Citation Nr: 0003759 Decision Date: 02/14/00 Archive Date: 02/15/00 DOCKET NO. 96-19 008 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Providence, Rhode Island THE ISSUE Entitlement to service connection for bilateral pes planus. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD Richard Giannecchini, Associate Counsel INTRODUCTION The veteran had active military service from September 1969 to April 1971. A perfected appeal to the Board of Veterans' Appeals (Board) of a particular decision entered by a Department of Veterans Affairs (VA) regional office (RO) consists of a Notice of Disagreement (NOD) in writing received within one year of the decision being appealed and, after a Statement of the Case (SOC) has been furnished, a substantive appeal (VA Form 9) received within 60 days of the issuance of the Statement of the Case or within the remainder of the one-year period following notification of the decision being appealed. The veteran was previously denied service connection for pes planus in an August 1973 decision of the Board. Under the law, that decision was final. In October 1995, the veteran sought to reopen his claim for entitlement to service connection for pes planus. The present appeal arises from a November 1995 rating decision, in which the RO determined that new and material evidence had not been presented to warrant reopening the veteran's claim for service connection for pes planus. The veteran filed an NOD in December 1995, and an SOC was issued by the RO in February 1996. The veteran filed a substantive appeal in April 1996. In October 1996, the veteran testified before a hearing officer at the VARO in Providence. A Hearing Officer's Decision was issued in March 1997. Supplemental statements of the case (SSOC) were issued in March 1996, as well as April and May 1999. The Board notes that, in reclassifying the issue on appeal as entitlement to service connection for pes planus, we have found that new and material evidence has been presented to reopen the veteran's claim. FINDINGS OF FACT 1. Service connection for pes planus was denied in an August 1973 Board decision. Under the law, that decision was final. 2. New and material evidence, in the form of a statement from the Chief of Podiatry at the VA Medical Center (VAMC) in Providence, in which it was noted that persons with the veteran's foot condition often suffer from "chronically tired feet", has been introduced into the record since service connection was previously denied for pes planus; thus, the newly submitted evidence warrants reopening the veteran's claim. 3. Considering all the evidence of record, new and old, the veteran's contention that his pes planus was aggravated by service is not supported by any medical evidence that would render the claim for service connection for that disability plausible under the law. CONCLUSIONS OF LAW 1. Evidence submitted since the previous final decision is new and material, and the veteran's claim of entitlement for service connection for pes planus is reopened. 38 U.S.C.A. §§ 7105(c), 5108 (West 1991); 38 C.F.R. §§ 3.104(a), 3.156(a) (1999). 2. The veteran has not submitted a well-grounded claim for service connection for pes planus, either on a direct basis, or by aggravation. 38 U.S.C.A. § 5107(a) (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSION I. Factual Basis A review of the veteran's service medical records reflects that, during an induction medical examination in August 1969, he was noted to suffer from pes planus. He was subsequently treated during basic military training, in October 1969, for congenital pes planus. In particular, on October 2, 1969, the veteran was scheduled for a consultation with Podiatry, for flat feet. On October 8, 1969, a treatment note reflected findings of "Cold [and] fallen arches". On October 20, 1969, he was examined at the Walson Army Hospital Podiatry Clinic. He reported pain in his feet on prolonged foot activity. On clinical evaluation, he was noted to suffer from congenital flat feet. It was reported that there was no limitation, and no pain was elicited. The examiner's impression was congenital pes planus. Subsequently, a treatment note, dated October 24, 1969, appears to reflect the veteran being issued orthotics. None of the veteran's additional service medical records reflects treatment for pes planus. In March 1971, he underwent a separation medical examination. In a Report of Medical History, the veteran noted that his fallen arches had never bothered him until basic training, and that he had a problem with standing on his feet for any length of time. In a Report of Medical Examination, the column labeled "Clinical Evaluation," was left blank. No clinical finding with respect to pes planus was reported. Following his separation from service, the veteran filed a claim for service connection for a skin condition, and was subsequently medically examined for VA purposes in October 1971. During the examination, the veteran reported suffering from painful flat feet if he stood for any length of time or walked any great distance. On clinical evaluation, the examiner noted that the veteran suffered from 3rd degree bilateral pes planus, which he described as moderately