Citation Nr: 20006080 Decision Date: 01/24/20 Archive Date: 01/24/20 DOCKET NO. 11-11 866 DATE: January 24, 2020 REMANDED Entitlement to service connection for cataracts, to include as secondary to service-connected diabetes mellitus is remanded. Entitlement to service connection for hypertension, to include as secondary to service-connected diabetes mellitus is remanded. REASONS FOR REMAND The Veteran had active service from November 1966 to September 1970. Following a long procedural history, the Board remanded this appeal for further development in September 2018. As detailed below, that development has not been accomplished, further action is needed. Stegall v. West, 11 Vet. App. 268 (1998). 1. Entitlement to service connection for cataracts, to include as secondary to service-connected diabetes mellitus is remanded. 2. Entitlement to service connection for hypertension, to include as secondary to service-connected diabetes mellitus is remanded. Following a May 2018 U.S. Court of Appeals for Veterans Claims (CAVC) remand, the Board issued a September 2018 decision which remanded the issues on appeal for VA medical opinions. Specifically, the Board directed VA examiners to opine as to direct causation and secondary causation, to include aggravation and progression past the natural progression of the claims. The May 2018 CAVC decision also found there was no medical opinion concerning any nexus between the Veteran’s hypertension and his conceded exposure to herbicides, and the September 2018 similarly directed an opinion be provided concerning this possible nexus. The Veteran was provided VA examinations for his cataracts and hypertension in June 2019 and in August 2019. The August 2019 VA examiner provided a negative etiologic opinion and stated only that the Veteran’s cataracts were less likely proximately due to his service-connected diabetes because cataracts are a normal part of the aging process, and the cataracts were at a level that is expected for the Veteran’s age. The June 2019 VA examiner provided a negative etiologic opinion concerning the direct and secondary theory of causation for the claimed hypertension but failed to provide an opinion as to the possible nexus between hypertension and the Veteran’s conceded exposure to herbicides. As such, addendum opinions are required. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007); Stegall, 11 Vet. App. 268. The matters are REMANDED for the following action: 1. Forward the record and a copy of this Remand to an appropriate VA clinician/s for preparation of these addendum opinions. The examiner/s is asked to provide a thorough response to each of the following: a) Whether it is at least as likely as not (50 percent probability or greater) that any eye disability, to include cataracts, was caused by the Veteran’s service-connected type II diabetes mellitus. b) Whether it is at least as likely as not (50 percent probability or greater) that any eye disability, to include cataracts, was aggravated or worsened by the Veteran’s service-connected type II diabetes mellitus. c) Whether it is at least as likely as not (50 percent probability or greater) that a hypertension disability began in service or is otherwise medically related to military service, to include related to exposure to herbicides. d) If a hypertension disability did not begin in service or is otherwise not medically related to military service, is it at least as likely as not (50 percent probability or greater) a hypertension disability was caused by the Veteran’s service-connected type II diabetes mellitus. e) If not caused by type II diabetes mellitus, is it at least as likely as not (50 percent probability or greater) that a hypertension disability was aggravated by the Veteran’s service-connected type II diabetes mellitus. A complete rationale for all conclusions must be included in the report(s) provided. (Continued on the next page)   2. Thereafter, readjudicate the Veteran’s claims. If any benefit sought on appeal is not granted in full, the Veteran should be issued a supplemental statement of the case and provided an opportunity to respond. The case should then be returned to the Board for further appellate consideration, if otherwise in order. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Peden The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.