Citation Nr: 20006598 Decision Date: 01/27/20 Archive Date: 01/27/20 DOCKET NO. 17-14 450 Date: January 27, 2020 SS 294 40 4858 LEONARD, James R The Honorable Rick W. Allen 2743 Perimeter Parkway Building 200, Suite 225 Augusta, GA 30909 Dear Congressman Allen: Your office previously expressed an interest in the above referenced case. The Board of Veterans’ Appeals has made a decision in this case on January 27, 2020 and a courtesy copy is enclosed. Sincerely yours, K. Osborne Deputy Vice Chairman Enclosures DATE: January 27, 2020 REMANDED Entitlement to service connection for glaucoma is remanded. REASONS FOR REMAND The Veteran had active service from September 1971 to August 1992. He presented sworn testimony at a hearing in October 2019 before the undersigned Veterans Law Judge, held at the VA Regional Office (RO) in Atlanta, Georgia. A transcript of that hearing has been associated with the claims file. The Veteran contends that his diagnosed glaucoma began during service, or was caused or aggravated by diagnosed ocular hypertension, which was diagnosed during his active service. The Board finds there is insufficient evidence upon which to adjudicate this claim fully and that a remand is necessary. Service personnel records confirm that the Veteran was diagnosed with intraocular hypertension, a disqualifying condition, but in April 1992, was granted a waiver to continue to serve as a pilot on active duty. Service medical records from July 1991 also mention that the Veteran has no family history of glaucoma. On VA examination in May 2014, the examiner acknowledged the onset of the Veteran’s symptoms was in 1992 but opined that the claimed condition was less likely than not incurred in or caused by service because it was more likely a hereditary disease. At the October 2019 hearing, the Veteran testified that the pressure in his eyes steadily increased over his years of active service and has worsened progressively since his separation from service in 1992. Since 1992, he has continued regular ophthalmological treatment at the Eisenhower Army Medical Center. He stated that his intraocular hypertension progressed into glaucoma, which was diagnosed in November 1992. In light of the Veteran’s testimony and other evidence of record, the Board finds the May 2014 VA medical opinion to be inadequate. The rationale provided in the opinion did not address the in-service occurrence of intraocular hypertension, nor did it consider the Veteran’s lack of family history of glaucoma. Further, the Board acknowledges that in support of his claim, the Veteran submitted an American Academy of Ophthalmology web article which states that ocular hypertension can cause glaucoma (see 09/11/2019 “Correspondence”). While this evidence is not specific to this Veteran’s medical condition, it is worth consideration as part of the Board’s request for an adequate medical opinion. Accordingly, this matter is REMANDED for the following actions: 1. Obtain any outstanding VA treatment records. Contact the Veteran to determine whether there are any additional relevant private treatment records and obtain any necessary authorizations to procure such records. The Board is particularly interested in any previously unobtained records of ophthalmological treatment that the Veteran has received at the Eisenhower Army Medical Center. Any and all attempts to obtain records should be recorded in the claims file. 2. Then, return the claims file to an appropriate examiner to provide an etiology opinion concerning the Veteran’s glaucoma condition. The Veteran may be recalled for examination if deemed necessary. Based on a review of the records and an examination of the Veteran if needed, the examiner should opine as to whether it is at least as likely as not (50% probability or greater) that the Veteran’s glaucoma had its onset in, or is otherwise related to, his military service—to include whether his diagnosed eye condition(s) is(are) related to his in service diagnosis of intraocular hypertension. In doing so, the examiner should address the article submitted by the Veteran which states that ocular hypertension can cause glaucoma. The examiner should discuss whether the Veteran’s glaucoma is considered a congenital disease, and if so, whether it was aggravated beyond its natural progression by his active service or the intraocular hypertension diagnosed during his active service. Complete rationale for all opinions expressed must be provided. THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Lee 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.