symptomatic. Thereafter, in November 1971, the veteran filed a claim for service connection for flat feet (pes planus). In a subsequent rating decision that same month, the veteran's claim for pes planus was denied. In October 1972, the veteran again underwent VA medical examination. He complained of difficulty walking or standing for prolonged periods of time. On clinical evaluation, the examiner noted the veteran to have 3rd degree bilateral pes planus with fallen metatarsal arches. His feet were noted to be moderately tender, with no swelling, muscle spasm, or callosities. An associated radiographic study of the veteran's feet was normal. The examiner's impression was 3rd degree bilateral pes planus with minimal disability. In a December 1972 rating decision, the RO denied the veteran's claim for bilateral pes planus. The veteran appealed the decision, and submitted a copy of letter from his congressman written to him during basic training. The letter, dated in October 1969, noted that the congressman was sorry to learn of the trouble the veteran was experiencing with his feet. The congressman reported that a service medical evaluation of the veteran's feet was to be undertaken, and a determination made as to whether the veteran's feet were bad enough to warrant a medical discharge. Thereafter, the veteran's appeal came before the Board, which, in an August 1973 decision, denied the veteran's claim of service connection for bilateral pes planus. Under the law, the decision of the Board was final. In March 1979, the veteran submitted a statement to the RO in which he requested that his claim for service connection for bilateral pes planus be reopened. He asserted that this pes planus was aggravated during service, and that his arches had been bothering him since that time. In letter from the RO to the veteran, dated in June 1979, the veteran was informed of the previous final decision with respect to his claim for service connection for pes planus. Furthermore, the RO indicated that, since no new and material evidence had been submitted, no change was warranted and no action would taken with respect to his claim. During this period, following the Board's August 1973 decision, the veteran submitted private medical records, as well as medical records and examination reports from the VA Hospital (VAH) in Newington and the VAMC in Providence, dated from April 1972 to September 1982. These records noted, overall, the veteran's treatment for his skin condition and a nervous disorder. Included within these records was a VAMC Providence Podiatry note, dated in May 1979, reflecting the veteran's treatment for pes planus. He complained of strained longitudinal arches and ankles, with pain running up his legs and thighs. He reported using a soft pair of sponge supports in his shoes, which had provided relief of symptoms of his pes planus for six months, but stated that symptoms had recently returned. The veteran reported that he worked as a postal clerk. Upon clinical evaluation, the veteran was noted to suffer from congenital flexible flat feet, which the examiner indicated were made symptomatic in the service. The examiner's diagnosis was strained pes planus, 3rd degree, symptomatic. Treatment called for raising the veteran's longitudinal arch supports by 1/4 inch. Also during this period of time, in reports as to his employment entered at VA examinations in April 1978 and November 1980, the veteran indicated that he had been employed as a postal clerk since March or April of 1974. In October 1995, the veteran requested that his claim for service connection for pes planus be reopened. That same month, the RO received VAMC Providence medical records, dated from November 1994 to October 1995. In particular, a treatment note, dated in December 1994, revealed that the veteran suffered from bilateral pes planus, and that he used orthotics in his shoes. A January 1995 treatment note reflected the veteran's complaint of left ankle pain since a left orthotic wedge had been inserted to help support his left arch. In a November 1995 rating decision, the RO determined that new and material evidence had not been submitted to reopen the veteran's claim. In December 1995, the RO received a medical statement from the Chief of Podiatry at the VAMC Providence, Richard Baker, D.P.M. Dr. Baker commented, in reference to an earlier RO decision: In your statement, you claim that the condition existed prior to military service. Then why was this man allowed to enter the military? People with this condition are notorious for requiring greater effort in order to ambulate. They often suffer from "chronically tired feet." If what I understand is true, Mr. [redacted] presented to sick call on several occasions during his military service for just such complaints. Dr. Baker also reported that he had been treating the veteran since 1993, and that the veteran suffered from severe pes planus. It was noted that the pain in the veteran's feet had not improved with treatment. In addition, Dr. Baker reported that low back pain, with which the veteran suffers, is a classic symptom of severe pes planus. He further stated that the veteran had a "low arch on and off weightbearing with calcaneal eversion", and