Citation Nr: 21000540 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 13-10 798 DATE: January 5, 2021 REMANDED Entitlement to service connection for an eye disability is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1968 to February 1985. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in August 2008 by a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the issue on appeal in June 2020 for further development, which is discussed in detail below. In June 2020, the Board also denied increased ratings for hypertension and hemorrhoids, which the Veteran did not appeal. 38 U.S.C. § 7266. As such, those issues are no longer part of the current appeal. 38 C.F.R. § 20.1100. 1. Entitlement to service connection for an eye disability. The Board most recently remanded the claim on appeal in June 2020 to attempt to obtain opinions concerning the etiology of the Veteran’s diagnosed eye disabilities. The Board requested that opinions be given as to any diagnosed eye disabilities. While the July 2020 and November 2020 opinions that were obtained addressed the diagnosed disabilities of glaucoma and cataracts, the opinions did not discuss the Veteran’s other diagnosed eye disabilities, specifically pinguecula, pseudophakia, dry eye syndrome and presbyopia. As the opinions did not address all of the eye disabilities diagnosed during the appellate period, the Board finds that there has not been substantial compliance with the Board remand. As such, a remand is necessary for another medical opinion. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Obtain an addendum opinion from the July 2019 VA examiner, or another medical professional if that examiner is unavailable, to determine the etiology of the Veteran’s eye disabilities. The examiner should answer the following: a) Is it at least as likely as not (a fifty percent probability or greater) that the Veteran’s service-connected hypertension caused the diagnosed: 1) Glaucoma? 2) Cataracts? 3) Pseudophakia? 4) Pinguecula? 5) Dry eye syndrome? 6) Presbyopia? b) If not, is it at least as likely as not (a fifty percent probability or greater) that the Veteran’s service-connected hypertension aggravated (worsened) the diagnosed: 1) Glaucoma? 2) Cataracts? 3) Pseudophakia? 4) Pinguecula? 5) Dry eye syndrome? 6) Presbyopia? In answering questions (a) and (b), attention is invited to the August 2017 medical opinion which notes hypertension as a risk factor for glaucoma (labelled “C&P Exam” – uploaded 8/22/17). c) If not, is it at least as likely as not (a fifty percent probability or greater) that any of the diagnosed eye disabilities, specifically glaucoma, cataracts, pseudophakia, pinguecula, dry eye syndrome and presbyopia, are causally related to the Veteran’s active service, to include exposure to herbicide agents? A detailed rationale for each opinion must be provided. The examiner is reminded that the term “as likely as not” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that, in the examiner’s expert opinion, it is as medically sound to find in favor of the proposition as against it. If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. Jones v. Shinseki, 23 Vet. App. 382 (2010). LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Wendell, 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.