Citation Nr: 21067657 Decision Date: 11/04/21 Archive Date: 11/04/21 DOCKET NO. 16-13 013 DATE: November 4, 2021 REMANDED Entitlement to service connection for an eye disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from July 1974 to June 1978, from February 1982 to May 1984 and from July 1986 to April 1990. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to service connection for an eye disability is remanded. The Veteran contends that he has an eye disability that is related to service. The matter appeared before the Board in November 2018, January 2021 and in June 2021, at which time the issue was remanded for further development. In the January 2021 Board remand, the Board noted that the Veteran underwent a November 2014 VA examination and in the examination report, the examiner noted that the Veteran had lacrimal gland and lid disorders (other than ptosis or anatomic loss), cataract and other lens conditions, and glaucoma, but did not provide an opinion as to these disorders. In November 2018 and June 2021, the matter was remanded to attempt to obtain outstanding treatment records. The Board notes that in June 2021, the VA provided notification to the Veteran requesting that he Veteran complete and return VA Form 21-4142a, General Release for Medical Provider Information to the Department of VA and VA Form 21-4142, Authorization to Disclose Information to the Department of VA so that treatment records may be obtained, but no completed forms have been returned in the record since the June 2021 notification letter was provided to the Veteran. Turning to the medical evidence of record, an October 1987 service treatment record notes a cut to right eyebrow while the STR's do not reflect note of vision or eye trouble. The Veteran's VA medical center (VAMC) treatment records include a February 2021 record noting that the Veteran continues to see a local eye doctor in Maryville every six months and is being worked up for cataract surgery. A March 2021 record reflects that the Veteran has active problems of diseases including dry syndrome and ectropion of eyelid. The Veteran underwent the VA eye examination in November 2014 at which time he was diagnosed with history of laceration below right eyebrow, healed with small residual scar and glaucoma suspect based on cup/disc asymmetry. The examiner reported that the Veteran had lacrimal gland and lid disorders (other than ptosis or anatomic loss), cataracts and other lens conditions and glaucoma. The examiner also found horizontal peripapillary atrophy. The examiner opined that the condition claimed is less likely than not proximately due to or the result of the Veteran's service-connected condition. The examiner rationalized that the Veteran is being followed as a glaucoma suspect, meaning he has risk factors for glaucoma. The examiner noted that if glaucoma is diagnosed in the future, he may need to take eye drops or possibly have surgery to prevent progression. The examiner found that this is unrelated to his history of injury with a superficial laceration below the right eyebrow, which healed leaving a small scar. In a March 2021 addendum opinion, the same VA examiner opined that the condition claimed (glaucoma suspect) was less likely than not incurred in or caused by the claimed in-service injury, event or illness. The examiner rationalized that the Veteran was followed as a glaucoma suspect, meaning he has risk factors for glaucoma and if glaucoma is diagnosed in the future, he may need to take eye drops or possibly have surgery to prevent progression. The examiner further opined that the condition claimed (nuclear cataracts) was less likely than not incurred in or caused by the claimed in-service injury, event or illness. The examiner rationalized that the Veteran was documented to have early nuclear cataracts consistent with his age. The examiner indicated that at the time of his examination, they were not affecting his vision significantly. The examiner noted that if cataracts progressed to the point that they interfere with vision and impacted activities of daily living, the Veteran may need surgery. The examiner concluded that age-related nuclear cataracts are unrelated to military service. Here, the Board notes that the while the Veteran has multiple diagnoses related to his eyes (including glaucoma suspect, lacrimal gland and lid disorders (other than ptosis or anatomic loss), cataracts, dry syndrome and ectropion of eyelid), shown in on the VA examinations and in his medical treatment records, opinions only as to glaucoma suspect and nuclear cataracts have been obtained. In regard to those two opinions, the Board finds that the rationale is inadequate as the examiner essentially indicated that the nuclear cataracts is due to age without any discussion of the Veteran's service. While the Veteran has not advanced a specific argument as to how his eye disorders are related to service, his service in military occupational specialties (MOS) include vehicle operator, heavy equipment operator and organizational automotive mechanic. He is also in receipt of a rifle marksman badge. The examiner indicated that his nuclear cataracts were not affecting his vision significantly and then discussed the possibilities of progression to the point of surgery in the future and a diagnosis of glaucoma. There is no discussion of the Veteran's military history in the rationale provided, and as the examiner discussed the possibilities of the condition, the opinions essentially amount to an evaluation of the status of his condition rather than explaining the etiology of the condition. Thus, the Board finds the opinions are inadequate and require remand in compliance with prior Board remands. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). The matters are REMANDED for the following action: 1. Obtain an addendum opinion regarding the etiology of the Veteran's diagnosed eye disabilities. Schedule a VA examination only if necessary. The examiner must review the claims file. The examiner is asked to provide an opinion as to whether each diagnosed eye disability is at least as likely as not related to service. In so opining, the examiner must address the eye disorders diagnosed at the Veteran's November 2014 VA examination: lacrimal gland and lid disorders (other than ptosis or anatomic loss), cataract and other lens conditions, and glaucoma and also dry syndrome and ectropion of eyelid as found in the VAMC treatment records. The examiner is asked to consider and address the Veteran's service, including his MOS of vehicle operator, heavy equipment operator and organizational automotive mechanic and experience as a rifle marksman. A complete rationale for all opinions provided is required. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Q. Alli, 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.