Citation Nr: 20030000 Decision Date: 04/29/20 Archive Date: 04/29/20 DOCKET NO. 18-36 015 DATE: April 29, 2020 ORDER Entitlement to an initial rating of 10 percent, but no higher, for bilateral pigmentary glaucoma is granted, subject to the regulations governing the award of monetary benefits. Entitlement to an effective date earlier than June 6, 2014, for the award of service connection for bilateral pigmentary glaucoma is denied. REMANDED Entitlement to service connection for a low back disorder is remanded. Entitlement to service connection for a right thumb disorder is remanded. Entitlement to service connection for hyperemia conjunctiva is remanded. Entitlement to service connection for sinusitis is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for a left elbow disorder is remanded. Entitlement to service connection for a right elbow disorder is remanded. FINDINGS OF FACT 1. The Veteran’s glaucoma has required continuous medication but has not produced incapacitating episodes or impairment of central visual acuity. 2. No claim (formal or informal) of service connection for glaucoma was received until June 6, 2015; and, service connection has been established effective June 6, 2014. CONCLUSIONS OF LAW 1. The criteria for an initial rating of 10 percent, but no higher, for bilateral pigmentary glaucoma are met. 38 U.S.C. § 1155; 38 C.F.R. § 4.79, Diagnostic Codes 6013, 6066. 2. The criteria for an effective date earlier than June 6, 2014, for the award of service connection for bilateral pigmentary glaucoma are not met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the Army from February 2009 to January 2013, including foreign service in Afghanistan. For his meritorious service, he was awarded (among other decorations) the Army Commendation Medal, the National Defense Service Medal with Bronze Service Star, and the Afghanistan Campaign Medal with two Campaign Stars. The appeal originates from September and October 2015 decisions of a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to an initial compensable rating for bilateral pigmentary glaucoma. Disability ratings are determined by comparing a veteran’s present symptoms with criteria set forth in VA’s Schedule for Rating Disabilities, which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. The General Rating Formula for Diseases of the Eye provides for evaluation on the basis of either visual impairment due to the particular condition or on incapacitating episodes, whichever results in a higher evaluation. A 60 percent rating requires documented incapacitating episodes requiring 7 or more treatment visits for an eye condition during the past 12 months. A 40 percent rating requires documented incapacitating episodes requiring at least 5 but less than 7 treatment visits for an eye condition during the past 12 months. A 20 percent rating requires documented incapacitating episodes requiring at least 3 but less than 5 treatment visits for an eye condition during the past 12 months. A 10 percent rating requires documented incapacitating episodes requiring at least 1 but less than 3 treatment visits for an eye condition during the past 12 months. Diagnostic Code 6013 addresses open-angle glaucoma. A 10 percent rating is assigned if continuous medication is required. The Veteran’s glaucoma is rated under Diagnostic Code 6066 based on impairment of central visual acuity. The Veteran was afforded a VA examination in July 2015. His corrected distance vision in both eyes was 20/40 or better. His glaucoma was noted to require continuous medication for control. The examiner indicated that there was no impairment of central visual acuity due to glaucoma. No incapacitating episodes were noted. Based on the evidence, the Veteran is entitled to an initial rating of 10 percent, but no higher, for bilateral pigmentary glaucoma under Diagnostic Code 6013 based on required continuous medication. However, a rating in excess of 10 percent is not warranted as he has not had impairment of central visual acuity or incapacitating episodes due to glaucoma. Such disability is not otherwise depicted in available VA treatment records. There is simply no basis for an initial rating in excess of 10 percent for glaucoma under any relevant diagnostic code. 2. Entitlement to an effective date earlier than June 6, 2014, for the award of service connection for bilateral pigmentary glaucoma. The law provides that the effective date for an award of service connection is the day following separation from active duty, or the day entitlement arose, if the claim is filed within the year after active duty. When the claim is filed more than a year after active duty, the effective date for service connection will be the date of VA receipt of the claim, or date entitlement arose, whichever is later. 38 U.S.C. § 5110 (a), (b)(1); 38 C.F.R. § 3.400(b)(2). The Veteran claims entitlement to an earlier effective date for bilateral pigmentary glaucoma. The record reflects that his Fully Developed Claim (FDC) for glaucoma was received on June 6, 2015. Entitlement to service connection was established shortly thereafter, via July 2015 VA examination. Thus, the RO granted an effective date one year prior to receipt of the claim based on the FDC process. See May 2018 SOC. The Veteran has already been awarded an effective date one year prior to receipt of his service connection claim. He offers no evidence or argument as to why an even earlier effective date is warranted. Accordingly, an effective date earlier than June 6, 2014, for the award of service connection for bilateral pigmentary glaucoma must be denied. REASONS FOR REMAND 1. Entitlement to service connection for a low back disorder, right thumb disorder, hyperemia conjunctiva, sinusitis, and tinnitus is remanded. The Veteran claims service connection for low back and right thumb disorders as well as hyperemia conjunctiva, sinusitis, and tinnitus. Though he references in-service treatment for back, right thumb, and respiratory conditions, he does not appear to report any current symptoms of disability. See June 2015 STR; July 2018 Form 9. VA treatment records are silent with respect to the claimed conditions. The Board notes that the service treatment records do not contain the Veteran’s entrance and separation examinations. Correspondence reflects request and receipt of the service treatment records in mid-2015, but it is unclear whether the entrance and separation examinations are extant. See January 2013 STR. The Veteran has requested that VA obtain these records or make a formal finding of unavailability and provide appropriate notice. See July 2018 Form 9. Adjudication of the issues must be deferred until this development is completed. 2. Entitlement to service connection for left and right elbow disorders is remanded. The Veteran claims service connection for a left elbow disorder generally and a right elbow disorder based on in-service treatment for elbow pain. See June 2015 STR; July 2018 Form 9. He was seen at VA primary care in April 2015 for numbness and tingling in the elbow area that was worse on the left side. EMG testing conducted in May 2015 showed very early stage entrapment neuropathy of the right ulnar nerve around the elbow, cubital tunnel syndrome. He was afforded VA elbow and peripheral neuropathy examinations in September 2015. The elbow examination indicates normal bilateral elbows. The peripheral neuropathy examination, however, notes the right ulnar neuropathy diagnosis as well as intermittent pain, paresthesias and/or dysesthesias, and numbness in the upper extremities. The examiner found that symptoms in the left upper extremity were subjective and of no clinical significance with no specified functional impairment due to pain. The examiner opined that the right ulnar neuropathy was less likely as not related to service based on the absence of in-service neuropathy symptoms. The Veteran contends that his in-service right elbow pain represents the beginning of his neuropathy. See July 2018 Form 9. He has submitted medical literature in support of his claim. See July 2018 articles. An addendum opinion should be obtained concerning this theory of service connection. The matters are REMANDED for the following action: 1. Obtain the Veteran’s entrance and separation examinations for active service. If the records are unavailable, make a formal finding of unavailability and provide the appropriate notice. 2. Then, provide the Veteran’s file to an examiner with the appropriate knowledge and expertise to opine on peripheral neuropathy. The examiner is asked to opine whether it is at least as likely as not that right peripheral neuropathy had its onset in service or within a year of service discharge or is otherwise etiologically related to active service. The examiner must address the Veteran’s contention that his in-service right elbow pain was an early sign of neuropathy and the medical literature received in July 2018. Kate E. Kovarovic Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Alhinnawi 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.