that he had been unable to tolerate efforts to support his medial arch area with orthotics. In March 1996, the RO received VAMC Providence medical records, some duplicative, dated from August 1991 to February 1996. In particular, these records noted the veteran's treatment for his pes planus, with treatment records noting adjustments being made in the veteran's orthotics. In October 1996, the veteran testified before a hearing officer at the VARO in Providence. The veteran reported that, prior to service, he was aware that he had pes planus, but that he had not experienced pain in his feet during this period. He stated that problems with his feet began during basic training at Fort Dix, NJ. The veteran reported that he subsequently received treatment for pes planus at Fort Dix, and was given arch supports. He also reported that the pain in his feet had continued since basic training, and as a result he could not walk long distances. Furthermore, the veteran indicated that he could only wear special sneakers, and not shoes. Additionally, the veteran noted that the pain in his feet made it difficult for him to work as a postal clerk for the U.S. Postal Service, and restricted his ability to go on long walks, jog, or go dancing with his wife. In July 1997, the RO received a VAMC Providence treatment record, dated that same month. This record noted the veteran's continued use of orthotics as treatment for his pes planus. II. Analysis A. New and Material Evidence The veteran was previously denied service connection for pes planus in an August 1973 Board decision. In order to reopen his claim, he must present new and material evidence with respect thereto. 38 U.S.C.A. § 5108. Because the present appeal does not arise from an original claim, but rather comes from an attempt to reopen a claim which was previously denied, the Board must bear in mind the important distinctions between those two types of claims. Prior to our discussion of the evidence which has been submitted since the August 1973 Board decision, we must first note that the United States Court of Appeals for Veterans Claims (previously known as the United States Court of Veterans Appeals) had previously held that the Secretary of Veterans Affairs, and, on appeal, the Board, were required to perform a two-step analysis when a claimant sought to reopen a claim based upon new evidence. First, it was to be determined whether the evidence was "new and material." Second, if the Board determined that the claimant had produced new and material evidence, the claim was reopened and the Board evaluated the merits of the veteran's claim in light of all the evidence, both old and new. Manio v. Derwinski, 1 Vet.App. 144 (1991). Whether the new evidence was "material" turned essentially upon the reasonable possibility that, when viewed in the context of all the evidence, it would change the outcome. Colvin v. Derwinski, 1 Vet.App. 171, 174 (1991). The Court more recently held that the two-step Manio process has been replaced with a three-step process. See Elkins v. West, 12 Vet.App. 209 (1999) (en banc), interpreting and applying a decision of the United States Court of Appeals for the Federal Circuit in Hodge v. West, 155 F.3d. 1356 (Fed. Cir. 1998). The procedure which we must now follow is - first, it must be determined whether the appellant has presented new and material evidence under 38 C.F.R. § 3.156(a); second, after the claim has been reopened, it must be determined whether, based upon all the evidence of record, the claim, as reopened, is well grounded; third, if the claim is well grounded, the merits of the claim must be addressed and, if ripe for decision, adjudicated. Winters v. West, 12 Vet.App. 203, 206 (1999) (en banc). In addition, Hodge overruled Colvin and its progeny as to the materiality element of the new-and-material-evidence test. See Elkins, supra, at 214. As defined by regulation, new and material evidence means evidence not previously submitted which bears directly and substantially upon the specific matter under consideration, which is neither cumulative nor redundant, and which, by itself or in connection with the evidence previously assembled, is so significant that it must be considered in order to fairly decide the merits of the claim. 38 C.F.R. § 3.156(a). The Federal Circuit Court has held that the regulatory standard alone must be the test of materiality. Hodge, supra. In determining whether new and material evidence has been presented, VA must initially decide whether evidence submitted since the prior final denial is, in fact, new. As indicated by the regulation cited above, and by judicial caselaw, "new" evidence is that which was not of record at the time of the last final disallowance ("on any basis" - merits or otherwise) of the claim, and is not "merely cumulative" of other evidence that was then of record. See Evans v. Brown, 9 Vet.App. 273, 283-285 (1996). This analysis is undertaken by comparing newly received evidence with the evidence previously of record. After evidence is determined to be new, the next question is whether it is material. Although, as noted above, Hodge overruled Colvin and its progeny as to the materiality test, it does not appear that the