Citation Nr: 21008255 Decision Date: 02/12/21 Archive Date: 02/12/21 DOCKET NO. 17-22 820 DATE: February 12, 2021 ORDER Entitlement to service connection for bilateral cataracts, to include as secondary to service-connected diabetes mellitus, type II, is granted. REMANDED Entitlement to service connection for a respiratory disability is remanded. Entitlement to service connection for a back disability is remanded. INTRODUCTION The Veteran served on active duty from November 1960 to November 1964. These matters come before the Board of Veterans’ Appeals (Board) on appeal from rating decisions by a Department of Veterans Affairs (VA) Regional Office (RO). In February 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of this hearing has been associated with the claims file. FINDING OF FACT The Veteran’s bilateral cataracts is proximately due to service-connected diabetes mellitus, type II. CONCLUSION OF LAW The criteria for service connection for bilateral cataracts as secondary to diabetes mellitus, type II, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran asserts that his current bilateral cataracts are secondary to his service-connected diabetes mellitus, type II. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be established on a secondary basis for a disability that is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). In April 2020, the Board remanded the Veteran’s claim in order to obtain an opinion from a VA examiner. In December 2020, the Veteran underwent a VA examination, which confirmed a diagnosis of bilateral cataracts, post-surgery. Although the examiner opined that the Veteran’s bilateral cataracts were less likely than not (a less than 50 percent probability) due to or a result of his diabetes mellitus, type II, the examiner provided the following rationale: Based on my examination and the [V]eteran’s history and medical records…it is impossible to determine if the [V]eteran’s bilateral cataracts are at least as likely proximately due to service-connected diabetes mellitus, in my opinion. Based on medical literature, diabetes mellitus can accelerate the progression of cataracts, but the [V]eteran’s records do not give any evidence as to the onset or progression of the cataracts. The cataracts could just as easily be explained by the natural progression of cataracts as a matter of aging. Diabetes mellitus can lead to pathologies in may tissues in the eye structure, with both a systemic chronic metabolic disease and a microangiopathic character. Cataract is one of the major causes of visual impairment in diabetic patients. Patients with [diabetes mellitus] are reported to be up to five times more likely to develop cataract… The examiner, thus, determined that the Veteran’s bilateral cataracts are equally attributable to aging and diabetes mellitus, type II. Given the examiner’s statement that people with diabetes mellitus, type II, are up to five times more likely to develop cataracts, the Board resolves the doubt in the Veteran’s favor. In sum, service connection has been granted for the Veteran’s diabetes mellitus, type II, and the evidence of record establishes the presence of bilateral cataracts. Resolving reasonable doubt in the Veteran’s favor, the Board finds that service connection on a secondary basis is warranted for bilateral cataracts. 38 C.F.R. §§ 3.102, 3.310; see Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). REASONS FOR REMAND In the April 2020 remand, the Board directed the RO to provide the Veteran with VA examinations regarding his respiratory disability and his back disability. With respect to a respiratory disability, the Board specifically explained that the Veteran’s service records demonstrated that he was exposed to petroleum products, herbicidal agents, jet fuel, and other hazardous chemicals. Indeed, the Veteran was stationed aboard the U.S.S. Taluga, which is a Cimarron-class fleet oiler that supplied combat vessels with petroleum products, including aircraft carriers conducting airstrike operations into the interior of the Republic of Vietnam. The examiner was supposed to assume these facts when rendering an etiological opinion. Despite these instructions, an October 2020 VA examiner opined, in part, that there “is no documentation” that the Veteran was exposed to hazardous chemicals. Consequently, the Board finds that a remand is required in order to obtain a supplemental opinion. With respect to the Veteran’s back disability, in the April 2020 remand, the Board noted presence of a July 2014 opinion that the Veteran’s back disability was consistent with an “old injury.” An October 2020 VA examiner did not consider or discuss this evidence. As such, a remand is required to obtain a supplemental opinion. The matters are REMANDED for the following action: 1. Obtain supplemental opinions from the October 2020 VA examiners that conducted the respiratory and back examinations. The Veteran’s electronic claims file must be made available to the examiners and the examiners must specify in the reports that it was contemporaneously reviewed. All pertinent symptomatology and findings must be reported. The examiners should then provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that any found respiratory disability, and/or back disability, were incurred in or due to his active duty. With respect to the Veteran’s respiratory disability, the examiner must specifically consider and discuss the Veteran’s presumed exposure to herbicidal agents and his demonstrated exposure to hazardous chemicals, including jet fuel and other petroleum products. The examiner is directed to do so despite the absence of records that specifically document this exposure. With respect to the Veteran’s back disability, the examiner must specifically consider and discuss the July 2014 opinion of record that the Veteran’s disability is consistent with an “old injury.” All rendered opinions must be accompanied by a thorough rationale. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Sean G. Pflugner, 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.