FLATFOOT BILATERAL ACQUIRED

Summary

The veteran, who served from October 2011 to July 2016, appeals the denial of service connection for bilateral pes planus and dermatitis, and the denial of a compensable rating for varicocele of the left testicle, while seeking service connection for a left deviated nasal septum. For bilateral pes planus, the Board found the evidence persuasively against the claim, noting normal foot findings at service induction and only an asymptomatic mild pes planus at separation, with no post-service treatment or complaints. For dermatitis, the Board found the evidence persuasively against the claim, noting normal skin findings at induction and separation, no post-discharge treatment, and that the veteran's reported rash was not supported by clinical evidence. For the left deviated nasal septum, the Board found service connection was warranted, noting normal nasal findings at induction but a positive finding of a left deviated nasal septum at separation, and that the VA examiner opined it was at least as likely as not incurred in or caused by service, with no contrary competent medical opinions. The Board resolved reasonable doubt in the veteran's favor for this condition. For varicocele of the left testicle, the Board denied a compensable rating, noting the condition is assigned a noncompensable rating under Diagnostic Code 7543, and the veteran did not meet the criteria for higher ratings under Diagnostic Codes 7523 or 7524, as there was no removal or atrophy of both testicles, nor erectile dysfunction.

Rationale

No competent and credible evidence of current bilateral pes planus; Evidence persuasively against the claim; Benefit-of-the-doubt doctrine not applicable

Full Decision Text

Citation Nr: A26040120
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 250529-549592
DATE: April 29, 2026

ORDER

Entitlement to service connection for bilateral pes planus is denied.

Entitlement to service connection for dermatitis is denied.

Entitlement to service connection for left deviated nasal septum is granted.

Entitlement to a compensable rating for varicocele of the left testicle is denied.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that the Veteran has had bilateral pes planus at any time during or approximate to the pendency of the claim.

2. The evidence of record persuasively weighs against finding that the Veteran has had dermatitis at any time during or approximate to the pendency of the claim.

3. Resolving reasonable doubt in the Veteran's favor, his left deviated nasal septum is at least as likely as not related to service.

4. The Veteran is already in receipt of a noncompensable disability rating for varicocele and hydrocele of the testicles, which is the maximum schedular rating for that disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for bilateral pes planus are not met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for dermatitis are not met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for left deviated nasal septum are met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for entitlement to a compensable rating for varicocele of the left testicle are not met.  38 U.S.C. §§ 1101, 1110, 1113;38 C.F.R. §§ 4.3, 4.7, 4.115a, 4.115b, Diagnostic Code 7543.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from October 2011 to July 2016.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from August 2024, October 2024, and April 2025 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO).  In the May 29, 2025, 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 August 2024 and October 2024 agency of original jurisdiction (AOJ) decisions, which was subsequently subject to higher-level review in April 2025.  38 C.F.R. § 20.301.  If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review 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 claims, 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 laws and regulations

Entitlement to service connection on a direct basis requires (1) evidence of current nonservice-connected disability; (2) evidence of in-service incurrence or aggravation of disease or injury; and (3) evidence of a nexus between the in-service disease or injury and the current nonservice-connected disability.  38 C.F.R. § 3.303(a); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); Saunders v. Wilkie, 886 F.3d 1356 (2018).

Federal law specifically limits entitlement for service-connected disease or injury to cases where such incidents result in a disability.  It is not enough for a claimant to seek some sort of benefit simply because he had
 evidence of current nonservice-connected disability; (2) evidence of in-service incurrence or aggravation of disease or injury; and (3) evidence of a nexus between the in-service disease or injury and the current nonservice-connected disability.  38 C.F.R. § 3.303(a); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); Saunders v. Wilkie, 886 F.3d 1356 (2018).

