FLATFOOT BILATERAL ACQUIRED

Summary

The Veteran served from April 1983 to September 1992 and again from December 2001 to November 2002, including service in Southwest Asia during the Persian Gulf War. The Veteran appeals the denial of service connection for bilateral pes planus. The Veteran contends that his flat feet developed during service due to physical training, heavy lifting, and prolonged standing, leading to injury and persistent pain. He reported being diagnosed with flat feet in 1983 during service and experiencing symptoms since December 1985. The Board found that while the service treatment records did not document the condition, the Veteran's lay statements and the representative's arguments, supported by web articles, were sufficient to establish an in-service incurrence. The Board noted conflicting medical opinions: two VA opinions were given low probative value due to outdated standards and inadequate consideration of lay evidence, while a November 2016 VA opinion found the condition at least as likely as not related to service and incurred during service. The Board found the evidence to be in equipoise regarding the service connection of the current disability. Resolving all doubt in the Veteran's favor, service connection for bilateral pes planus was granted.

Rationale

Current diagnosis of bilateral pes planus; Lay statements and representative's arguments sufficient to establish in-service incurrence; Evidence in equipoise regarding service connection; Benefit of the doubt resolved in Veteran's favor

Full Decision Text

Citation Nr: A26035793
Decision Date: 04/16/26	Archive Date: 04/16/26

DOCKET NO. 241112-492861
DATE: April 16, 2026

ORDER

Entitlement to service connection for bilateral pes planus is granted.

FINDING OF FACT

Resolving reasonable doubt in the Veteran's favor, his bilateral pes planus is at least as likely as not related to his active military service.

CONCLUSION OF LAW

The criteria for service connection for bilateral pes planus are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active military service from April 1983 to September 1992 and from December 2001 to November 2002.

The rating decision on appeal was issued in November 2022 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In February 2023, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of the November 2022 rating decision. In April 2023, the agency of original jurisdiction (AOJ) issued the HLR decision, which considered the evidence of record at the time of the prior November 2022 decision. In June 2023, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of the pes planus issue recently addressed in the April 2023 rating decision. In September 2023, the AOJ issued a supplemental claim decision, which found that new and relevant evidence had been received and denied the claim based on the evidence of record at the time of that decision. 

Although the Veteran initially requested HLR when submitting a March 2024 VA Form 20-0996, Decision Review Request: HLR in response to the September 2023 rating decision, the Higher-Level Reviewer, in an April 2024 rating decision, determined that there had been a duty to assist error and transferred the appeal to the Supplemental Claim decision review option for additional development. In October 2024, the AOJ issued the supplemental claim decision on appeal, which found that new and relevant evidence had been received and denied the claim based on the evidence of record at the time of that decision.  

In the November 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the October 2024 AOJ supplemental claim decision on appeal. 38 C.F.R. § 20.301. If evidence was submitted after the AOJ issued the supplemental claim decision on appeal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 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. 

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1. Entitlement to service connection for bilateral pes planus.

The Veteran contends that his flat feet developed "[o]ver time due to physical training, injury to left foot occurred which required surgery. Unable to run, climb, or stand for long periods of time due to permanent injury." See June 2015 VA 21-4138 Form. At his November 2016 VA examination, the Veteran reported that he was diagnosed with flat feet in 1983 (during service). At his September 2018 VA examination, he stated that the date of onset of his symptoms was December 1985 (during service). He indicated that his flat feet "began while stationed overseas and did a lot of training, running in preparation for military fitness exams." See September 2018 VA examination.

The Board concludes that the Veteran has a current disability that is related to his active military service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a).

The
 (during service). At his September 2018 VA examination, he stated that the date of onset of his symptoms was December 1985 (during service). He indicated that his flat feet "began while stationed overseas and did a lot of training, running in preparation for military fitness exams." See September 2018 VA examination.

The Board concludes that the Veteran has a current disability that is related to his active military service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a).

The October 2024 rating decision made a Favorable Finding that the Veteran has a current diagnosis. 

During service, the Veteran served in Southwest Asia during the Persian Gulf War, as shown on his DD-214 Forms. His military entrance examination does not document any complaints of or diagnosis of pes planus. His DD-214 Forms note that the Veteran's military occupational specialties (MOSs) were Fuels Craftsman and Fuels Supervisor.

Regarding an in-service incurrence, his representative argued that the Veteran's active military service "required [the Veteran] to do repeated heavy lifting - water hoses and fuel holders - which caused considerable wear and tear on his shoulders and pressure on his feet; he also spent long hours on his feet conducting mechanical maintenance (reaching overhead and performing repetitive movements), conducting mandatory physical fitness training, and other activities

resulting in in musculoskeletal injuries to his shoulders and feet. [The Veteran] did not mention any traumatic injuries that would have led to notations in his service treatment records, instead he managed the condition on his own." See June 2023 VA Form 20-0995. The representative submitted Web articles at the same time to support these arguments.

The Board finds that the aforementioned evidence is sufficient to establish an in-service incurrence.

Thus, the question becomes whether the current disability is related to service. On this question, there are probative opinions in favor of and against the claim.

The evidence against the claim includes May 2022 and July 2023 VA medical opinions. The May 2022 opinion violates recent case law by using an outdated legal standard in its opinion. Further, it is unclear whether the May 2022 VA examiner is referring to the Veteran's feet or his left Achille's condition. The July 2023 opinion is inadequate because the VA examiner does not address the Veteran's and his representative's lay statements regarding an in-service incurrence, and instead relies on the absence of evidence in the Veteran's service treatment records. The Board assigns a low probative value to these medical opinions.

The evidence in favor of the claim includes a November 2016 VA medical opinion. After reviewing the Veteran's electronic claims file and examining the Veteran, the VA examiner determined that "The Veteran's disability is at least as likely as not a diagnosable chronic multi-symptom illness with a partially explained etiology." Regarding the etiology, the VA examiner opines that, "The Veteran incurred his flat feet during his military service. Since that time, the Veteran has had mild

pain especially during weight-bearing on both feet due to his flat feet condition." The finds that this opinion is supported by the lay statements and treatment records, which document an in-service incurrence of the Veteran's flat feet and symptoms since his military discharge.

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Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current bilateral pes planus is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for bilateral pes planus is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. The claim is granted.

 

 

I. Cannaday

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S. M. Watkins, 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.