Citation Nr: 1318958 Decision Date: 06/11/13 Archive Date: 06/21/13 DOCKET NO. 08-00 055A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Oakland, California THE ISSUE Entitlement to service connection for vision problems. REPRESENTATION Veteran represented by: Disabled American Veterans ATTORNEY FOR THE BOARD P. Childers, Counsel INTRODUCTION The Veteran served on active duty from March 1971 to April 1972, including service in Vietnam from August 1971 until April 1972. This case comes before the Board of Veterans' Appeals (Board) on appeal from an October 2006 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) that denied, in pertinent part, reopening of a claim for service connection for refractive error or other vision problem. In a decision in September 2011, the Board reopened the claim and then denied, on the merits, the issue of service connection for vision problems. In October 2011 the Veteran appealed the Board's September 2011 denial of his claim for service connection for vision problems to the United States Court of Appeals for Veterans Claims (Court). In a Memorandum Decision dated September 26, 2012, the Court vacated that part of the Board's September 2011 decision that denied service connection for vision problems and remanded the matter for further development. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, D.C. VA will notify the appellant if further action is required. REMAND On entry into service in 1971 the Veteran was diagnosed to have a bilateral refractive error. His visual acuity was 20/400 in each eye, corrected to 20/20. However, post-service medical records advise of low tension glaucoma and cataracts in both eyes; the symptoms of which the Veteran asserts have been present since service. Additionally, in correspondence in January 2013 the Veteran stated that he was told that a 2006 CT scan of the brain showed that he had suffered a mild stroke in 1972, which he opined might have something to do with his loss of vision. He also recalled that he began to take medications for psychiatric complaints in 1972, and wondered if his vision problems could be related to that treatment. The Veteran should be examined to ascertain whether any current disability may be linked to service. Likewise, relevant ongoing medical records should also be associated with the claims file. 38 U.S.C.A. § 5103A(c) (West 2002). Accordingly, the case is REMANDED for the following action: 1. Send notice to the Veteran that apprises him of the information and evidence needed to establish a claim of service connection for a visual disorder on a secondary basis. See 38 C.F.R. § 3.310. 2. Associate, with the claims file, VA treatment records dating from September 2006 from the Central California Health Care System. Also, ask the Veteran to provide the names and addresses of any other medical care providers who have treated him for his visual problems. After attaining the necessary authorization from the Veteran, any relevant records which are not duplicates of records already contained in the claims file should be requested. 3. After the above has been completed, schedule the Veteran for a VA examination regarding the claim of service connection for vision problems. The claims file must be made available to, and reviewed by, the examiner in conjunction with the examination. Following a review of the claims file, to include service and post-service medical records, the examiner is requested to state, for each diagnosed visual disorder, whether it is at least as likely as not that the disorder was (a) incurred in-service or is related to some incident of service; or (b) whether the disorder was directly caused by the Veteran's service-connected psychiatric disability or by his psychotropic medication regime; or (c) whether the disorder has increased in severity beyond its natural progression as a result of any service connected disability (or medication therefore). The Veteran is presently 100 percent service-connected for bipolar disorder; 10 percent service-connected for tinnitus; and 0 percent service-connected for bilateral hearing loss. In formulating the opinion the examiner should note that the Veteran has been treated with psychotropic medications for his psychiatric complaints, and has complained of vision loss, since 1972. The phrase "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of a certain conclusion as it is to find against it. A complete rationale for all opinions must be provided. If an opinion cannot be rendered on a medical or scientific basis without invoking processes relating to guesswork or judgment based upon mere conjecture, the examiner should clearly and specifically so state in the examination report, and explain why that is so. 4. After completion of all of the above and any other development deemed necessary, re-adjudicate the claim. If the benefit sought remains denied, provide the Veteran and his representative a supplemental statement of the case and return the case to the Board. The Veteran has the right to submit additional evidence and argument on the matter 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 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ MICHAEL E. KILCOYNE 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) (2012).