Citation Nr: 21062879 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 09-23 458 DATE: October 12, 2021 REMANDED Entitlement to service connection for a left eye disorder, to include as secondary to the service-connected vitreous floater disability, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from January 2001 to September 2005. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2007 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In November 2010, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A hearing transcript is in the record. In March 2015, the Board remanded entitlement to service connection for a left eye disorder. In a January 2017 Board decision, the Veteran was awarded service connection for vitreous floaters, however the Board remanded the issue of service connection for a left eye disorder, to include pinguecula. In November 2017, the Board again remanded the issue of entitlement to service connection for a left eye disorder, other than vitreous floaters, for further development. In a January 2019 decision, the Board denied the claim. The Veteran appealed the decision to the United States Court of Appeals for Veterans Claims (Court). In a December 2019 joint motion for remand (JMR) and Court order, the Board's denial of entitlement to service connection for a left eye disorder, to include pinguecula as secondary to the service-connected vitreous floater disability, was vacated and remanded back to the Board for additional development. In May 2020, the Board remanded the claim for additional development in compliance with the December 2019 JMR. The appeal has returned to the Board for further appellate review. Entitlement to service connection for a left eye disorder, to include as secondary to the service-connected vitreous floater disability, is remanded. Unfortunately, there has not been substantial compliance with the Board's previous remand directives regarding the issue. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). In May 2020 the Board remanded the issue of service connection for a left eye disorder. The Board instructed the agency of original jurisdication (AOJ) to obtain a medical opinion on the nature and etilogy of any left eye disorder to include pinguecula. The examiner was instructed to identify any diagnoses of the left eye and determine whether they were caused or related to service or service-connected vitreous floaters. The examiner was also instructed to explain the reasons behind any opinions and discuss the facts and medical principals involved. Review of the subsequent March 2021 VA medical opinion reflects these instructions were not substantially carried out. The March 2021 VA examination notes the Veteran was diagnosed with allergic conjunctivitis, temporal pinguecula, and vitreous syneresis. However, the March 2021 VA opinion recites the same information previously mentioned by previous medical examiners and does not provide an adequate rationale for the opinion reached. Additonally, the April 2021 addendum opinion fails to provide adequate rationale for the opinion reached. In short, the opinions of record do no more than provide conclusory statements on whether any left eye disability was caused or related to service or service-connected viterous floaters. Thus, remand is required. The matter is REMANDED for the following action: 1. Obtain an addendum opinion by an appropriate clinician to determine the nature and etiology of any left eye disability to include pinguecula and allergic conjunctivitis. The record, to include a copy of this Remand, must be made available to and be reviewed by the examiner, and the examination report should note that review. 2. After reviewing all available records, the examiner should: (a.) Determine whether it is at least as likely as not (that is, a probability of at least 50 percent) that any diagnosed left eye disorder, to include pinguecula and allergic conjunctivitis, was caused or aggravated by his service, to include as a result of conceded in-service injuries. (b.) If not, whether it is at least as likely as not (i.e. a 50 percent probability) that any currently diagnosed left eye disorder, to include pinguecula, and allergic conjunctivitis is (1) proximately due to the Veteran's service-connected vitreous floaters, or (2) aggravated beyond its natural progression by his service-connected vitreous floaters. If the examiner determines that the Veteran's current disorder was aggravated by his service-connected vitreous floaters, then the examiner should cite medical records which show the baseline severity prior to aggravation. If the examiner is unable to establish a baseline prior to the aggravation, he or she should state such and explain why a baseline cannot be determined. The examiner must explain the reasons behind any opinions expressed and conclusions reached. A discussion of the facts and medical principals involved would be of considerable assistance to the Board. The examiner must review the entire record in conjunction with making the requested opinions. IN ADDITION TO ANY RECORDS THAT ARE GENERATED BECAUSE OF THIS REMAND, the VA examiner's attention is drawn to the following: *The Veteran's military occupational specialty (MOS) was that of an aircraft armament systems journeyman from January 2001 to September 2005. *In July 2004, service treatment records reflect the Veteran reported that he was exposed to chemicals and dust while working with aircrafts. *Service treatment records also note the Veteran served in Kuwait. *Service treatment records are silent as to any complaints, treatments, or diagnosis of the left eye. *On the June 2009 VA form 9, the Veteran reported that he injured his left eye while working on the flight line. He recited that as he was cleaning an F-15E aircraft with an acid solution when the wind blew the bottle of solution off the jet causing some of the solution to get into his left eye. Additionally, he sustained a cut to his left eye after a part of an aircraft popped out. The Veteran also noted that he was in close proximity to an aircraft when a new pilot turned the wrong way in attempting to "take off" and this resulted in the wind blowing off the Veteran's headphones. *An August 2018 VA addendum opinion notes pinguecula is caused by exposure to external factors such as dust, wind, or sunlight. *The March 2021 VA medical opinion notes the Veteran's pinguecula OS developed between 2011 and 2015. 3. After completing the above development and any other development deemed warranted, readjudicate the claim. If the benefit sought remains denied, furnish the Veteran and his representative a supplemental statement of the case (SSOC) and the requisite opportunity to respond before the case is returned to the Board. K.A. KENNERLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. McDuffie, 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.