Citation Nr: 21076601 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 17-10 919A DATE: December 27, 2021 ORDER Entitlement to service connection for glaucoma is granted. Entitlement to service connection for cataracts is granted. REMANDED Entitlement to service connection for an eye disability, other than glaucoma or cataracts, is remanded. FINDINGS OF FACT 1. The Veteran's glaucoma was caused by his boxing in active service. 2. The Veteran's cataracts were caused by his boxing in active service. CONCLUSIONS OF LAW 1. The criteria for service connection for glaucoma have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for cataracts have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1979 to November 1985. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO), which denied the Veteran service connection for glaucoma. The August 2021 Board remand expanded the Veteran's claim to include any eye disability. In February 2019 and August 2021, the Board remanded the Veteran's claim to the Agency of Original Jurisdiction (AOJ) for further action consistent with the Board's remand directives. Specifically, the Board remanded to request an opinion as to whether any eye disability was the result of boxing in service. The claim is back before the Board for further appellate proceedings. A Veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called "nexus" requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). Importantly here, the Veteran has glaucoma and cataracts. See September 2021 VA examination report. He was a boxer for the U.S. Army for six years. See March 2015 notice of disagreement, STRs. Indeed, the Veteran received several injuries as a result of boxing. See STRs. Thus, the first two Shedden elements are met and not in dispute. The narrow issue before the Board is whether the Veteran's disabilities are a result of boxing in service. The Veteran was afforded a VA examination in September 2021. The examiner reviewed the Veteran's medical records, contentions, and service record. See September 2021 VA examination report. He opined that the Veteran's glaucoma and cataracts are at least as likely as not a result of boxing in service. Id. The Board finds that the examiner's opinion is highly probative. Thus, the third Shedden element is met. Accordingly, the Board finds that the Veteran's glaucoma and cataracts are etiologically related to service. Therefore, the criteria for service connection for the Veteran's glaucoma and cataracts have been met. See 38 C.F.R. §§ 3.102, 3.159, 3.303; Gilbert v. Derwinski, 1 Vet. App. 9, 55-57 (1990). REASONS FOR REMAND As discussed above, the Board expanded the Veteran's claim to include any eye disability in its August 2021 remand. In the remand, the Board instructed the examiner to discuss the etiology of any eye disability. Regrettably, the Board finds that further evidentiary development is necessary and remands the case to ensure compliance with the Board's prior remand instructions. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The Veteran was afforded a new examination upon remand. See September 2021 VA examination report. After a physical examination and review of the documents, the examiner listed all eye pathology within the appellate period. Id. The examiner then provided an etiological opinion with reasoning as related to the Veteran's glaucoma and cataracts. Id. Unfortunately, the examiner did not provide a complete rationale as to the Veteran's remaining pathology, to include ptosis, dry eye, keratitis, pseudophakia, and pinguecula. Id. Relevantly, the examiner's opinion states that the "Veteran had Bell's palsy in 1978 and 1999 but was in service from 1979 to 1985. He says the ptosis and dry eye and keratopathy. [sic] Therefore, it seems less likely than not . . . ." It appears the examiner mistakenly forgot to include the reasoning for the opinions expressed. The Board does not otherwise have competent medical evidence to rely on for adjudicative purposes at this time. Thus, remand is necessary for a new opinion. The matter is REMANDED for the following action: 1. Obtain any outstanding VA and/or private treatment records relevant to treatment the Veteran received for his eye disabilities that are not already of record. All obtained records should be associated with the evidentiary record. If any identified records are not obtainable (or none exist), the Veteran and his representative, if any, should be notified, and the record clearly documented. 2. After the above development is completed, obtain an opinion from an appropriately qualified clinician to determine the nature and etiology of the Veteran's eye disabilities. The evidentiary record, including a copy of this remand, must be made available and reviewed by the clinician. The opinion should include a notation that this record review took place. It is up to the discretion of the reviewing clinician as to whether a new examination is necessary to provide an adequate opinion. After the record review, and examination if deemed necessary, the reviewing clinician is asked to respond to the following inquiries as to each disability other than glaucoma and cataracts, to include ptosis, dry eye, keratitis, pseudophakia, and pinguecula: Is it at least as likely as not that the Veteran's eye disability was incurred in, or is otherwise related to, his time on active service, to include boxing for the U.S. Army therein? The reviewing clinician must discuss the Veteran's circumstances of boxing for the military for six years, to include injuries sustained related to boxing. See STRs. The reviewing clinician should consider the September 2021 VA examination report, to include its opinions. In rendering this opinion, the reviewing clinician is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the reviewing clinician rejects the Veteran's reports, he or she must provide an explanation for such rejection. The reviewing clinician is not to improperly discount the Veteran's lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the reviewing clinician must provide a complete explanation for why an opinion cannot be rendered. In so doing, the reviewing clinician must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. 3. After the above has been completed to the extent possible, readjudicate the claims. If any benefit sought remains denied, provide the Veteran and his representative, if any, with a supplemental statement of the case (SSOC), and return the case to the Board. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Strickland 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.