bowing of the achilles tendon. There were no marked inward displacement or severe spasms of the achilles tendon. She did not exhibit Morton's neuroma or metatarsalgia. Functional loss was limited to interference with standing and pain on prolonged walking. No other functional losses were identified. She regularly used a cane to ambulate. In his opinion statement, the VA clinician indicated that the Veteran's medical records had been reviewed. He stated that that he treated the Veteran at the Atlanta VAMC Women's Wellness Clinic for pes planus. The VA clinician stated that a review of the Veteran's medical records shows that the
not fall over or medial to the great toe. She did not have inward bowing of the achilles tendon. There were no marked inward displacement or severe spasms of the achilles tendon. She did not exhibit Morton's neuroma or metatarsalgia. Functional loss was limited to interference with standing and pain on prolonged walking. No other functional losses were identified. She regularly used a cane to ambulate. In his opinion statement, the VA clinician indicated that the Veteran's medical records had been reviewed. He stated that that he treated the Veteran at the Atlanta VAMC Women's Wellness Clinic for pes planus. The VA clinician stated that a review of the Veteran's medical records shows that the Veteran's right foot pain and discomfort "has not significantly improved with time despite current treatment with therapy and medication."

For her part, the Veteran testified before a Veterans Law Judge that she experiences symptoms such as chronic foot pain, swelling, flare-ups requiring rest, and using prescription cream to relieve foot pain. To the extent that the Veteran has testified to symptoms of which she has firsthand knowledge and experience, the Board finds this testimony competent and credible.

The Board finds that this evidence weighs in favor of assigning an increased rating of 20 percent, but no higher, for right foot pes planus. From the date of the claim for an increased rating, the evidence of record reveals that the Veteran's right foot pes planus is more nearly manifested by symptoms of pain on use, pain accentuated on use, swelling on use, pain on manipulation, pain accentuated on manipulation, decreased longitudinal arch height on weight-bearing, mild/moderate hallus valgus, pain on weight-bearing, pain on non-weight bearing, extreme tenderness of plantar surfaces not relieved with orthotics, marked deformity, pronation of right foot not relieved with orthotics, weight-bearing line over or medial to the great toe, and other lower extremity deformity causing alteration of the weight-bearing line.

The Board acknowledges the Veteran's testimony in her hearing before a Veterans Law Judge that her 2018 VA examination was inadequate because she was not given a full examination of the foot but was rather fully evaluated for a psychiatric disability and knee disabilities. While the Veteran is competent to report evidence of which she has firsthand knowledge, once basic competency is met, the Board must consider the credibility of those statements. In this matter, the Board observes that the December 2018 VA examination report is quite thorough, which could not be expected of an examination that only required the patient to walk across the room and back. Further, the symptoms reported in that examination report were generally supported by the private examination report submitted by the Veteran in support of her claim a mere three months later. As such, the Board is satisfied that the December 2018 VA examination is adequate to rate the Veteran's pes planus during the period in question. See Caluza v. Brown, 7 Vet. App. 498 (1995).

The Board has also considered evidence submitted by the Veteran in support of her claim during the 90-days following her hearing before a Veterans Law Judge, but does not find it persuasive for purposes of rating the disability, as addressed in the April 2020 rating decision, and readjudicated in the September 2020 rating decision now on appeal, which reviewed the rating for the Veteran's pes planus through July 1, 2020. Those records are primarily comprised of treatment records and a VA examination report completed by a private physician between August and October 2024, roughly four or more years after the decisions in question, and thus do not explicitly speak to the severity of the Veteran's disability during the period in question. Additionally, the Board notes contradictory evidence in those records which call into question how severe some of the symptoms reported might be. For example, a treatment report dated September 16, 2024, describes the Veteran's pes planus of the right foot at "mild" with intact fascia and pain on palpation at the midfoot and heel, while another notation on that same date indicates moderate severity with collapsed arches aggravated by physical activity. Other symptoms in October 2024 indicate swelling, tenderness, numbness and pain on weight bearing. The examination report completed in September 2024 (the same date as the report of "mild" pes planus in her treatment records), is contradictory as to how long the pain had been experienced, although it seems to indicate that foot pain had only been an issue for two years. It indicated that the Veteran did not elaborate on vital topics such as flare ups and contains contradictory information such as reporting extreme tenderness of the plantar surfaces but denying pain on manipulation of the feet. It denies swelling, despite a contemporary treatment record documenting that symptom. The report indicates that arch support both gives
es aggravated by physical activity. Other symptoms in October 2024 indicate swelling, tenderness, numbness and pain on weight bearing. The examination report completed in September 2024 (the same date as the report of "mild" pes planus in her treatment records), is contradictory as to how long the pain had been experienced, although it seems to indicate that foot pain had only been an issue for two years. It indicated that the Veteran did not elaborate on vital topics such as flare ups and contains contradictory information such as reporting extreme tenderness of the plantar surfaces but denying pain on manipulation of the feet. It denies swelling, despite a contemporary treatment record documenting that symptom. The report indicates that arch support both gives relief and does not relieve symptoms. Further, that report indicates that a possible second disability (or multiple other disabilities) cause alteration of the weight bearing line, but does not describe what they are, or how they contribute to the disability, leaving question as to the severity of the pes planus by itself. Given the contradictory nature of this medical evidence, and the fact that it does not explicitly speak to the severity of the disability during the period in question (prior to July 1, 2020), the Board does not find that it carries significant weight in assessing the rating for the Veteran's pes planus as part of this appeal.

Caselaw also requires the Board to take due consideration that the beneficial effects of medication are discounted unless such effects are otherwise contemplated in a particular diagnostic code. See Ingram v. Collins, 38 Vet. App. 130 (2025). In this case, the VA examiners, in rendering their findings, noted and considered the Veteran's lay statements describing functional limitations when her pain and functional impairment is at its worst (e.g., during flare ups, on repetitive motion, due to lack of weakness, etc.). The Board notes that the reported using topical creams for pain. There is no indication, however, that the Veteran was taking medication or using topical cream at the time of any examinations of record. Further, even presuming that topical creams were in use, the Board has considered the Veteran's lay statements regarding the effectiveness of those treatments and discounted their use. Thus, the Board finds the examination reports and the remainder of the evidentiary record adequate to base a decision, resolving all reasonable doubt in the Veteran's favor.

The Board has considered whether a 30 percent (maximum) rating is appropriate but does not find evidence of the types of symptoms resulting in such a rating (for example, marked pronation, extreme tenderness, marked inward displacement, and severe spasm not improved by shoes or appliances).

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In sum, the Board finds that for the period prior to July 1, 2020, the Veteran's right foot pes planus was manifested by symptoms such as characteristic callouses, accentuated pain, marked deformity (pronation), swelling on use, inward bowing of the achilles tendon, and pain on manipulation and use of the feet. As such, the Board will afford the benefit of a doubt and grant a 20 percent rating for the period in question. To this extent, the appeal is granted.

M. Pryce

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Loy, T.

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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