Federal law specifically limits entitlement for service-connected disease or injury to cases where such incidents result in a disability.  It is not enough for a claimant to seek some sort of benefit simply because he had a disease or injury on active duty.  In the absence of proof of a current disability, there can be no valid claim.  See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Degmetich v. Brown, 104 F.3d 1328, 1333 (1997) (upholds Court of Appeals for Veterans Claims decision to require a current existing disability).

Generally, lay evidence is competent with regard to identification of a disease with unique and readily identifiable features which are capable of lay observation.  See Barr v. Shinseki, 21 Vet. App. 303, 308 (2007).  A lay person may speak to etiology in some limited circumstances in which nexus is obvious merely through observation, such as sustaining a fall leading to a broken leg.  See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir 2007).  Lay persons may also provide competent evidence regarding a contemporaneous medical diagnosis or a description of symptoms in service which supports a later diagnosis by a medical professional.  However, a lay person is not competent to provide evidence as to more complex medical questions, i.e., those which are not capable of lay observation.  Lay statements are not competent evidence regarding diagnosis or etiology in such cases.  See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007) (concerning rheumatic fever); Jandreau, at 1377, n. 4 ('sometimes the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer'); 38 C.F.R. § 3.159(a)(2).

After the evidence has been assembled, it is the Board's responsibility to evaluate the entire record.  38 U.S.C. § 7104(a).  When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall resolve all reasonable doubt in favor of the claimant. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990); 38 C.F.R. § 3.102.  This standard does not require the evidence to be exactly equal; rather, it includes "scenarios where the evidence is not in equipoise but nevertheless is in approximate balance.  Put differently, if the positive and negative evidence is in approximate balance (which includes but is not limited to equipoise), the claimant receives the benefit of the doubt."  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

1. Entitlement to service connection for bilateral pes planus 

The Veteran seeks service connection for bilateral pes planus.  See March 2024 Fully Developed Claim.

Turning to the evidence, service treatment records include a report of medical examination performed in March 2011 (service induction) which shows that findings for the feet were normal arch and asymptomatic.  No defects were noted.  In the concurrent report of medical history, the Veteran denied foot trouble and did not report any pertinent problems at that time.  In the April 2016 report of medical examination (service separation), there was a finding of abnormality for the feet and a diagnosis of mild pes planus, asymptomatic. 

Post-service medical records do not reveal complaints, treatments, or diagnoses pertinent to right or left foot pes planus.  See September 2016 to August 2024 VA Treatment Records. 

In March 2024, the Veteran filed a claim seeking service connection for bilateral pes planus.

In an April 2025 Highter Level Review Informal Conference, the Veteran reported that a doctor stated he has flat feet.

It is acknowledged that
 the concurrent report of medical history, the Veteran denied foot trouble and did not report any pertinent problems at that time.  In the April 2016 report of medical examination (service separation), there was a finding of abnormality for the feet and a diagnosis of mild pes planus, asymptomatic. 

Post-service medical records do not reveal complaints, treatments, or diagnoses pertinent to right or left foot pes planus.  See September 2016 to August 2024 VA Treatment Records. 

In March 2024, the Veteran filed a claim seeking service connection for bilateral pes planus.

In an April 2025 Highter Level Review Informal Conference, the Veteran reported that a doctor stated he has flat feet.

It is acknowledged that subsequent to the April 2025 Higher Level Review decision, evidence related to this matter was entered into the record, specifically contained a May 30, 2025 VA clinical record. It is reiterated that under current law and regulations, the Board may not consider this evidence in this decision. However, if the Veteran would like VA to consider this evidence, 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 claims, considering the new evidence in addition to the evidence previously considered.  Specific instructions for filing a Supplemental Claim are included with this decision.

After review of the evidence associated with the claims file within the eligible evidence window and in conjunction with the applicable laws and regulations, the Board finds the criteria for entitlement to service connection for bilateral pes planus are not met.

