Citation Nr: 18106984 Decision Date: 06/01/18 Archive Date: 05/31/18 DOCKET NO. 15-08 921 DATE: June 1, 2018 REMANDED Entitlement to service connection for a back disability is remanded. Entitlement to service connection for bilateral shin splints with edema (claimed as a bilateral foot condition) is remanded. Entitlement to service connection for eye disabilities to include esotropia and cataracts is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from July 1984 to July 1994 and for several years thereafter in the United States Army Reserve including from 2007 to 2011. This appeal comes to the Board of Veterans’ Appeals (Board) from an October 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge in November 2017. A transcript of the hearing is associated with the Veteran’s claims file.   A review of the Veteran’s service treatment records shows multiple complaints of injury and impairment in regard to the Veteran’s back, lower extremities, and eyes. The Veteran alleges the reported events and symptoms in service are related to her current disabilities. At her hearing, the Veteran’s representative asserted her back disability was further aggravated by events during training in 2009, and the reserve unit service treatment records show complaints of shin splints during a period of active duty for training from August 2008 to September 2008. The Veteran also testified that she has current foot disabilities, which she indicated were caused or aggravated by her other conditions and incidents of service. The Veteran has not been afforded VA examinations to assist in determining whether the Veteran’s claimed disabilities of the (1) back, (2) shins (to include edema and symptoms affecting the feet), and (3) eyes (to include esotropia and bilateral cataracts) are current disabilities caused or aggravated by in-service events. On remand, the AOJ should afford the Veteran appropriate examinations of the claimed disabilities to determine whether they are related to her service. The matters are REMANDED for the following action: 1. The AOJ should contact the Veteran and her representative and request their assistance in identifying any outstanding relevant records. The AOJ should make reasonable attempts to obtain all identified outstanding records and associate them with the Veteran’s claims file. 2. After associating any identified relevant outstanding evidence with the Veteran’s claims file, the AOJ should schedule the Veteran for examinations by appropriate examiners to determine the nature and etiology of any current back, shin, foot, and eye disabilities. The AOJ should provide the examiners with complete copies of the Veteran’s claims file to include this remand order. The AOJ should follow these directives to ensure that the examinations are adequate: (a) The AOJ should ensure that each examiner opines whether each identified current disability is at least as likely as not (50 percent or greater probability) related to an in-service injury, event, or disease. The AOJ should ensure that the examiners consider the Veteran’s statements about the onset of her disabilities in the context of her service treatment records, which show multiple complaints of trauma and symptoms related to the Veteran’s eyes, back, and lower extremities. (b) The AOJ should ensure that the VA examiners also address the Veteran’s contentions that her disabilities were aggravated during service to include during periods of active duty for training and inactive duty for training from 2007-2011. The examiners should opine whether it at least as likely as not that each current disability was permanently worsened beyond normal progression (aggravated) during each of the Veteran’s periods of service. The examiners must identify the baseline level of the disability that existed before aggravation of a service-connected disability occurred. (c) The AOJ should ensure that the VA eye examiner identifies with specificity all eye disabilities which are currently manifested, or which have been manifested at any time including esotropia and cataracts. The examiner should opine whether each condition constitutes a congenital disease, a congenital defect, or an acquired disease or injury. The term “disease” is broadly defined as any deviation from or interruption of the normal structure or function of any part, organ, or system of the body that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown. On the other hand, the term “defect” would be definable as structural or inherent abnormalities or conditions that are more or less stationary in nature. If the examiner determines that any eye disability is a congenital defect, the examiner should opine whether the Veteran now has additional disability due to an in-service disease or injury superimposed upon such defect. If the examiner determines that the Veteran’s eye disability is a congenital disease, the examiner should opine whether the disability clearly and unmistakably existed prior to her active service and clearly and unmistakably underwent no permanent increase in severity as a result of the Veteran’s service. For any other eye disability that is not congenital in nature and/or did not preexist service, the examiner should opine as to whether it is at least as likely as not that it originated during active duty or is in any other way causally related to the Veteran’s active duty service. The examiner should consider the Veteran’s reports about the onset of her symptoms and relevant notes in the service treatment records regarding eye trauma, surgery, and relevant symptoms. (d) The AOJ should also ensure that the VA back, shin, and foot examiners opine whether it is at least as likely as not that each current disability identified is (1) proximately due to a service-connected disability to include the Veteran’s claimed back, shin, and foot disabilities, or (2) aggravated beyond its natural progression by such disabilities. 3. After completing the above action and any other necessary development, the claims must be readjudicated. If a claim remains denied, a Supplemental Statement of the Case must be provided to the Veteran and current representatives. After the Veteran has had adequate opportunity to respond, the appeal must be returned to the Board for appellate review. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Michael Duffy, Associate Counsel