Citation Nr: 21010728 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 18-46 614 DATE: February 25, 2021 REMANDED Entitlement to service connection for a bilateral eye disability is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1957 to August 1959. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an April 2018 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO or AOJ). In March 2020, the Veteran testified before the undersigned Veterans Law Judge in a Video Conference Board Hearing. A transcript of that hearing is of record. This case was previously before the Board in July 2020 when it was remanded for additional development. It has now returned to the Board for further appellate action. Unfortunately, the Board finds that further action in this appeal is warranted, even though such will, regrettably, further delay an appellate decision on this matter. A remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with the remand instructions, and imposes upon the VA a concomitant duty to ensure compliance with the terms of the remand. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Veteran was afforded a VA examination in October 2020 for his bilateral eye disability. At that time, the examiner noted diagnoses of macular degeneration and pseudophakia. The examiner indicated the symptoms of macular degeneration to include blurred vision. He indicated that there were no symptoms of pseudophakia. He noted that pseudophakia does not cause decreased vision. A negative October 2020 medical opinion was provided. As rationale, the examiner stated that macular degeneration rarely occurs in people under age 50. He stated that the earliest records in the Veteran’s file are from 2000, and show macular degeneration was present but was having little effect on vision. In addressing the Veteran’s contentions, the examiner stated that it was unlikely that the Veteran was experiencing macular degeneration in service. The examiner noted the Veteran had a positive Amsler grid test in 1998, but stated that visual acuity was still good at that time. The probative value of the October 2020 opinion is limited. First, the opinion does not adequately address the clinical significance of a June 1998 private treatment record documenting the Veteran’s complaints of eye distortion for “x25 years” described as “slightly worse – gradually.” Second, the record indicates diagnoses of macular edema and choroidal nevus during the period on appeal. See November 2017 private treatment record. These diagnoses were not addressed by the examiner. For the reasons set forth above, a remand is necessary here to comply with the VA’s duty to assist the Veteran. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The matters are REMANDED for the following action: Schedule the Veteran for a new examination by an appropriate clinician, other than the October 2020 VA examiner, to determine the nature and etiology of any bilateral eye disability. As an initial matter, the examiner is asked to clarify whether the Veteran currently or at any point during the period on appeal had diagnoses of macular edema and/or choroidal nevus. After reviewing the claims file and examining the Veteran, the examiner should address the following: a. Identify/diagnose any disability of the eyes that presently exists or that has existed during the appeal period. If the examiner finds that the record does not support diagnoses of bilateral macular degeneration, pseudophakia, macular edema, and/or choroidal nevus, such should be clearly stated with supporting rationale. b. For each diagnosed disability of the eyes, to include bilateral macular degeneration, pseudophakia, macular edema, and choroidal nevus, state whether it is it at least as likely as not (50 percent or greater probability) that it had its initial onset in service, or is otherwise related to an event, injury, or illness during active service. The examiner must consider and address the Veteran’s lay report that he experienced gray areas in his vision and wavy lines during his active service, and that those problems had persisted and progressed since that time. If there is any evidence to accept or reject that stated in-service history, such evidence should be identified and explained. To that end, the June 1998 private treatment record documenting the Veteran’s complaints of eye distortion for “x25 years” described as “slightly worse – gradually” should be addressed by the examiner. A complete rationale for all opinions must be provided. If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. The examiner must indicate whether there is any further need for information or testing necessary to make a determination. Additionally, the examiner must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Smith, 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.