The Board has considered the Veteran's mild pes planus that was noted as asymptomatic at the time of the April 2016 separation; and has considered the Veteran's April 2025 statement that he was told by a doctor he has pes planus. The Veteran's April 2025 statement may only be considered as argument rather than evidence; and in any case the statement does not indicate whether a doctor recently told him he has pes planus, or whether the Veteran is relying on what was told to him at the time of service separation in 2016.  In view of the evidence eligible for review, the Board finds that the medical evidence demonstrates that there is no current diagnosis of bilateral pes planus that is related to service.  Indeed, as there are no records of treatment for and/or complaints of bilateral pes planus in the September 2016 to August 2024 VA treatment records, or any other medical records, the Board finds there is no competent and credible evidence associated with the file that establishes that the Veteran has had a current bilateral flat foot condition during any time of the period on appeal.  

Accordingly, the evidence is persuasively against the claim.  As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable and service connection for bilateral pes planus is not warranted.  See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

2. Entitlement to service connection for dermatitis

The Veteran seeks service connection for dermatitis.  See March 2024 Fully Developed Claim.

Turning to the evidence, service treatment records include a report of medical examination performed in March 2011 (service induction) which shows that findings for the skin were normal.  In the concurrent report of medical history, the Veteran denied any skin disease, to include eczema.  In the April 2016 report of medical examination (service separation), there was a normal finding for skin.  The Veteran denied any skin disease, to include eczema, on the report of medical history at that time.

Post-discharge medical records do not reveal complaints, treatments, or diagnoses pertinent to eczema.  See September 2016 to August 2024 VA Treatment Records. 

In March 2024, the Veteran filed a claim seeking service connection for dermatitis.

In an April 2025 Highter Level Review Informal Conference, the Veteran reported that he gets a skin rash on his back and side.

After review of the claims file in conjunction with the applicable laws and regulations, the Board finds the criteria for entitlement to service connection for dermatitis are not met.

The Board has considered the Veteran's April 2025 statement that he gets a rash on his back and side.  While a Veteran is generally competent to report observable symptoms such as a rash under Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir 2007), such statements must be weighed against the clinical evidence.  Here, the service treatment records reflect that the Veteran's skin was normal upon entry in March 2011 and
, the Veteran reported that he gets a skin rash on his back and side.

After review of the claims file in conjunction with the applicable laws and regulations, the Board finds the criteria for entitlement to service connection for dermatitis are not met.

The Board has considered the Veteran's April 2025 statement that he gets a rash on his back and side.  While a Veteran is generally competent to report observable symptoms such as a rash under Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir 2007), such statements must be weighed against the clinical evidence.  Here, the service treatment records reflect that the Veteran's skin was normal upon entry in March 2011 and at the time of separation in April 2016.  Indeed, the Veteran denied any skin disease, to include eczema, at both of those times.  In addition, post-discharge VA treatment records spanning from September 2016 to August 2024 reveal no diagnosis of, or treatment for, dermatitis or eczema.  The Board finds that the absence of any contemporaneous medical documentation of a skin condition over an eight year period since discharge weighs heavily against the claim.  Without a current medical diagnosis of dermatitis, there can be no valid claim.  See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

Accordingly, the evidence is persuasively against the claim.  As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable and service connection for dermatitis is not warranted.  See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

3. Entitlement to service connection for a left deviated nasal septum

The Veteran seeks service connection for a left deviated nasal septum.  See March 2024 Fully Developed Claim.

Turning to the evidence, service treatment records include a report of medical examination performed in March 2011 (service induction) which shows that findings for the nose were normal.  In the concurrent report of medical history, the Veteran denied any nose trouble.  In the April 2016 report of medical examination (service separation), there was a finding for nasal abnormalities, to include a left deviated nasal septum.

In March 2024, the Veteran filed a claim seeking service connection for left deviated nasal septum.

