Citation Nr: 21073988 Decision Date: 12/13/21 Archive Date: 12/13/21 DOCKET NO. 15-12 353 DATE: December 13, 2021 REMANDED Entitlement to service connection for a back disability is remanded. Entitlement to service connection for a left foot condition, to include as secondary to a back disability is remanded. Entitlement to service connection for a bilateral eye disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from December 1966 to December 1970. These matters come before the Board of Veterans' Appeals (Board) on appeal from an April 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office. The case was previously before the Board in August 2019 when it was remanded for further development. 1. Back disability 2. Left foot disability, to include as secondary to a back disability Unfortunately, the Board finds that additional remand is warranted. The Board previously remanded the Veteran's back disability in August 2019 because the September 2013 VA examiner's medical opinion was based on the absence of contemporaneous treatment for a back condition after service. However, the Board noted that the Veteran reported being treated by Dr. Clatterbaugh from approximately January 1971 to 2012., and that remand was warranted to obtain a new VA examination. The Veteran underwent a VA examination in December 2019. However, upon review of the December 2019 VA medical opinion, the Board finds that it remains inadequate for adjudication. The December 2019 VA examiner's opinion is again based on the absence of contemporaneous medical treatment for a back disability and is not supported by a detailed rationale. The medical opinion at best is conclusory. As such, remand is again warranted to obtain an adequate medical opinion. Pertaining to his left foot disability, the Veteran asserts that it is related to his lumbar spine disability. As the Board is again remanding his back disability, his left foot disability remains inextricably intertwined with that disability. Harris v. Derwinski, 1 Vet. App. 180 (1991) (two issues are "inextricably intertwined" when they are so closely tied together that a final Board decision on one issue cannot be rendered until the other issue has been considered). As such, his left foot disability is further remanded. 3. Bilateral eye disability The Board further finds that the Veteran's bilateral eye disability must also be remanded for additional development. In the August 2019 remand, the Board remanded the Veteran's bilateral eye disability to obtain a VA examination to address whether his current eye disability is related to his eye treatments during service. The Veteran was provided with a VA examination for his bilateral eye disability in December 2020, but the VA examiner did not provide any medical opinion. As such, another VA examination was obtained in April 2021. Upon review of the April 2021 VA examination, the Board finds that the VA medical opinion remains inadequate for adjudication purposes. Specifically, the VA treatment records reflect multiple diagnosis of eye disabilities to include, glaucoma, retinal detachment, cataracts, and bilateral pseudophakia. However, the April 2021 VA examiner only provided a medical opinion as to his cataracts. The VA examiner also did not address whether his bilateral eye disability is etiologically related to his in-service eye condition in which he sought treatment for. The April 2021 VA medical opinion also lacks an adequate rationale and is conclusory as to only stated that cataracts were age-related. Based on the foregoing reasons, the Board finds that additional remand is warranted to obtain an adequate VA opinion regarding the Veteran's bilateral eye disability. The matters are REMANDED for the following actions: 1. Obtain the Veteran's VA treatment records for the period from September 2020 to the present. 2. Obtain an addendum opinion from an appropriate clinician regarding the Veteran's back disability. The electronic claims file, including a copy of this remand, must be provided to the clinician in conjunction with the requested opinion. a) The clinician is requested to provide a medical opinion as to whether the Veteran's back disability at least as likely as not (50 percent probability or greater) related to an in-service injury, event, or disease, to include the Veteran's report of falling on a big tire in service. In providing this opinion, the clinician must address the Veteran's contention that he was treated for back pain from 1971 to 2012 from Dr. Clatterbaugh. b) The clinician must also opine as to whether it is at least as likely as not that his left foot disability is (1) proximately caused or (2) aggravated beyond its natural progression by the Veteran's back disability. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 3. Obtain an addendum opinion from an appropriate clinician regarding the Veteran's eye disabilities. The electronic claims file, including a copy of this remand, must be provided to the clinician in conjunction with the requested opinion. The clinician must answer the following: a) Identify all of the Veteran's eye disabilities. b) For each eye disability identified, the clinician is requested to opine as to whether it is at least as likely as not (50 percent probability or greater) that each eye disability is etiologically related to an in-service event, injury, or disease, to include his in-service treatment for an eye condition around March 1970. A complete and detailed rationale for these opinions should be provided for every opinion requested by the examiner. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. Bonnie A. Yoon Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Xiong, 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.