Citation Nr: 21003495 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 17-03 291 DATE: January 21, 2021 REMANDED Entitlement to service connection for seasonal allergic conjunctivitis (claimed as vision disability) is remanded. REASONS FOR REMAND The Veteran served in the U.S Navy from June 2001 to April 2005. This matter comes before the Board of Veterans’ Appeals (Board) from an August 2016 rating decision issued by the regional office (RO) for service connection for a low back disability, allergic conjunctivitis and acquired psychiatric disorder. The Veteran testified before the undersigned Veterans Law Judge in September 2019, and a copy of the transcript is of record. The matter was previously before the Board in January 2020, where it was remanded for further evidentiary development. As part of the Board’s remand directives, the RO was instructed to afford the Veteran VA examinations. The Board, however, finds that with respect to the allergic conjunctivitis claim, there has not been substantial compliance with its January 2020 remand. See Stegall v. West, 11 Vet. App. 268 (1998). The matter has returned to the Board for further appellate review. During the pendency of this appeal, in a March 2020 rating decision, the Veteran’s service connection claims for unspecified anxiety disorder and low back disability were granted by the RO. The Veteran has not in response, separately appeal either the ratings or effective dates assigned for his now service-connected unspecified anxiety disorder and low back disability. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997) (where an appealed claim for service connection is granted during the pendency of the appeal, a second Notice of Disagreement (NOD) thereafter must be timely filed to initiate appellate review of the claim concerning "downstream" issues such as the compensation level assigned for the disability and effective date). As such, the service connection claims for unspecified anxiety disorder and low back disability are no longer on appeal to the Board. Entitlement to service connection for seasonal allergic conjunctivitis (claimed as vision disability) is remanded. While additional delay is regrettable, further development is required to fairly decide the Veteran's claim. Unfortunately, the February 2020 VA opinion (obtained pursuant to the January 2020 Board Remand) is inadequate because the examiner, despite the Board's specific directives, did not provide adequate rationale for his opinion. Stegall, 11 Vet. App. at 271. In the February 2020 Eye Conditions Disability Benefits Questionnaire (DBQ), the Veteran was diagnosed of chronic seasonal allergic conjunctivitis, which he asserted had its onset in 2005. The examiner opined that the claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. The examiner’s rationale was that, given that 33 percent of the population suffers from allergies, and 75 percent of those patients suffer from ocular allergies, it is less likely than not that the seasonal allergies are related to service conditions. See February 2020 C&P Examination. The Board however notes that this opinion appears to be based on general facts about the incidence of allergic conjunctivitis among the general population. As such, the rationale lacks specificity regarding the Veteran’s situation. For this reason, the February 2020 DBQ is inadequate for adjudicative purposes. Thus, an addendum opinion is warranted.   The matters are REMANDED for the following action: 1. Obtain any outstanding, relevant VA and non-VA treatment records. 2. After completing the foregoing development, obtain an addendum medical opinion from a suitable clinician who has never examined the Veteran as to the following (an examination should be scheduled only if deemed necessary by the opinion provider): Is it at least likely or not (50 percent or greater probability) the Veteran’s diagnosed seasonal allergic conjunctivitis is related to the Veteran's active service? The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, to include lay statements regarding the onset and persistence of his disability, and that his reports must be taken into account in formulating the requested opinion. 3. After the foregoing development have been completed, adjudicate the claim for service connection for seasonal allergic conjunctivitis. If the benefit sought is denied, furnish the Veteran a supplemental statement of the case   (SSOC) and allow time for the Veteran/ his representative to respond. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. M. Rogers, 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.