Citation Nr: 20044570 Decision Date: 07/02/20 Archive Date: 07/02/20 DOCKET NO. 16-59 250 DATE: July 2, 2020 REMANDED Entitlement to service connection for ophthalmologic condition, to include diplopia and pseudophakia, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1968 to June 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2013 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). In March 2020, the Veteran appeared before the undersigned Veterans Law Judge at a travel board hearing in Portland, Oregon. A transcript of the hearing has been associated with the electronic file. Entitlement to service connection for ophthalmologic condition, to include diplopia and pseudophakia, is remanded. The Veteran contends that his ophthalmologic condition to include diplopia and pseudophakia (afterwards, ‘eye condition’) was caused by, or incurred during, his active duty service where he believes he started to suffer from an autoimmune disease that caused swelling in his eyes. See NOD received 9/26/2014. A remand is warranted in order for the Board to make a fully informed decision on the issue of service connection for an eye condition since it finds that the August and October 2013 VA opinions are inadequate. In the August 2013 medical opinion, the VA examiner did not provide an etiology for the Veteran’s eye condition but rather stated that “there is no way for me to know if his euthyriod Graves’ disease is related to his other episodes of swelling and inflammation without resorting to specualation ”. See C&P Exam received 8/30/2013 at page 3. However, the examiner did not state why he needed to resort to specualtion. See Jones v. Shinseki, 23 Vet. App. 382 (2010) (holding that an examiner’s report that he or she cannot provide an opinion without resort to speculation is inadequate unless the examiner provides a rationale for that statement). In his October 2013 addendum opinion, the VA examiner was asked to opine on whether the “etiology of the Veteram’s opthalmic condition was proximately due to or the result of his rheumatoid arthritis”, which the Board notes is a contention that the Veteran made when he stated that he believes his eye condition was caused by an autoimmune disease. In the addendum opinion, the examiner stated that there was no direct link between Graves’ disease and rheumitoid arthritis. See C&P Exam received 10/03/2013. In other words, the examiner failed to properly address the question of secondary service connection. Since the opinions of record are inadequate, the Board cannot make an informed decision. Accordingly, this matter is remanded for a new examination and opinion. At the travel Board hearing, the Veteran stated a desire to submit additional evidence. See Hearing Transcript received 3/02/2020 at page 16. As of this date, no has been added to the claims file so the Veteran is advised that he may submit any relevant, additional evidence on remand. This matter is REMANDED for the following action: Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any diagnosed ophthalmologic condition to include diplopia and pseudophakia. The examiner must opine: (a) whether it is at least as likely as not related to an in-service injury, event, or disease, including exposure to AO. (b) whether it is at least as likely as not (1) proximately due to a service-connected disability, OR (2) aggravated by service-connected disability to include rheumatoid arthritis. Inform the examiner that a comprehensive rationale for all opinions is to be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts/information are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Dixon, 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.