Citation Nr: 21076216 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 17-37 284 DATE: December 22, 2021 REMANDED Entitlement to service connection, to include on a secondary basis, for left eye disability is remanded. Entitlement to a disability rating in excess of 30 percent for no more than light perception in the right eye is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from April 1982 to March 1984. These matters come before the Board of Veterans' Appeals (Board) on appeal from January 2008 and March 2015 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO) and were previously remanded by the Board in April 2019 and May 2021. 1. Entitlement to service connection, to include on a secondary basis, for left eye disability is remanded. The Board's May 2021 remand directed the RO to afford the Veteran a new VA examination to obtain a medical opinion as to the nature and etiology of all left eye diagnoses made during the pendency of the Veteran's claim, to include whether such diagnoses are caused or aggravated by the Veteran's service-connected right eye disability, to include due to overcompensation. The VA examiner was to offer an opinion as to each left eye impairment diagnosed in both VA and private treatment records and VA examinations. Specifically, pinguecula (June 2007 and July 2011), cataract (from 2010 to the present), and meibomitis, blepharitis, and arcus (July 2011). The August 2021 VA examination does not reflect compliance with the Board's May 2021 remand directives because the VA examiner only addressed the etiology of the Veteran's diagnosed left eye cataract, rather than the remaining left eye diagnoses made during the Veteran's claim, to include left eye pinguecula, meibomitis, blepharitis, and arcus. Further, while the August 2021 VA examiner noted that the Veteran's "pain and light sensitivity are related to his right eye service-connected disability," the examiner did not specify whether the symptoms of pain and light sensitivity were in relation to the Veteran's left eye or right eye. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). For this reason, the matter is remanded to obtain an addendum VA medical opinion which addresses the nature and etiology of all left eye diagnoses made during the entire claims period, as well as to clarify whether the Veteran's pain and light sensitivity, noted in the 2021 VA examination, is attributed to his left eye. 2. Entitlement to a disability rating in excess of 30 percent for no more than light perception in the right eye is remanded. The Veteran contends that his service-connected right eye disability warrants a rating higher than 30 percent. However, the Board notes that adjudication of the claim of entitlement to service connection for a left eye disability may impact adjudication of the claim for entitlement to a higher rating for the service-connected right eye disability, as higher ratings are assigned for bilateral visual impairment when both eyes are service-connected. Consequently, these claims are inextricably intertwined. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). Thus, adjudication of the claim for a disability rating in excess of 30 percent for no more than light perception in the right eye must be remanded. The matters are REMANDED for the following action: 1. With any necessary identification of sources and authorization by the Veteran, request all VA and private treatment records for the Veteran not already associated with the file. Copies of any outstanding VA and private treatment records should be added to the Veteran's electronic claims file. 2. Thereafter, obtain an addendum medical opinion from an appropriate clinician regarding the etiology of any diagnosed left eye disability made during the pendency of the Veteran's claim, to include pinguecula, meibomitis, blepharitis, and arcus. Copies of all pertinent records must be made accessible to the designated professional for review. Following the review of the claims file, the medical opinion provider is then requested to respond to the following: a. Identify all diagnosed left eye disabilities made during the pendency of the Veteran's claim, to include left eye pinguecula, meibomitis, blepharitis, and arcus. b. Is at least as likely as not (a 50 percent probability or greater) that any left eye disability specifically diagnosed above had its onset in service or is otherwise directly related to service? c. If not, is at least as likely as not (a 50 percent probability or greater) that any left eye disability specifically diagnosed in (a.) is proximately due to or caused by the Veteran's service-connected right eye disability? d. If not, is at least as likely as not (a 50 percent probability or greater) that any left eye disability specifically diagnosed in (a.) is aggravated by (defined as any increase in disability) the Veteran's service-connected right eye disability? e. The medical opinion provider is also asked to clarify whether the Veteran's complaints of pain and light sensitivity made during the August 2021 VA examination refer to his left eye, and to provide further rationale pertaining to the examiner's opinion that the Veteran's "pain and light sensitivity are related to his right eye service-connected disability." A complete rationale must be provided for all opinions. If the requested opinions cannot be provided without a new examination, one should be scheduled. 3. After completing all indicated development, the Agency of Original Jurisdiction should readjudicate the Veteran's claims, to include the intertwined issue of entitlement to a disability rating in excess of 30 percent for no more than light perception in the right eye. If the benefits sought on appeal remain denied, the Veteran should be furnished with a supplemental statement of the case, given the opportunity to respond, and the case should thereafter be returned to the Board for further appellate review, if warranted. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Houle, 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.