Citation Nr: 21007193 Decision Date: 02/08/21 Archive Date: 02/08/21 DOCKET NO. 13-35 392 DATE: February 8, 2021 REMANDED Entitlement to service connection for an eye disorder, claimed as eye pain with fatigue is remanded. REASONS FOR REMAND The Veteran served in the United States Army from July 1979 to July 1982 with subsequent service in the Army Reserve. This matter comes before the Board of Veterans’ Appeals (Board), on appeal from an August 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In the December 2013 VA Form 9, the Veteran declined an optional Board hearing. The Board previously considered this appeal in October 2017 and October 2019 for further development. The October 2017 decision included, among other things, scheduling the Veteran for a VA examination to determine the etiology of the Veteran’s eye disorder and obtain a nexus opinion of whether the Veteran’s eye disorder is at least as likely as not related to military service. While the Veteran underwent a VA examination in January 2019, the Board, in its October 2019 decision, found the January 2019 addendum opinion inadequate. In the Board 2019 decision, the Board directed the RO to obtain outstanding VA and private treatment records, obtain an addendum opinion for each eye disorder, to include blepharitis, on whether such disorder is at least as likely as not causally related to active service. Such opinions needed to address the Veteran’s reported exposure to PD680 and other hazardous chemicals during active service as well as lay statements and the medical treatise evidence submitted by the Veteran. In January 2020, the RO obtained private treatment records and associated them with the claims file. In October 2019, the RO obtained an addendum opinion. The October 2019 examiner only addressed blepharitis, which lacked a sufficient rationale. The opinion did not address any of the Veteran’s other eye conditions and did not address the etiology of any of the Veteran’s eye conditions or whether any of them were at least as likely as not caused by the Veteran’s reported exposure to PD680 and other hazardous chemicals during active service. The examiner also did not comment on the lay statements and medical treatise (i.e. the internet article regarding the chemical PD-680 and its potential health effects) submitted by the Veteran when formulating his conclusions. Consequently, the Board finds the October 2019 addendum opinion inadequate. Thus, the Board finds the RO did not substantially comply with the October 2019 remand directives. Stegall v. West, 11 Vet. App. 268 (1998). Accordingly, while the Board regrets the delay, the Board finds that another remand is needed in order to obtain an etiology opinion that adequately addresses all the Veteran’s eye conditions, to include blepharitis, and whether any such conditions are attributable to service. The examiner when providing the requested opinions must also specifically consider and discuss the evidence submitted by the Veteran regarding the PD680’s potential health effects in eyes and skin as well as the January 2020 private treatment record. Additionally, the examiner must provide a reasoned rationale to support opinions proffered. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination with an appropriate examiner, in order to obtain an addendum opinion as to the nature and etiology of the Veteran’s eye conditions. 2. Provide the examiner the claims file, to include the October 2017 Remand, October 2019 Remand, and this Remand order. The examination report should reflect that such review was accomplished. 3. The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that his reports must be considered in formulating the requested opinions. 4. Based on review of the record and examination of the Veteran, and after eliciting a detailed history from the Veteran, the examiner is requested to: a. Identify any and all current and prior eye conditions, to include all of the diagnoses in the December 2017 VA examination; b. For each eye diagnosis, opine whether it is at least as likely as not (probability of 50 percent or more) is caused by or is otherwise attributable to service, to include exposure to chemicals. In providing such opinion, the examiner must specifically address lay statements and medical treatise (i.e. the internet article regarding the chemical PD-680 and its potential health effects). The examiner’s opinions must address the January 2020 private treatment records. 5. The examiner must provide detailed rationale for all proffered opinions. All appropriate studies and consultations should be accomplished, and all clinical findings should be reported in detail. If an opinion as to any aspect of the aforesaid inquiries cannot be provided without resorting to speculation, the examiner is requested to provide an explanation as to why this is so and to clarify what additional development, if any, would permit the requested opinion to be rendered. 6. After completing the foregoing and any other development necessary, readjudicate the Veteran’s claims. 7. If any benefit sought on appeal remains denied, a Supplemental Summary of the Case (SSOC) should be furnished to the Veteran and his representative, and he and his representative should be afforded a reasonable opportunity to respond. Cynthia M. Bruce Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Agarwal, 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.