In August 2024, the Veteran underwent an in-person VA examination which noted review of the VA e-folder.  The Veteran reported he started to experience difficulty breathing out of his left nostril in 2013/2014.  He denied any trauma to the nose.  There was a diagnosis of left deviated nasal septum, nontraumatic.  The examiner opined that the Veteran's left deviated nasal septum is at least as likely as not incurred in or caused by service.  The rationale provided was that the March 2011 entrance examination was silent for any history of deviated nasal septum, there are no treatment records for a traumatic injury to the nose while on active duty, and the April 2016 separation examination was positive for "deviated septum to the left."  The examiner stated there is evidence to suggest that the Veteran's deviated septum occurred while on active duty since there is no evidence the condition was present prior to service.  

In October 2024, the VA examiner was asked, "[I]f there was no traumatic event, what caused the deviation in the septum?"  In response, the August 2024 VA examiner provided an October 2024 VA addendum opinion stating, "I am unable to determine what caused veterans deviated septum without speculations after veteran's interview."

An October 2024 rating decision denied service connection for a left deviated nasal septum.

In an April 2025 Highter Level Review Informal Conference, the Veteran reported that he feels his left deviated nasal septum in due to IED explosions.

In the April 2025 rating decision, the RO made the following favorable findings: (1) there is a current diagnosis of left deviated nasal septum; (2) based on his service in Southwest Asia, toxic exposure is conceded; and (3) review of service treatment records show complaints of left deviated nasal septum.  Under the AMA, the Board is bound by favorable findings made by the RO.  38 C.F.R. §§ 3.104(c), 20.801(a).

After review of the claims file in conjunction with the applicable laws and regulations, and resolving all reasonable doubt in the Veteran's favor, the Board finds that criteria for entitlement to service connection for a left deviated nasal septum are met.

Here, while the October 2024 VA
 made the following favorable findings: (1) there is a current diagnosis of left deviated nasal septum; (2) based on his service in Southwest Asia, toxic exposure is conceded; and (3) review of service treatment records show complaints of left deviated nasal septum.  Under the AMA, the Board is bound by favorable findings made by the RO.  38 C.F.R. §§ 3.104(c), 20.801(a).

After review of the claims file in conjunction with the applicable laws and regulations, and resolving all reasonable doubt in the Veteran's favor, the Board finds that criteria for entitlement to service connection for a left deviated nasal septum are met.

Here, while the October 2024 VA addendum opinion could not determine the exact cause of the Veteran's deviated septum without speculation, the Board finds that this did not negate the initial examiner's opinion in August 2024 finding that the left deviated nasal septum is at least as likely as not incurred in or caused by service.  Rather, since service treatment records reflect normal findings for the nose at induction and a left deviated nasal septum at separation, the Board finds the condition manifested during service.  The Board finds the VA examiner's opinion, which was provided after the examiner reviewed the claims file and examined the Veteran, is highly probative as it reflects consideration of all relevant facts and the examiner provided a detailed rationale for the conclusion reached.  See Nieves-Rodriguez v. Peake, 22?Vet. App.?295 (2008); Stefl v. Nicholson, 21?Vet. App.?120, 124 (2007) ("[A]medical opinion...must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions").  The VA examiner determined his left deviated nasal septum was related to active duty service.  Importantly, there are no competent medical opinions of record to the contrary.

In light of the above, the Board finds the evidence is at least in equipoise with respect to whether the Veteran's left deviated nasal septum was caused by or related to his service.  The Board resolves any reasonable doubt in favor of the Veteran.  Accordingly, entitlement to service connection for left deviated nasal septum is warranted.

4. Entitlement to a compensable rating for varicocele of the left testicle

The Veteran seeks a compensable rating for varicocele of the left testicle. 

Disability ratings are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities.  See 38 U.S.C. §1155; 38 C.F.R. §4.1.  If two ratings are potentially applicable, the higher rating will be assigned if the disability more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned.  See 38 C.F.R. §4.7.  Any reasonable doubt regarding the degree of disability will be resolved in favor of the veteran. See 38 C.F.R. §4.3.

