Citation Nr: 18147335 Decision Date: 11/05/18 Archive Date: 11/02/18 DOCKET NO. 15-21 637 DATE: November 5, 2018 REMANDED Entitlement to service connection for bilateral cataracts is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1985 to July 1991. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office. In April 2016, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. At such time, the undersigned held the record open for 60 days for the submission of additional evidence. In June 2016, the Veteran, through his representative, requested an extension of time to submit evidence. While such motion was never ruled upon, he has not submitted any additional evidence to date. Furthermore, as his claim is being remanded, he will have the opportunity to submit any additional evidence prior to the readjudication of his claim by the Agency of Original Jurisdiction. Entitlement to service connection for bilateral cataracts. At his April 2016 Board hearing and in documents of record, the Veteran contends that his cataracts had their onset during service as his reported symptoms at such time were identical to those that ultimately led to such diagnosis in 2012. In this regard, he asserts a continuity of symptomatology of blurry vision and glare from the first onset of symptoms in service to his diagnosis of cataracts in June 2012. The Veteran further alleges that his cataracts developed as a result of treatment with Prednisone in 1988 for poison ivy. Therefore, he claims that service connection for bilateral cataracts is warranted. The Veteran’s service treatment records (STRs) reflect that, in June 1985, he reported that rifle cleaning fluid got into his eye and complained of blurry vision in the left eye. In July 1986, he complained of left eye irritation, itching, and blurring, claiming that it felt something was in his eye. In November 1986, the Veteran reported blurring of vision. In September 1988, he was prescribed Prednisone for poison ivy for approximately two weeks. A January 1990 Report of Medical History reflects a report of eye trouble, and it was noted that the Veteran’s far sight vision worsens and gets better approximately three times a year, but the reason was unknown. Post-service records reflect a diagnosis of bilateral cataracts, at the age of 50, in June 2012, with subsequent surgeries in August 2012 and October 2012. In this regard, the Veteran reported that his treatment provider, Dr. L., indicated at such time that a diagnosis of cataracts in people as young as the Veteran was steroid-related. Furthermore, in a February 2013 statement, Dr. L. noted that the use of steroids significantly increased the risk factor for cataracts. In addition, the Veteran testified that his VA primary care physician also believed that his cataracts were diagnosed at an early age. Based on the foregoing, the Veteran was afforded a VA examination in June 2013 in order to ascertain the nature and etiology of his bilateral cataracts. At such time, the examiner found that the Veteran did not have cataracts. Following a review of records from Dr. L. that documented such diagnosis, the examiner provided an addendum opinion in August 2013. In this regard, she concluded that the Veteran’s bilateral cataracts was less likely than not related to his in-service steroid use. While the examiner acknowledged that the use of steroids increases the risk for cataracts, she indicated that there was insufficient evidence to correlate his cataracts with steroid use. Specifically, she found that there were only a few records documenting the use of steroids, and cataracts associated with steroid use were typically found with chronic usage. Therefore, the examiner found that the Veteran’s cataracts are just as likely age-related. However, based on the examiner’s phrasing, it is not entirely clear whether she attributes the same likelihood to steroid use and age as a cause of the Veteran’s cataracts. Furthermore, she did not address whether his documented in-service symptoms, which he alleged continued after service, were evidence of the onset of cataracts. Therefore, the Board finds that a remand to obtain an addendum opinion addressing the etiology of the Veteran’s bilateral cataracts is necessary. The matter is REMANDED for the following action: Return the record to the VA examiner who conducted the June 2013 VA eye examination and provided the August 2013 addendum opinion. The record and a copy of this Remand must be made available to the examiner. If the 2013 VA examiner is not available, the record should be provided to an appropriate medical professional so as to render the requested opinion. The need for an additional examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion. Following a review of the record, the examiner should offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s diagnosed bilateral cataracts had their onset in, or are otherwise related to, his military service, to include his reported in-service symptoms of blurry vision and/or use of Prednisone to treat poison ivy for 2 weeks in September 1988. In this regard, the examiner is specifically requested to address whether the Veteran’s reported in-service symptoms, to include blurred vision, are indicative of the presence of cataracts at such time. In this regard, he or she is advised that the Veteran has alleged that his reported symptoms at during service were identical to those that ultimately led to such diagnosis in 2012. The examiner should also consider the Veteran’s report of a continuity of symptomatology of blurry vision and glare from the first onset of symptoms in service to his diagnosis of cataracts in June 2012. Finally, he or she should consider the report by various medical professionals that the use of steroids increases the risk for cataracts. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Robert Almosd, Associate Counsel