Citation Nr: 21071983 Decision Date: 12/01/21 Archive Date: 12/01/21 DOCKET NO. 19-23 775 DATE: December 1, 2021 REMANDED Service connection for a vision condition (claimed as eyeglasses and both eyes burning and/or running water) is remanded. Service connection for bilateral cataracts is remanded. REASONS FOR REMAND The Veteran was a member of the Army National Guard (ARNG) and was on active duty for training (ACDUTRA) from August 1974 to December 1974. This matter is before the Board of Veterans' Appeals (Board) on appeal from an October 2016 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran and his son provided testimony at a hearing before the undersigned Veterans Law Judge in December 2020; a transcript of the hearing is associated with the claims file. This matter was remanded by the Board in March 2021 to obtain VA examinations and medical opinions. Service connection for loss of eyebrows and eyelashes (bilateral madarosis) was granted in an August 2021 rating decision. As this was a full grant of the issue on appeal, these matters are no longer before the Board. Grantham v. Brown, 114 F.3d 1156, 1158 (Fed. Cir. 1997). A remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with the remand instructions and imposes upon the VA a concomitant duty to ensure compliance with the terms of the remand. Stegall v. West, 1 Vet. App. 268, 271 (1998). Where the remand orders of the Board are not complied with, the Board errs as a matter of law when it fails to ensure compliance. As such, another remand is warranted. Once VA undertakes to provide an examination, VA must provide an adequate examination and opinion. Barr v. Nicholson, 21 Vet. App. 303 (2007). In the March 2021 remand order, the Board directed the VA examiner to identify the nature and etiology of each diagnosis or disability affecting the Veteran's eyes. The examiner was further instructed to specifically consider and comment on whether treatment for the Veteran's service-connected skin disabilities more likely than not caused or aggravated his eye disabilities. VA treatment records show that since at least August 2019, the Veteran has been diagnosed with bilateral meibomitis and tylosis. The Veteran attended a VA eye examination in May 2021. The VA examiner diagnosed him with bilateral cataracts, bilateral dry eye syndrome and bilateral madarosis. The VA examiner rendered negative nexus opinions regarding bilateral dry eye syndrome and cataracts, explaining that the Veteran's service-connected skin disabilities were not related to the onset of cataracts or dry eye syndrome, but were due to his age and poor-quality tears. The examiner did not render an opinion as to whether the treatment for the Veteran's service-connected skin disabilities, including the application of topical medication to his eyes and face, could have caused or aggravated his dry eyes or cataracts. The examiner did not address the effect of treatment for the Veteran's service-connected skin conditions. At a June 2021 VA skin examination, the examiner documented that the Veteran had been using clotrimazole eye drops almost constantly for the past 12 months to treat his eczema. The nexus opinions of record regarding the Veteran's vision condition and cataracts are inadequate, as they did not comply with the March 2021 remand instructions. First, the May 2021 examiner failed to render an opinion as to whether treatment for the Veteran's service-connected skin disabilities at least as likely as not (50 percent probability or greater) caused or aggravated his cataracts and/or vision conditions. Additionally, the VA examiner did not render an opinion as to whether the Veteran's eye conditions were at least as likely as not (50 percent or greater) caused or aggravated by the Veteran's now service-connected disability of madarosis. Unfortunately, a remand is required. The matters are REMANDED for the following action: 1. Obtain an addendum nexus opinion from a VA examiner regarding the Veteran's diagnosed eye conditions, to include bilateral nuclear cataracts, dry eye syndrome, meibomitis and tylosis. The claims folder must be reviewed in conjunction with the examination; provision of a new physical examination is at the discretion of the reviewer. The examiner must opine as to whether any of the Veteran's currently diagnosed eye conditions (including those listed above) is at least as likely as not (50 percent or greater) caused or aggravated by service or the Veteran's service-connected disabilities, to include treatment for such. The examiner must specifically consider and comment on whether the Veteran's service-connected bilateral madarosis of his eyelashes and eyebrows caused or aggravated his currently diagnosed eye conditions. The examiner must also specifically consider and comment whether treatment for the Veteran's service-connected skin disabilities, including Clotrimazole eyedrops documented in the June 2021 VA skin examination, caused or aggravated any currently diagnosed eye condition. A full and complete rationale is required for all opinions provided. Jones v. Shinseki, 23 Vet. App. 382 (2010). 2. Then, readjudicate the claims on appeal. If any benefit sought remains denied, issue a supplemental statement of the case and, after an appropriate time for response, return the appeal to the Board if otherwise in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Megan-Brady Viccellio 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.