analysis as to what is new evidence has been overruled. See Vargas-Gonzalez v. West, 12 Vet.App. 321, 326 (1999), noting that Hodge did not deal with the test for determining whether evidence is new, which is a separate decision from whether it is material. As to the materiality standard, the Federal Circuit's holding in Hodge has been interpreted by a panel of the Court of Appeals for Veterans Claims: "Hodge provides for a reopening standard which calls for judgments as to whether new evidence (1) bears directly or substantially on the specific matter, and (2) is so significant that it must be considered to fairly decide the merits of the claim." Fossie v. West, 12 Vet.App. 1, 4 (1998), motion for recon/review denied, 12 Vet. App. 234 (1999). In determining whether newly submitted evidence is material under the caselaw discussed above, we are further guided by the Federal Circuit Court's discussion of the "uniquely pro-claimant" quality of the veterans' benefits system such that, although "not every piece of new evidence is 'material' . . . we are concerned . . . that some new evidence may well contribute to a more complete picture of the circumstances surrounding the origin of a veteran's injury or disability, even where it will not eventually convince the Board to alter its ratings decision." Hodge v. West, supra, at 1363. The credibility of new evidence is assumed for the limited purpose of determining whether it is material. Justus v. Principi, 3 Vet.App. 510 (1992). As noted above, under the precedent decision of the Court in the Evans case, supra, in order to reopen a previously and finally denied claim there must be new and material evidence entered into the record since the most recent denial on any basis, either on the merits or on an attempted reopening. Id. at 285. Therefore, the evidence which must be considered at this time, in connection with the veteran's claim of service connection for pes planus, is that which has been submitted since the Board entered its decision on this matter in August 1973. Evidence submitted since the final Board decision entered in 1973 includes: 1. Multiple private and VA medical treatment records and notes, as well as examination reports, dated from April 1972 to September 1982. 2. VAMC Providence podiatry note, dated in May 1979. 3. VAMC Providence treatment records, dated from August 1991 to July 1997. 4. Medical opinion from Richard Baker, D.P.M, Chief of Podiatry, VAMC Providence, dated in December 1995. 5. Transcript of personal hearing, conducted in October 1996. Following a review of the record, the Board finds that evidentiary items (1), (2), (3), and (5), while new, are not material evidence sufficient to warrant reopening the veteran's claim for bilateral pes planus. In this regard, we note that the various private and VA medical records, overall, reflect the veteran's treatment for a skin condition and nervous disorder. In addition, the VAMC Providence Podiatry note and treatment records report the veteran's treatment for his pes planus and the adjusting of his orthotics. The Podiatry note also contained a notation that the veteran's flat feet had been made symptomatic in service. With regard to these records, we find that they do not provide medical nexus evidence with respect to whether the veteran's pes planus was aggravated during service, and are cumulative of evidence that the Board had previously considered in its August 1973 decision. Furthermore, the veteran's lay assertions, documented in the hearing transcript, although they may be sincerely felt, do not constitute competent medical evidence sufficient to reopen a claim. See, e.g., Voerth v. West, 13 Vet. App. 117, 120 (1999) ("Unsupported by medical evidence, a claimant's personal belief, no matter how sincere, cannot form the basis of a well-grounded claim."); Bostain v. West, 11 Vet.App. 124, 127 (1998) ("lay testimony . . . is not competent to establish, and therefore not probative of, a medical nexus"); Routen v. Brown, 10 Vet.App. 183, 186 (1997) ("a layperson is generally not capable of opining on matters requiring medical knowledge"), aff'd sub nom. Routen v. West, 142 F.3d 1434 (Fed. Cir. 1998); cert. denied, 119 S. Ct. 404 (1998). With respect to the statement from Dr. Baker, evidentiary item (4), we note that he did not specifically discuss whether the veteran's pre-service bilateral pes planus was aggravated during service. However, he did note that persons with the veteran's condition often suffer from "chronically tired feet", and that he understood that the veteran had presented to sick call in service on several occasions complaining of fatigued feet. Furthermore, Dr. Baker believed the veteran's pes planus was related to service. We note that it does not appear that Dr. Baker reviewed the veteran's claims file prior to his opinion, and, therefore, his findings are predicated on a history provided by the veteran, and thus can be no better than the facts related to him by the patient. See Elkins v. Brown, 5 Vet.App. 474, 478 (1993); Reonal v. Brown, 5 Vet.App. 458, 460-61 (1993); Swann v. Brown, 5 Vet.App. 229, 233 (1993). However, we are not unmindful of the mandate in the recent Hodge precedent, discussed above. Therein, the