Service connection for a functionally impairing right ankle disability, as secondary to service-connected right leg varicose veins, is granted.

Citation Nr: 26001406 Decision Date: 01/30/26 Archive Date: 01/30/26 DOCKET NO. 20-01 878 DATE: January 30, 2026 ORDER Service connection for a functionally impairing right ankle disability, as secondary to service-connected right leg varicose veins, is granted. FINDINGS OF FACT 1. Currently the Veteran experiences functional impairment in the right ankle due to pain, which results in limitation of motion of the right ankle. 2. The right ankle functional impairment was caused by the service-connected right leg varicose veins. CONCLUSION OF LAW Resolving reasonable doubt in favor of the Veteran, the criteria for service connection for a right ankle disability, as secondary to service connected right leg varicose veins, have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310, 3.326; Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran, who is the appellant, had active service from June 1987 to July 1987, and from August 1994 to May 1995. This matter came before the Board of Veterans' Appeals (Board) on appeal from a March 2018 Department of Veterans Affairs (VA) Regional Office (RO) rating decision. The instant matter has a long procedural history discussed in prior Board decisions. Most recently, in a May 2024 decision, the Board, in pertinent part, denied service connection for a right ankle disability, to include as secondary to the service connected right leg varicose veins. The Veteran appealed the May 2024 Board decision to the United States Court of Appeals for Veterans Claims (Court). In an Order dated July 2025, the Court granted a Joint Motion for Partial Remand (JMPR), which remanded the secondary service connection denial back to the Board for development consistent with the JMPR. As the instant decision grants service connection for a functionally impairing right ankle disability, as secondary to service-connected right leg varicose veins, which is a complete grant as to the sole remaining issue on appeal, no further discussion of Court remand compliance is necessary. See Forcier v. Nicholson, 19 Vet. App. 414 (2006). Service Connection for a Functionally Impairing Right Ankle Disability is Granted. Service connection may be granted for disability arising from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Service connection may be granted for disability that is proximately due to or the result of a service-connected disability. An increase in severity of a non-service-connected disorder that is proximately due to or the result of a service connected disability, and not due to the natural progress of the non service connected condition, will be service connected. Aggravation will be established by determining the baseline level of severity of the non service connected condition and deducting that baseline level, as well as any increase due to the natural progress of the disease, from the current level. See 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439, 448 (1995). With any claim for service connection (under any theory of entitlement), it is necessary for a current disability to be present. See Brammer v. Derwinski, 3 Vet. App. 223 (1992); see also McClain v. Nicholson, 21 Vet. App. 319 (2007) (service connection may be warranted if there was a disability present at any point during the claim period, even if it is not currently present); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013) (when the record contains a recent diagnosis of disability immediately prior to a veteran filing a claim for benefits based on that disability, the report of diagnosis is relevant evidence that the Board must address in determining whether a current disability existed at the time the claim was filed or during its pendency). The Federal Circuit has held that pain alone that causes a functional impairment of earning capacity, even without a specifically diagnosed underlying pathology, could constitute a disability. See Saunders v. Wilkie, 886 F.3d 1356, 1369 (2018). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether the persuasive weight of the evidence is against a claim, in which case, the claim is denied. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application). The Veteran appeals for service connection for a right ankle disability as secondary (38 C.F.R. § 3.310) to the service-connected right leg varicose veins. As discussed in an August 2025 post Court remand brief, the Veteran argues that, while there is no expressly diagnosed right ankle disability, the service-connected right leg varicose veins have manifested as compensable painful limitation of motion in the right ankle that is not currently being compensated. In its May 2024 decision the Board found that, while VA examiners opined there was not a currently diagnosed right ankle disability, there was a history or findings of painful limitation of motion in the right ankle, manifesting in dorsiflexion limited to 10 degrees, which was caused by the service-connected right leg varicose veins. Under Diagnostic Code 5271, dorsiflexion of 10 degrees constitutes "moderate" limitation of motion, warranting a 10 percent disability rating. See 38 C.F.R. § 4.71a. As such, while there is no medical diagnosis of a specific right ankle disability, the Board finds that the evidence is at least in approximate balance on the question of whether there is a current functional impairment in earning capacity due to right ankle pain that equates to a disability. See Saunders, 886 F.3d at 1369. In its May 2024 decision, despite finding that the Veteran had painful limitation of motion in the right ankle that was due to the symptoms of the service-connected right leg varicose veins, the Board denied secondary service connection and/or a separate compensable disability rating for the right ankle. This denial was based upon a finding that such award would constitute improper pyramiding of compensation, that is, would compensate twice for the same disability. 38 C.F.R. § 4.14. The Board found that the symptoms of pain, swelling, and decreased range of right ankle motion were the same symptoms as pain and persistent edema contemplated when assigning the 40 percent disability rating for the right leg varicose veins under Diagnostic Code 7120. 38 C.F.R. § 4.104. Per the June 2025 JMPR, however, the parties agreed that the limitation of motion in dorsiflexion is "not contemplated by 38 C.F.R. § 4.104, Diagnostic Code (DC) 7120, which is used to rate varicose veins, but [is] discussed in 38 C.F.R. § 4.71a, DC 5270 and DC 5271." In other words, the parties agreed that it would not be improper pyramiding to grant secondary service connection and/or a separate compensable disability rating for the painful limitation of motion in the right ankle. As the parties in the June 2025 JMPR have agreed that it would not be improper pyramiding to grant secondary service connection and/or a separate compensable disability rating for the painful limitation of motion in the right ankle due to the service-connected right leg varicose veins, and considering the specific facts and circumstances relevant to this case, for the above reasons the Board will resolve reasonable doubt in favor of the Veteran to find the criteria have been met for service connection for a functionally impairing right ankle disability, as secondary (38 C.F.R. § 3.310) to the service-connected right leg varicose veins. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch; Saunders. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Blowers, 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.