Citation Nr: 21072886 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 18-46 297 DATE: December 6, 2021 REMAND Entitlement to service connection for a right eye disability, to include glaucoma and macular degeneration, is remanded. Entitlement to service connection for a left eye disability, to include glaucoma and macular degeneration, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1988 to October 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In December 2020, the Board issued a decision entitlement to service connection for left eye glaucoma and right eye glaucoma. The Veteran appealed to the United States Court of Appeals for Veterans Claims (Court). In an June 2021 order, pursuant to a Joint Motion for Partial Remand (JMPR), filed by representatives for the Veteran and the VA Secretary, the Court vacated the portions of the December 2020 Board decision denying the above-referenced issues and remanded them to the Board for appellate consideration. The Board finds that the Veteran's claims for iatrogenic glaucoma also entails a claim for the macular degeneration diagnosed by the January 2019 VA examiner as well as any other eye disabilities diagnosed during the appeal period. As such, the Board has characterized the Veteran's claims as claims for a left and right eye disability, to include glaucoma and macular degeneration, as listed above. See Brokowski v. Shinseki, 23 Vet. App. 79, 84 (2009); Clemons v. Shinseki, 23 Vet. App. 1, 45 (2009). Entitlement to service connection for a right eye disability and a left eye disability are remanded. To qualify as adequate, a medical examination and opinion provided for the purposes of assessing secondary service connection must address both whether the claimed disability was proximately caused by some service-connected disability and whether the claimed disability was aggravated by some service-connected disability. See El-Amin v. Shinseki, 26 Vet. App. 136, 13941 (2013). The Board finds that the January 2019 VA opinion is lacking both for an overall discussion regarding aggravation and because its discussion of causation is inadequate. The opinion states in its entirety: In veteran's claim file it states that she has iatrogenic glaucoma due to plaquenil therapy. This is incorrect. There is no correlation between plaquenil and glaucoma. Furthermore, there is no proximal link to the veteran's in-service illness (allergic conjunctivitis) and her current glaucoma diagnosis. A connection has not been established, making it less likely than not that the veteran's glaucoma is a result of her in service illness. The opinion does not discuss at all whether glaucoma is caused or aggravated by any medication taken for any of the Veteran's service-connected disabilities. Thus, an entirely new opinion is warranted. See id. The matters are REMANDED for the following action: 1. Obtain a medical opinion from an appropriate clinician regarding the nature and etiology of any current left and right eye disabilities, to include glaucoma and macular degeneration. The entire claims file must be provided to the examiner for review, and the examination report should reflect that such a review was accomplished. An examination of the Veteran is not required unless deemed necessary by the examiner. For each diagnosed eye disability, the examiner is asked to opine as to the following: 1) is it at least as likely as not (a fifty percent probability or greater) that the disability was caused by any service-connected disability, to include any prescribed medication? 2) is it at least as likely as not (a fifty percent probability or greater) that the disability was aggravated by any service-connected disability, to include any prescribed medication? A detailed rationale supporting the examiner's opinions must be provided. Separate opinions and rationales must be provided for causation and aggravation. Patrick M. Johnson Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Trevor T. Bernard, 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.