Where the appeal arises from the original assignment of a disability evaluation following an award of service connection, the severity of the disability at issue is to be considered during the entire period from the initial assignment of the disability rating to the present time.  Fenderson v. West, 12 Vet. App. 119, 126 (1999).

When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability, such doubt will be resolved in favor of the veteran.  38 C.F.R. §4.3.

In this case, the Veteran's varicocele of the left testicle is currently assigned a noncompensable evaluation effective March 18, 2024, pursuant to  38 C.F.R. § 4.115b, Diagnostic Code 7543, for varicocele/hydrocele.

Under Diagnostic Code 7543, a noncompensable disability rating is assigned for varicocele/hydrocele.  There are no additional ratings contemplated for this disability.  Thus, under Diagnostic Code 7543, the Veteran is limited to a single noncompensable disability rating for varicocele/hydrocele regardless of its severity or whether it is unilateral or bilateral.  See Smith v. Nicholson, 19 Vet. App. 63 (2005).  Therefore, the Board finds that a compensable rating under Code 7543 for service-connected varicocele of the left testicle is precluded as a matter of law.

The Board has considered the applicability of other Diagnostic Codes to maximize the Veteran's disability rating.  

Conditions of
7543, a noncompensable disability rating is assigned for varicocele/hydrocele.  There are no additional ratings contemplated for this disability.  Thus, under Diagnostic Code 7543, the Veteran is limited to a single noncompensable disability rating for varicocele/hydrocele regardless of its severity or whether it is unilateral or bilateral.  See Smith v. Nicholson, 19 Vet. App. 63 (2005).  Therefore, the Board finds that a compensable rating under Code 7543 for service-connected varicocele of the left testicle is precluded as a matter of law.

The Board has considered the applicability of other Diagnostic Codes to maximize the Veteran's disability rating.  

Conditions of the testes are rated under Diagnostic Codes 7523 and 7524.  Under Diagnostic Code 7523, a 20 percent rating is warranted for complete atrophy of both testes.  Under Diagnostic Code 7524, a 30 percent rating is warranted for removal of both testes.  38 C.F.R. § 4.115b.  

In August 2024, the Veteran underwent an in-person VA conditions examination which noted review of the VA e-folder.  The Veteran reported flares once a month which include throbbing pain, difficulty walking due to swelling, and increased urinary frequency.  There were a diagnoses of varicocele and voiding dysfunction with an unknown etiology.  The Veteran has not had an orchiectomy nor was there a diagnosis of atrophy of the testis.  There was no erectile dysfunction.  Functional impact was noted as, "When he has a flare he does not want to do anything.  He just wants to sit in his chair.  Makes it to where he cannot do a whole lot."

Here, the Board finds there is no medical or lay evidence that the Veteran has met the criteria for a compensable rating for service-connected varicocele of the left testicle under either Diagnostic Code 7523 or 7524.  The August 2024 VA examination report of record shows that the Veteran has not had an orchiectomy nor was there a diagnosis of atrophy of the testis.  As there is no evidence of removal or atrophy of both testicles, or nonfunctioning of the testicles, a compensable rating is not warranted under Diagnostic Code 7523 or 7524.  To the extent the Veteran reported urinary frequency associated with flareups of the varicocele condition, the examiner did not correlate the conditions, rather finding that the urinary frequency was of unknown origin. The Board points out that the applicable diagnostic codes, as explained above, do not contemplate an effect on urinary frequency.  Further, there is no compelling evidence that his symptoms resulted in a functional impairment of earning capacity to a compensable degree or loss of use of a creative organ.  

Therefore, the Board finds that there are no other diagnostic codes that are applicable to the Veteran's service-connected varicocele of the left testicle, and entitlement to a compensable rating is not warranted.  See Butts v. Brown, 5 Vet. App. 532, 538 (1993). 

 

JONATHAN B. KRAMER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A.M. Edwards, 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.