Citation Nr: 20072896 Decision Date: 11/12/20 Archive Date: 11/12/20 DOCKET NO. 09-09 570 DATE: November 12, 2020 REMANDED Entitlement to service connection for a bilateral eye disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1998 to April 2004, July 2004 to June 2005, to include service in the Southwest Asia Theater of Operations. The Veteran is seeking entitlement to service connection for a bilateral eye disorder that she believes is due to her military service, to include her service in Southwest Asia and exposure to environmental hazards. Specifically, she contends that she would wipe sweat from her eyes while on deck, was exposed to toxins due to a chemical fire while in Kuwait, and was exposed to constant sand and debris. See October 2020 Correspondence. In January 2020, the Veteran was scheduled for a VA examination regarding this claim. The VA examination report reflects that the Veteran reported seeing floaters in approximately 2002, after experiencing a glare off of freshly laid tar. She also reported occasional blurry vision out of right eye on the right side. The VA examiner noted that the Veteran exhibited constricted visual fields inconsistent with physical findings. It was noted that the test was of low reliability, and repeat testing needed to verify. Nevertheless, regarding the diagnosed vitreous floaters, the examiner opined that they are less likely than not related to the claimed in-service condition as the vitreous floaters in this case are usually idiopathic, and not the result of trauma or illness. The examiner noted that the Veteran did not experience ocular trauma while in service, and stated that she experienced extreme glare while laying tar, which would not cause vitreous floaters. As for the diagnosed dry eyes disorder, the examiner noted that the Veteran was diagnosed with dry eyes after service and, in fact, was an incidental finding on examination and is completely unrelated. Again, the examiner noted that the Veteran's visual fields are inconsistent with clinical findings and it was suspected she had difficulty performing the test. The Board finds that this examination is inadequate for rating purposes. Specifically, the VA examiner noted that there were inconsistencies with the examination itself. Given such, these inconsistency should be reconciled. Moreover, an opinion as to whether the Veteran’s diagnosed bilateral eye disorders may be due to or the result of her exposure to environmental toxins while in Southwest Asia was not provided. Barr v. Nicholson, 21 Vet. App. 303 (2007). As such, a remand is required for a new examination and opinion. The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA examination concerning the claimed bilateral eye disorders. The entire claims file must be made available to the examiner. The examiner is asked to provide answers to the following: (a.) whether it is at least as likely as not that diagnosed bilateral eye disorders diagnosed on examination, to include bilateral dry eyes and vitreous floaters, can be attributed to known clinical diagnoses. (b.) If the examiner attributes any current eye disorder to known clinical diagnoses, the examiner must state whether it is at least as likely as not that any such diagnosis is related to or had its onset in service or is otherwise related to service. In doing so, the examiner must acknowledge and discuss any lay report of recurrent symptoms since service, such as blurry vision. (c.) If the examiner finds the Veteran's eye symptoms cannot be attributed to known diagnoses or if the examiner finds that the Veteran has a medically unexplained chronic multi symptom illness, the examiner should indicate if the symptoms are chronic (i.e., have they existed for six months or more or exhibited intermittent episodes of improvement and worsening over a six-month period) and the examiner should indicate if they have become manifest to a compensable degree at any time after her military service, or were first manifest in service. (d.) The examiner should comment, if possible, on whether any of the diagnosed eye disorders may be due to exposure to environmental hazards, to include as due to wiping sweat from her eyes while on deck, exposure to toxins due to a chemical fire while in Kuwait, and exposure to constant sand and debris. See October 2020 Correspondence. The examiner should additionally consider that in Dalton v. Nicholson, 21 Vet. App. 23 (2007), the Court determined an examination was inadequate where the examiner did not comment on the Veteran's report of in-service injury and, instead, relied on the absence of evidence in the Veteran's service treatment records to provide a negative opinion. All findings, along with a fully articulated medical rationale for all opinions expressed should be set forth in the examination report. 2. THE AOJ MUST REVIEW THE CLAIMS FILE AND ENSURE THAT THE FOREGOING DEVELOPMENT ACTION HAS BEEN COMPLETED IN FULL. IF ANY DEVELOPMENT IS INCOMPLETE, APPROPRIATE CORRECTIVE ACTION MUST BE IMPLEMENTED. IF ANY REPORT DOES NOT INCLUDE ADEQUATE RESPONSES TO THE SPECIFIC OPINIONS REQUESTED, IT MUST BE RETURNED TO THE PROVIDING EXAMINER FOR CORRECTIVE ACTION. YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Berry, Counsel 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.