Citation Nr: 21076386 Decision Date: 12/23/21 Archive Date: 12/23/21 DOCKET NO. 07-33 957 DATE: December 23, 2021 REMANDED Service connection for a left eye disorder. REASONS FOR REMAND The Veteran served on active duty from July 1977 to March 1983. The Veteran died in August 2014. The appellant is his surviving spouse. The case is on appeal from an August 2007 rating decision. The case was most recently before the Board in June 2021. At that time, the Board remanded the present matter for further development in compliance with a February 2021 United States Court of Appeals for Veterans Claims (Court) Order in light of a February 2021 Joint Motion for Remand (JMR). Service connection for a left eye disorder. In its June 2021 decision, the Board remanded the present matter on the basis of a February 2021 Joint Motion for Remand (JMR) to obtain an addendum opinion to determine whether any of the Veteran's left eye disorders were preexisting conditions, and if so, whether any identified condition was aggravated beyond its natural progression by an in-service injury, event, or illness. The Board requested, in pertinent part, a medical opinion to clarify whether any of the Veteran's left eye disorders were a congenital disease or defect, and if not, to opine whether any left eye disorder "clearly and unmistakably" preexisted service and if yes, whether any such condition clearly and unmistakably was not aggravated by an in-service injury, event, or illness. An addendum opinion was obtained in September 2021. With respect to the congenital disease or defect question, the examiner opined that the claimed left eye disorders are less likely than not disorders of a congenital nature but with a known etiology. With particular relevance to the preexisting question, the examiner noted that the Veteran's conjunctival melanosis is "more common in patients of darker pigmentation, including African Americans. The examiner also indicated that the Veteran's eye conditions are more likely than not due to either the natural aging process and/or "racial predilections." The Board finds that while the opinion seems to be adequate with respect to the congenital disease/defect questions, it failed to clarify whether any of the identified eye disorders clearly and unmistakably preexisted service and, if so, whether it is clearly and unmistakably that any such disorder was not aggravated by an in-service injury, event, or illness. The Board notes that this request was specifically included in the June 2021 Remand directives in an effort to address the presumption of soundness question set forth in the February 2021 JMR. Furthermore, the September 2021 examiner indicated that the Veteran's left eye disorders were less likely than not "aggravated" by the welding incident in service. The opinion, as written, not only suggests the possibility of a left eye disorder at the time of the in-service event, but the "less likely than not" legal standard used by the examiner is not the correct one. VA's burden of proof requires that if a preexisting disability is found, the evidence must show that it "clearly and unmistakably" was not aggravated by an in-service event, injury, or illness. As the questions remain unanswered, further clarification is necessary. For the reasons set forth above, the Board finds that a remand for an addendum opinion is warranted for substantial compliance with the February 2021 JMR and June 2021 Board remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The matter is REMANDED for the following action: Forward the entire claims file to the VA examiner who proffered the September 2021 VA opinion. Schedule a new VA examination if needed. Upon review of the Veteran service treatment records and post service medical evidence, the examiner should address the following questions: a) Whether there is clear and unmistakable evidence that any claimed left eye disorder, to include polypoidal chorioretinopathy, cataracts, dry eyes, and/or conjunctival melanosis existed prior to entry into active duty in July 1977. The examiner should discuss whether the Veteran's eye disabilities are congenital in nature and, if so, if there is evidence that they pre-existed his service. If the congenital disorder actually showed onset following service, such should be explained. b) If any left eye disorder existed prior to service, the examiner should opine as to whether any left eye disorder was "clearly and unmistakably" not aggravated by military service, to include consideration and discussion of the January 1978 service treatment record showing left eye pain after welding and diagnosis of scleral irritation, the November 1978 record showing a scratch to the inner canthus, as well as the April 1980 and June 1980 reports of sore/tired eyes and June 1982 report of pain when moving his eyes. All opinions expressed must be accompanied by supporting medical rationale and analysis. R. Erdheim Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board William Pagan, 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.