Citation Nr: 21012604 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 15-30 922 DATE: March 4, 2021 REMANDED Entitlement to service connection for a left eye disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the Air Force from May 1965 to March 1969, including service in Thailand. His decorations include a Vietnam Service Medal and a Republic of Vietnam Campaign Medal. In November 2015, the Veteran and his spouse testified at a videoconference hearing before the undersigned, and a transcript of that hearing is of record. The Board remanded the issue for further development in January 2017, July 2018, and July 2019. The Board notes that the Veteran has perfected separate appeals for service connection for gastroesophageal reflux disease (GERD), hypertension (claimed as high blood pressure), and bronchitis; however, the Veteran requested a Board hearing, which has not yet occurred. As such, the Board will not address these issues in this decision, and they will be the subject of a subsequent Board decision, if otherwise in order. The Board also notes that the Veteran initiated appeals for service connection for obstructive sleep apnea, bilateral toenail fungus, and vertigo; however, in July 2020, during the pendency of appeal, service connection was granted for these disabilities. Because the Veteran was awarded service connection, these issues are no longer on appeal. See generally Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997). 1. Entitlement to service connection for a left eye disability is remanded. Unfortunately, another remand is required. Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration. The July 2019 Board remand directives included obtaining an opinion from a medical expert on the etiology of the left eye disability, to include whether it was caused or aggravated by the Veteran’s service-connected diabetes mellitus. The examiner was expressly asked to discuss a July 2018 opinion by a private optometrist, Dr. A.S.; an undated letter received in March 2019 from a private physician, Dr. R.H.; and a May 2019 letter from Dr. R.H. Subsequently, in November 2019, the Veteran had a VA eye conditions examination. The examiner concluded that the claimed left eye condition was less likely than not proximately due to or the result of the service-connected diabetes. The examiner noted, however, that he was unable to find the opinions from Dr. A.S. and Dr. R.H. A subsequent May 2020 addendum opinion provided the opinions of Dr. A.S. and Dr. R.H. The examiner simply stated that “the three opinions were reviewed and the medical opinion rendered at the 11/26/19 exam remains unchanged.” As further rationale the examiner cited to the American Academy of Ophthalmology that the etiology was unknown and therefore cannot be attributed to diabetes. Therefore, there has not been substantial compliance with the remand directives, and corrective action is necessary. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding that where the remand of the Board or the Court is not complied with, the Board errs as a matter of law when it fails to ensure compliance). Although the opinions were eventually reviewed, they were not discussed and the rationale for the opinion being unchanged is conclusory. In addition, the Board notes that the Veteran asserted in an October 2020 statement that his service-connected sleep apnea caused him to have a stroke, which in turn caused left eye partial blindness. As such, on remand, the examiner should consider and discuss this contention. The matter is REMANDED for the following action: Contact the VA examiner who conducted the November 2019 VA eye conditions examination (or if he or she is no longer available, a suitable replacement) and ask the examiner to review the record and prepare an addendum to the medical opinion. The examiner should be provided copies of the July 2018 opinion by Dr. A.S., the undated letter received in March 2019 from Dr. R.H., and the May 2019 letter from Dr. R.H. The entire claims file, including a copy of this REMAND, must be reviewed by the examiner. Based on this review, the examiner is asked to provide opinions on the following: (a) Whether it is at least as likely as not (a 50 percent or greater probability) that any left eye condition is related to incident, injury, or event in active service. (b) Whether it is at least as likely as not that any left eye condition is proximately due to the service-connected diabetes mellitus. If not, did any left eye condition increase in severity beyond its natural progression by the service-connected diabetes mellitus? (c) Whether it is at least as likely as not that any left eye condition is proximately due to the service-connected obstructive sleep apnea. If not, did any left eye condition increase in severity beyond its natural progression by the service-connected obstructive sleep apnea? A thorough rationale should be provided for all opinions expressed, to include discussion of the three medical opinions noted above, and to include the Veteran’s October 2020 statement that his service-connected sleep apnea caused him to have a stroke, which in turn caused the left eye condition. If any requested medical opinion cannot be given, the examiner should state the reason(s) why. If the examiner determines that further examination is necessary in order to render any requested medical opinion, the AOJ should schedule the Veteran for such an examination. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Nelson 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.