Federal Circuit Court declared: We certainly agree with the Court of Veterans Appeals that not every piece of new evidence is "material"; we are concerned, however, that some new evidence may well contribute to a more complete picture of the circumstances surrounding the origin of a veteran's injury or disability, even where it will not eventually convince the Board to alter its ratings decision. Where so much of the evidence regarding the veterans' claims for service connection and compensation is circumstantial at best, the need for a complete and accurate record takes on even greater importance. Hodge v. West, supra, at 1363. In view of the change in course dictated by the Federal Circuit Court, the Board concludes that the threshold for reopening a previously denied claim has been lowered somewhat. Thus, given that Dr. Baker discusses the veteran's current bilateral pes planus condition in relation to his period of military service, and resolving any reasonable doubt in favor of the veteran, we find that the statement from Dr. Baker meets the regulatory standard of evidence "which by itself or in connection with evidence previously assembled is so significant that it must be considered in order to fairly decide the merits of the claim." 38 C.F.R. § 3.156(a) (1999). Accordingly, the Board concludes that the veteran has submitted evidence which is new and material, and the claim for service connection for bilateral pes planus is reopened. In addition, we are also aware that, in its February 1996 SOC, the RO cited to 38 C.F.R. § 3.156, the regulation discussed with approval in Hodge, and quoted the regulation's pertinent language as it relates to new and material evidence claims. However, in the analysis under "Reasons and Bases", the RO noted, in part, "To justify a reopening of a claim on the basis of new and material evidence, there must be a reasonable possibility that the new evidence, when viewed in the context of all the evidence, both new and old, would change the outcome." This language was also noted in later SSOC's dated in March 1996 and April 1999. We acknowledge that the RO's analysis appeared to be predicated, in part, upon language found impermissible by Hodge. However, in a subsequent May 1999 SSOC, the RO did not cite to the impermissible language, and appropriately considered the veteran's claim solely under the language of § 3.156. In any event, we find that the claim has been reopened. B. Well-Groundedness A claimant seeking benefits under any law administered by the Secretary of Veterans Affairs has the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded. Now that Hodge has overruled the Colvin materiality test, the existence of a well-grounded claim no longer necessarily flows from a determination that new and material evidence has been presented. Put another way, Hodge implicitly held that new and material evidence can have been presented even though a claim is not well grounded. Elkins v. West, supra, at 218. Thus the Board, following its determination in this case that new and material evidence has been presented, must next determine, as part of its review of the claim under section 5108, whether the veteran's claim, as reopened, is well grounded in terms of all the evidence in support of the claim, generally presuming the credibility of that evidence. See Elkins, supra. The Court of Appeals for Veterans Claims has held that, in order to establish that a claim for service connection is well grounded, there must be competent evidence of: (1) a current disability (a medical diagnosis); (2) the incurrence or aggravation of a disease or injury in service (lay or medical evidence); and (3) a nexus (that is, a connection or link) between the in-service injury or aggravation and the current disability. Competent medical evidence is required to satisfy this third prong. See Elkins v. West, supra, citing Caluza, supra, aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996) (table), and Epps, supra. "Although the claim need not be conclusive, the statute [38 U.S.C.A. §5107] provides that [the claim] must be accompanied by evidence" in order to be considered well grounded. Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992). In a claim of service connection, this generally means that evidence must be presented which in some fashion links the current disability to a period of military service or to an already service-connected disability. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. § 3.303 (1998); Rabideau v. Derwinski, 2 Vet.App. 141, 143 (1992); Montgomery v. Brown, 4 Vet.App. 343 (1993). Evidence submitted in support of the claim is presumed to be true for purposes of determining whether it is well grounded. King v. Brown, 5 Vet.App. 19, 21 (1993). Lay assertions of medical diagnosis or causation, however, do not constitute competent evidence sufficient to render a claim well grounded. Grottveit v. Brown, 5 Vet.App. 91, 93 (1992); Espiritu v. Derwinski, 2 Vet.App. 492, 495 (1992). Under applicable criteria, service connection may be granted for a disability resulting from disease or injury which was incurred in, or aggravated by, service. 38 U.S.C.A. §§ 1110 (West 1991). To establish a 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. 