Citation Nr: 20009976 Decision Date: 02/06/20 Archive Date: 02/05/20 DOCKET NO. 13-11 953 DATE: February 6, 2020 REMANDED Entitlement to service connection for an eye disability, to include as secondary to service-connected migraine headaches is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from September 1971 to September 1974. Entitlement to service connection for an eye disability, to include as secondary to service-connected migraine headaches is remanded. The Veteran appeals the denial of an eye disability. This matter was initially before the Board in My 2017. It was determined that further development was needed, which included a VA examination. The examiner was requested to opine as to whether the Veteran’s eye disability is related to active service, as well as whether the Veteran’s eye disability was caused by or aggravated by his service-connected migraine headaches. The Veteran was scheduled for a VA examination in January 2019. The examiner diagnosed the Veteran with dry eyes, macular degeneration, and pseudophakia. The examiner opined that the Veteran’s eye disabilities are less likely than not incurred in or caused by active service. The examiner stated that there was no medical literature showing a relation between migraines and macular degeneration, as well as dry eyes. The examiner next stated that the Veteran’s migraines had no effect on his blurry vision as the Veteran did not report auras of visual disturbance with the headaches. However, the Veteran has previously described blurry vision during headaches, see VA Form 9 received March 2013, and a VA examiner in May 2010 previously stated that migraines could cause blurry vision. Thus, the examiner’s rationale is not adequate. Therefore, the Board finds that a remand is necessary to address the nature and etiology of the Veteran's eye disorders. See Barr v. Nicholson, 21 Vet. App. 30 (2007) (holding that once VA undertakes the effort to provide an examination or obtain medical opinion, it must ensure that one is provided or obtained that is adequate for the determination being made). The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the nature and etiologies of his dry eyes, macular degeneration, and pseudophakia. The examiner is requested to review the claims folder, to include this REMAND. All appropriate tests or studies should be accomplished, and all clinical findings should be reported in detail. The examiner must opine whether it is at least as likely as not the Veteran’s eye disabilities are (1) caused by the service-connected migraine headaches, or (2) aggravated by the service-connected migraine headaches. In so doing, the examiner should consider that the Veteran has previously described blurry vision during headaches, see VA Form 9 received March 2013, and that a VA examiner in May 2010 stated that migraines could cause blurry vision. The term aggravation is defined as any incremental increase in disability attributable to the service-connected disability, i.e., any additional impairment of earning capacity that is above the degree of disability existing before the increase, regardless of its permanence. See Ward v. Wilkie, 31 Vet. App. 233 (2019). If the examiner determines there has been aggravation, he or she should try and quantify the amount of additional disability (e.g., vision loss) the Veteran had, above and beyond that he had prior to the aggravation. The examiner must provide a detailed rationale for any opinion expressed. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that his reports must be taken into account in formulating the requested opinion. 2. Thereafter, readjudicate the claim. If any benefit sought on appeal remains denied, furnish the Veteran and his representative a supplemental statement of the case and allow an appropriate period of time to respond. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Adeleke, Associate 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.