Citation Nr: 21062305 Decision Date: 10/07/21 Archive Date: 10/06/21 DOCKET NO. 15-03 932A DATE: October 7, 2021 REMANDED Entitlement to a disability rating higher than 10 percent for post-traumatic scar, status-post injury of left orbital area ("eye scar"), rated under Diagnostic Code 7800 is remanded. REASONS FOR REMAND The Veteran testified before the undersigned Veterans Law Judge in a May 2018 video conference hearing. A transcript of that hearing has been associated with the file. The Board remanded the matter three timesin April 2020, August 2020, and May 2021. Unfortunately, there has not been substantial compliance with the remand directives and the increased rating claim for eye scar must be remanded again. See Stegall v. West, 11 Vet. App. 268, 271 (1998). First, an adequate opinion is needed regarding the May 2012 VA Eye Conditions Disability Benefits Questionnaire (DBQ) examination report, to include consideration as to whether the evidence supports the Veteran's scar had visible or palpable tissue loss at any time during the appeal period. Given the other DBQs of record that clearly stated there was no visible or palpable tissue loss, a clarification opinion of the May 2012 VA examination report is required. In the May 2012 VA Eye Conditions DBQ examination report, the examiner indicated that the Veteran's scar had visible or palpable tissue loss. On remand the Board requested that this examiner, if available, provide an addendum opinion. Unfortunately, this examiner is not available (see May 2021 exam request), and the medical opinions provided in June 2021 are inadequate. The June 2021 VA examiner concluded that 2012 DBQ was erroneously described. The rationale stated was that the subsequent exams as well as the exam performed that day did not show evidence of tissue loss, indentation, or hypo-hyper pigment changes. This opinion is inadequate as it is wholly conclusory and fails to address the specific questions posed in the remand directives. As described in detail in the May 2021 Board remand, there are other opinions of record, but these too are inadequate. The RO assigned a 10 percent disability rating under Diagnostic Code 7800 for the eye scar based on one characteristic of disfigurement (scar at least one-quarter inch wide at widest part). Under Diagnostic Code 7800 a higher rating of 30 percent is warranted if there is visible or palpable tissue loss with two or three characteristics of disfigurement. As such, the issue as to whether the Veteran's eye scar had visible or palpable tissue loss at any time during the appeal period is critical when assessing the current level of severity. Additionally, the May 2021 remand directives requested the examiner to perform unretouched color photographs. The June 2021 DBQ report illustrates that photographs were not taken. Therefore, the matter must be remanded to obtain adequate medical opinions to assess the current level of severity of the Veteran's eye scar and to take photographs of the scar. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination from an appropriate medical professional to determine the current nature and severity of his left eye scar. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. Additionally, the examiner is asked to perform/provide unretouched color photographs. Review of the entire file is required; however, attention is invited to the May 2012 VA Eyes Condition DBQ, describing the left eye scar as having visible or palpable tissue loss and an indented scar around orbital rim in superior temporal area (VBMS, document labeled VA examination, receipt date May 23, 2012, pg. 13 of 27). The examiner is requested to specifically comment on the May 2012 VA examination report and opine as to whether, given the current level of severity of the Veteran's left eye scar, it would be reasonable to describe the scar as having visible or palpable tissue loss and an indented scar around orbital rim in superior temporal area in 2012. If the examiner finds that it is not reasonable to have reached such a conclusion, he/she is requested to provide an opinion as to how and why an examiner would have described the scar as such, to include whether it could have been misdiagnosed, erroneously described, or otherwise resolved. The examiner is also asked to opine as to the level of severity throughout the appeal period (from November 2011 to present), to include as to whether the evidence illustrates visible or palpable tissue loss of the scar at any time during the appeal period. All opinions and conclusions must be supported by a complete rationale. 2. The AOJ should ensure that the examiner provides all information required for rating purposes and complies with the remand directives. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Talamantes, 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.