38 C.F.R. § 3.303(b) (1999). If chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim. Id. Service connection may be granted for any disease diagnosed after discharge, when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (1999). The law provides that a veteran shall be presumed to have been in sound condition at the time of acceptance for service, except for defects noted at that time or where clear and unmistakable evidence demonstrates that the disability or disease existed prior to service and was not aggravated by such service. 38 U.S.C.A. §§ 1111, 1137; 38 C.F.R. § 3.304(b). A preexisting disability or disease will be considered to have been aggravated by active service when there is an increase in disability during service, unless there is clear and unmistakable evidence (obvious and manifest) that the increase in disability is due to the natural progress of the disability or disease. 38 U.S.C.A. § 1153; 38 C.F.R. § 3.306(a), (b). Aggravation may not be conceded where the disability underwent no increase in severity during service on the basis of all the evidence of record pertaining to the manifestations of the disability prior to, during and subsequent to service. 38 C.F.R. § 3.306(b). See Falzone v. Brown, 8 Vet.App. 398, 402 (1995) (holding that the presumption of aggravation created by section 3.306 applies only if there is an increase in severity during service); Akins v. Derwinski, 1 Vet.App. 228, 231 (1991). The Court has further stated that "temporary or intermittent flare-ups during service of a preexisting injury or disease are not sufficient to be considered 'aggravation in service' unless the underlying condition, as contrasted to the symptoms, is worsened." Hunt v. Derwinski, 1 Vet.App. 292, 297 (1991); see also Daniels v. Gober, 10 Vet.App. 474, 479 (1997); see also Browder v. Brown, 5 Vet.App. 268, 271 (1993) (Board must "explain the criteria it used to determine whether there was an increase in disability of [preexisting condition] during service and how, pursuant to such criteria, it concluded that [there was no in-service worsening]"). In reviewing the evidence before us, the Board finds that the veteran suffered from pes planus prior to service. As the U.S. Court of Appeals for Veterans Claims has held, the presumption of soundness upon entry into service may not be rebutted without "contemporaneous clinical evidence or recorded history" in the record. Miller v. West, 11 Vet.App. 345, 348 (1998). In this instance, the veteran's service entrance medical examination noted that he suffered from pes planus. Furthermore, during his personal hearing, the veteran testified that he knew he had flat feet before entering service. Thus, we find the presumption of soundness has been rebutted, and that the veteran's pes planus did exist prior to service. In light of the conclusion that the presumption of soundness is rebutted, the next question becomes whether the veteran's pes planus worsened, or became aggravated, during service. As noted above, there must be a showing that the veteran's underlying flat foot disorder, as contrasted to the symptoms, increased in severity. In reviewing the evidence of record, we are cognizant that the veteran has a currently diagnosed disability, severe pes planus. He has also reported that he had not experienced problems with feet before service, but that his flat foot disorder was symptomatic during his basic military training at Fort Dix. During this period, the evidence reflects that the veteran was treated on a few occasions in October 1969 for bilateral pes planus. There is a lack of evidence for additional treatment during service. The veteran subsequently complained of problems with his feet at separation, but no clinical finding regarding the severity of his foot disorder, or whether it had been aggravated by service, was made. Thereafter, subsequent VA examinations, in October 1971 and 1972, reported that the veteran suffered from symptomatic pes planus in moderate and mild form, respectively. The examiners did not offer comments as to whether the veteran's pes planus had been aggravated during service. The veteran reportedly began to work for the U.S. Postal Service in 1974, and he testified at his personal hearing in 1996 that the job required him to be on his feet a great deal of the time. His post-service career, therefore, has been largely spent in employment requiring long periods of time on his feet. Furthermore, various VAMC Providence treatment records reflect the veteran's use of orthotics as treatment for his bilateral pes planus, but do not contain any medical nexus evidence as to whether his disability was aggravated during service. With respect to Dr. Baker, he has reported that he had begun treating the veteran in 1993. It does not appear that he reviewed the veteran's service medical records or claims file prior to rendering his opinion regarding the veteran's bilateral pes planus. Dr. Baker did not comment as to whether the veteran's pes planus condition was aggravated by service, but instead asserted that the veteran should have been service connected for pes planus because of his complaints of foot pain and fatigue in service. He further