Citation Nr: 0505172 Decision Date: 02/24/05 Archive Date: 03/04/05 DOCKET NO. 03-14 547 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Chicago, Illinois THE ISSUE Entitlement to service connection for blurred vision, claimed as a residual of an in-service injury of the right eyebrow. REPRESENTATION Appellant represented by: Vietnam Veterans of America ATTORNEY FOR THE BOARD L. Cryan, Counsel INTRODUCTION The veteran had active service most recently from June 1972 to February 1976 with 16 years of prior active duty. This case is before the Board of Veterans' Appeals (Board) on appeal from a March 2003 rating decision by the RO, which, inter alia, denied service connection for blurred vision. This appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify you if further action is required on your part. REMAND Historically, in a claim received at the RO in October 1991, the veteran asserted that he sustained an injury to an area of his head at his right eyebrow when he fell on a flashlight during service in 1956. The veteran reported that he suffered swelling and throbbing in the area of his right eyebrow, as well as blurred vision which he felt was related to the injury. The veteran's service medical records reflect that the veteran had uncorrected defective distance vision of 20/50 in the right eye and 20/40 in the left eye on his February 1956 enlistment examination. Eye examinations throughout the veteran's twenty years of service continued to note defective distance vision, as well as complaints of eye strain and burning in the eyes. On examination in November 1958, the veteran's distant visual acuity was 20/40, corrected to 20/20 in both eyes, and his near visual acuity was 20/30, corrected to 20/20 in both eyes. On examination in February 1966, it was noted that the veteran sustained an injury over his right eyelid after falling on a flashlight in 1956. The laceration was sutured, and there were no complications or sequelae. A 2-inch traumatic scar over the right eyelid that was well-healed was noted with no symptoms. The veteran's distant visual acuity was noted as 20/50 corrected to 20/20 in the right eye, and 20/70, corrected to 20/20 in the left eye. The veteran's near vision was 20/30, corrected to 20/20 in the right eye and 20/30, corrected to 20/20 in the left eye. The veteran's separation physical in May 1975 noted distant visual acuity of 20/50, corrected to 20/20 in the right eye and 20/40, corrected to 20/20 in the left eye. Near visual acuity was 20/40, corrected to 20/20 in both eyes. In December 1991, the veteran was afforded a VA examination to determine the current nature and likely etiology of the scar above his right eyebrow. The examiner noted that the veteran had an old scar over the right brow. The examiner noted that the wound was well-healed and the scar was matured. The examiner indicated that the veteran could not improve on the scar with surgery. The examiner recommended that the veteran do nothing for the problem as there was no deformity and the eyebrow was functional. It does not appear that the veteran's vision was examined and his complaints of blurred vision were not addressed by the examiner. In a March 1992 rating decision, service connection was granted for a well-healed scar of the right eyebrow. The RO did not address that part of the veteran's claim asserting that service connection was warranted for blurred vision as a residual of the in-service injury to the right eyebrow. In January 2003, the veteran submitted a claim for increased ratings for his service-connected disabilities. Of particular note, the veteran asserted that the scar condition of his right eye was causing blurred vision, and that this condition was getting worse. In conjunction with his claims for increased ratings, the veteran was afforded a series of VA examinations in January 2003, including an eye examination. The eye examiner indicated that there was no diplopia. The examiner indicated that he completed a full eye examination and noted the following visual acuity: NEAR: FAR: Right Eye, uncorrected: 20/130 20/25 Right Eye, corrected : 20/40 20/30 Left Eye, uncorrected: 20/170 20/25 Left Eye, corrected: 20/30 20/25 The examiner concluded that (1) there was a possibility of some early signs of macular degeneration; and (2) the veteran had a diagnosis of presbyopia, secondary to his advancing age. The examiner did not address the veteran's assertions that he had blurred vision due to his right eyebrow injury in service. In a March 2003 rating decision, service connection for blurred vision was denied. The veteran timely appealed that determination. In his April 2003 Notice of Disagreement, the veteran once again asserted that his blurred vision was a result of the in-service injury to the right eyebrow. While it is true that the claims file does not currently contain any medical evidence relating the veteran's current vision defect to his military service, the VA examiners in December 1991 and January 2003 never addressed the veteran's contentions, despite being asked to do so. In other words, the VA examinations of December 1991 and January 2003 noted current defective vision, but did not address the likely etiology of the defective vision in light of the veteran's contentions that his blurred vision was caused by the in- service injury. The United States Court of Appeals for Veterans Claims (Court), has stated that the duty to assist claimants in developing the facts pertinent to their claims may, under appropriate circumstances, include a duty to conduct a thorough and contemporaneous medical examination. Proscelle v. Derwinski, 2 Vet. App. 629, 632 (1992); Green v. Derwinski, 1 Vet. App. 121, 124 (1991). In addition, the VA duty to assist includes the conduct of VA examination where the record does not adequately reveal the current state of the claimant's disability. Proscelle v. Derwinski, 2 Vet. App. 629, 632 (1992) citing Schafrath V. Derwinski, 1 Vet. App. 589, 595 (1991). In light of the foregoing, the case is REMANDED to the AMC for the following action: 1. The AMC should take appropriate action to contact the veteran in order to request that he identify the names, addresses, and approximate dates of treatment for any VA and non-VA health care providers who treated him for blurred vision and/or defective visual acuity in the right eye. After obtaining any necessary authorization from the veteran, the AMC should attempt to obtain copies of pertinent treatment records identified by the veteran in response to this request, which have not been previously secured. All VA treatment records, not previously secured, should be obtained. Once obtained, all records must be associated with the claims folder. 2. The AMC then should schedule the veteran for a VA examination to determine the current nature and the likely etiology of the blurred vision. All indicated tests must be conducted. The claims folder must be made available to and pertinent documents therein reviewed by the examiner prior to the requested studies. The examiner in this regard should elicit from the veteran and record a full clinical history referable to the blurred vision. Based on his/her review of the case, the examiner should provide an opinion, with adequate rationale, as to whether it is at least as likely as not that the veteran's current blurred vision or defective visual acuity is a residual of the in-service injury of the right eyebrow. The examiner should specifically indicate if the veteran's defective vision noted at entry into service was at least as likely as not aggravated beyond the natural progression due to the in-service injury sustained to the right eyebrow. A complete rationale for any opinion expressed must be provided. The examination report should be associated with the claims folder. 3. Following completion of the development requested hereinabove, the AMC must undertake to review the veteran's claim of service connection. If any benefit sought on appeal remains denied, then the veteran and his representative should be provided with a supplemental statement of the case (SSOC). The SSOC must contain notice of all relevant actions taken on the claim for benefits, to include a summary of the evidence and applicable law and regulations considered pertinent to the issue currently on appeal. An appropriate period of time should be allowed for response thereto. Thereafter, the case should be returned to the Board for the purpose of appellate disposition, if in order. The Board intimates no opinion as to the ultimate outcome of this case. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See The Veterans Benefits Act of 2003, Pub. L. No. 108-183, § 707(a), (b), 117 Stat. 2651 (2003) (to be codified at 38 U.S.C. §§ 5109B, 7112). _________________________________________________ BARBARA B. COPELAND Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2004).