Citation Nr: 21001982 Decision Date: 01/12/21 Archive Date: 01/12/21 DOCKET NO. 10-22 561 DATE: January 12, 2021 REMANDED Service connection for bilateral ocular hypertension, to include as secondary to the service-connected hypertension and/or headaches, is remanded. REASONS FOR REMAND The Veteran, who is the Appellant, served on active duty from June 2008 to August 2008. He was also a member of the United States Naval Reserves. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from September 2010 rating decision from the Regional Office (RO), which, in pertinent part, denied service connection for a bilateral eye disorder. Service connection for a bilateral eye disorder was previously before the Board in March 2014, November 2014, July 2017, and December 2018. In the December 2018 Board decision, the Board bifurcated the issue of service connection for a bilateral eye disorder, denying service connection for bilateral refractive errors, dry eyes, incipient nuclear sclerosis, pinguecula, blepharitis, and open angle glaucoma suspect, and remanding service connection for bilateral ocular hypertension for a VA medical opinion, to include on a direct basis and as secondary to the service-connected hypertension and headaches. A remand by the Board confers on the claimant, as a matter of law, the right to compliance with the remand orders. Failure of the Board to ensure compliance with remand instructions constitutes error and warrants the vacating of a subsequent Board decision. Stegall v. West, 11 Vet. App. 268, 271 (1998). VA must afford a veteran a medical examination and/or obtain a medical opinion when it is necessary to decide a claim. 38 U.S.C. § 5103A (d) (2012); 38 C.F.R. § 3.159(c)(4) (2017). To that end, when VA undertakes to either provide an examination or to obtain an opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). On remand, the VA examiner was asked to review the claims file and provide the requested direct and secondary service connection opinions. Specifically, the VA examiner was asked to opine whether bilateral ocular hypertension was directly related to service or was caused or aggravated (worsened beyond a natural progression) by the service-connected hypertension or headaches. While the VA examiner in April 2020 provided an opinion on the theory of direct service connection, no opinion was rendered regarding whether the bilateral ocular hypertension was caused or aggravated by the service-connected hypertension or headaches. No VA or other medical examiner of record has opined as to whether bilateral ocular hypertension was caused or worsened by hypertension or headaches. For these reasons, another remand is necessary for an addendum VA opinion. Service connection for bilateral ocular hypertension is REMANDED for the following action: 1. Return the VA medical opinion report to the VA examiner who provided the medical opinion in April 2020. If the original VA examiner is unavailable, a new examiner may be assigned to address the requested opinion. The relevant documents in the record should be reviewed by the examiner and a detailed history of relevant symptoms should be obtained from the record. A rationale for all opinions and a discussion of the facts and medical principles involved should be provided. The examiner should offer opinions: a) Is it at least as likely as not (50 percent or higher degree of probability) that the currently diagnosed bilateral ocular hypertension was caused by the service-connected hypertension. b) Is it at least as likely as not (50 percent or higher degree of probability) that the currently diagnosed bilateral ocular hypertension is aggravated (i.e., worsened in severity beyond a natural progression) by the service-connected hypertension. c) Is it at least as likely as not (50 percent or higher degree of probability) that the currently diagnosed bilateral ocular hypertension was caused by the service-connected headaches. d) Is it at least as likely as not (50 percent or greater probability) that the current bilateral ocular hypertension was aggravated by (worsened beyond its natural progression by) the service-connected headaches? J. PARKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Moore 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.