stated that many people with pes planus often complain of "chronically tired feet". There is also a question as to whether Dr. Baker believes that the veteran's pes planus pre- existed service. As reported above, Dr. Baker noted in his statement, in reference to an earlier RO decision, "you claim that the condition existed prior to military service. Then why was this man allowed to enter the military?" Thus, the Board finds Dr. Baker's opinion and comments, while noting the veteran's treatment for pes planus and his history of complaints in service, to be inconclusive, given that he did not offer an opinion on the issue of whether the increase in the veteran's pes planus symptomatology was or was not due to the natural progress of his pes planus disorder. Furthermore, as noted above, Dr. Baker began treating the veteran more than 20 years after the veteran separated from service, and his comments are based on a history provided by the veteran, and thus can be no better than the facts related by the veteran to him. See Elkins, Reonal, Swann, supra. As the Court has clearly held in Hunt, supra, and other precedent decisions, the mere increase in symptomatology in service does not establish permanent aggravation of a pre- service disorder. Therefore, after a thorough review of all the evidence of record, and consideration of Dr. Baker's comments and opinion, we find that competent medical evidence has not been presented that provides that the veteran's pre-service bilateral pes planus condition was aggravated by service, and, as a result, the veteran's claim is not found to be well grounded. See Caluza, supra. While we do not doubt the sincerity of the veteran's contentions that he suffers from bilateral pes planus, and that it is related to service, our decision must be based upon competent medical testimony or documentation. In a claim of service connection, this generally means that competent medical evidence must establish that a current disability exists, and then link that disability to a period of active military service. No competent medical evidence has been presented establishing that the veteran's pes planus was incurred in, or aggravated by, service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1999); Rabideau v. Derwinski, Montgomery v. Brown, both supra. In addition, the veteran does not meet the burden of presenting evidence of a well-grounded claim merely by presenting his own testimony, because, as a lay person, he is not competent to offer medical opinions. See Voerth, Bostain, Routen, supra. Under the law, the veteran is free, at any time in the future, to submit new and material evidence to reopen his claim for bilateral pes planus, regardless of the fact that he currently is not shown to be suffering from a disability that may be service-connected. Such evidence would need to show, through competent medical evidence, a current disability or disabilities, and that such disability "resulted from a disease or injury which was incurred in or aggravated by service." 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. § 3.303 (1999); Rabideau, Montgomery, supra. In absence of a well-grounded claim, there is no duty to assist the veteran further in its development, and the Board does not have jurisdiction to adjudicate it. Boeck v. Brown, 6 Vet.App. 14 (1993); Grivois v. Brown, 5 Vet.App. 136 (1994). Accordingly, as a claim that is not well grounded does not present a question of fact or law over which the Board has jurisdiction, the claim for service connection for bilateral pes planus must be denied. See Epps v. Gober, supra. Finally, the Board notes that, in March 1996, the veteran requested that the RO obtain treatment records from the VAH in Newington for the period 1971 to 1978. He reported that those records would document treatment for his feet, which included being issued arch supports. The RO noted, in its March 1996 rating decision, that treatment records from VAH Newington for the periods identified were already on file, and had been considered. We note that, while there are records currently on file from the Newington VAH, none of these pertain to the veteran's feet, except for VA examination reports in October 1971 and 1972. In any event, the veteran has not reported that a treating doctor at VAH Newington during this period opined that his bilateral pes planus was aggravated as a result of service. Furthermore, it appears that these records, based on the veteran's report, pertain more to the issuance of orthotics for his feet. Therefore, after careful review of the record, the Board can find no reason that a remand of the veteran's appeal, to obtain those VAH Newington records requested by the veteran, would be judicially expedient or otherwise result in a different finding. Thus, such a remand would result in unnecessarily imposing additional burdens on VA with no benefit flowing to the veteran. The Court has held that such remands are to be avoided. See Winters v. West, 12 Vet.App. 203, 207 (1999) (en banc); Soyini v. Derwinski, 1 Vet.App. 540, 546 (1991); Sabonis v. Brown, 6 Vet.App. 426, 430 (1994). ORDER Entitlement to service connection for pes planus is denied. ANDREW J. MULLEN Member, Board of Veterans' Appeals