Citation Nr: 1319226 Decision Date: 06/13/13 Archive Date: 06/21/13 DOCKET NO. 09-49 642 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Paul, Minnesota THE ISSUE Entitlement to service connection for pterygium. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD D. M. Donahue, Associate Counsel INTRODUCTION The Veteran served on active duty from April 1996 to February 2004. This case comes before the Board of Veterans' Appeals (Board) on appeal from a June 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Paul, Minnesota. The Board notes that, in addition to the paper claims file, there is a Virtual VA electronic claims file associated with the Veteran's claims. A review of the documents in the electronic file reveals that they are either duplicative of the evidence in the paper claims file or are irrelevant to the issues on appeal. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The Veteran seeks entitlement to service connection for a pterygium which he contends is due to excessive sun and wind exposure during active duty. In an August 2009 letter, the Veteran asserted his pterygium was due to exposure to environmental conditions while stationed in Egypt. The Veteran's DD-214 indicates service in Egypt from July 2003 to January 2004. After a thorough review of the Veteran's claims file, the Board has determined that additional development is necessary prior to the adjudication of the claim. In a January 2004 post-deployment assessment, the Veteran reported exposure to sand and dust often. He also denied redness of the eyes with tearing. Post-service treatment includes a May 2007 private eye examination indicating early pterygium. A November 2008 VA ophthalmology note included a diagnosis of pterygium. An internet search of pterygium yielded a National Institute of Health article which notes that risk factors for pterygium are "exposure to sunny, dusty, sandy, or windblown areas." Though the Veteran has a current diagnosis, he has not been afforded a VA examination to determine the etiology of his pterygium. Under these circumstances, the Board finds that an examination and medical opinion-based on full consideration of the Veteran's documented medical history and assertions, and supported by clearly-stated rationale-would be helpful in resolving the claims for service connection. See 38 U.S.C.A. § 5103A(d) (West 2002); 38 C.F.R. § 3.159 (2010); McLendon v. Nicholson, 20 Vet. App. 79 (2006). Additionally, in a November 2008 VA progress note, the Veteran indicated that his last eye examination was in 2004 in Cedar Rapids, Iowa. However, there is no record of this eye examination in the claims file. Thus, the Board finds that upon remand attempts should be made to obtain any identified outstanding VA or private treatment records. Accordingly, the case is REMANDED for the following action: 1. The Veteran should be requested to provide the names, addresses and approximate dates of treatment of all medical care providers, VA and non-VA, who have treated him for his claimed eye disorder, to include any outstanding eye examination dated in 2004. After the Veteran has signed the appropriate releases, those records should be obtained and associated with the claims folder. All attempts to procure records should be documented in the file. If the AMC/RO cannot obtain records identified by the Veteran, a notation to that effect should be inserted in the file. The Veteran and his representative are to be notified of unsuccessful efforts in this regard, in order to allow him the opportunity to obtain and submit those records for VA review. 2. Then, the Veteran should be afforded a VA examination, with an appropriate examiner, to determine the nature, severity, and etiology of the Veteran's pterygium. The Veteran's claims file should be made available to the examiner prior to the examination, and the examiner is requested to review the entire claims file in conjunction with the examination. All tests and studies deemed necessary by the examiner should be performed. Based on a review of the claims file, the relevant information obtained from the examiner's interview of the Veteran, and the clinical findings from the examination, the VA examiner is requested to offer an opinion as to whether it is at least as likely as not (e.g., a 50 percent or greater probability) that the Veteran's pterygium is etiologically related to the environmental exposures during service or to any other injury or illness incurred during service. A complete rationale should be given for all opinions and conclusions. Such rationale must include a discussion of all relevant evidence in the claims file (to include the diagnoses and positive nexus findings expressed in the Veteran's VA treatment records), relevant findings on examination and from the Veteran's stated history, and applicable medical principles. If the examiner finds that an etiology opinion cannot be provided without resort to speculation due to limitations of knowledge in the medical community at large, the examiner must identify the facts that cannot be determined, what additional information is necessary to render an appropriate opinion. All findings, conclusions, and supporting rationale should be expressed in a typewritten report. 3. After completion of the above development, and any other development deemed necessary based upon the results of the foregoing development, the Veteran's claims of entitlement to service connection for depression and headaches should be readjudicated. If any determination remains adverse to the Veteran, he and his representative should be furnished with a Supplemental Statement of the Case and given an opportunity to respond. 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 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ MICHAEL LANE 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).