Citation Nr: 21012877 Decision Date: 03/05/21 Archive Date: 03/05/21 DOCKET NO. 13-06 403 DATE: March 5, 2021 ORDER A rating of 10 percent for cataracts prior to June 2, 2013 is granted. A compensable rating for cataracts with diplopia from June 3, 2013 is denied. FINDINGS OF FACT 1. The Veteran filed a claim for an increased rating for his diabetes mellitus on March 1, 2011 and he has developed cataracts secondary to his service-connected diabetes. 2. Prior to cataract surgery on June 3, 2013, the Veteran’s corrected distance vision more nearly approximated 20/40 (right) and 20/100 (left) at worst. 3. The Veteran underwent cataract surgery for his left eye on June 3, 2013, and for his right eye on June 10, 2013. 4. Since June 3, 2013, his corrected distance vision has remained 20/40 or better throughout. 5. The Veteran developed diplopia due to aggravation of strabismus by the cataract surgery; his diplopia is intermittent and correctable by prism spectacles. CONCLUSIONS OF LAW 1. The criteria for entitlement to a rating of 10 percent for cataracts prior to June 2, 2013 are met. 38 U.S.C. §§ 1155, 5107 (2014); 38 C.F.R. § § 4.1-4.16, 4.31, 4.75-4.79, Diagnostic Codes (DCs) 6027, 6066 (2020). 2. The criteria for entitlement to a compensable rating for cataracts with diplopia prior from June 3, 2013 are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § § 4.1-4.16, 4.31, 4.75-4.79, Diagnostic Codes (DCs) 6027, 6066, 6090. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Marine Corps from August 1966 to June 1969. His service included service in the Republic of Vietnam. m His awards included a Navy Commendation Medal for participation in numerous combat operations with courage and composure under fire. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2012 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The September 2012 rating decision granted entitlement to service connection for cataracts due to diabetes, with an initial noncompensable rating, effective August 17, 2009. An October 2012 rating decision continued the noncompensable rating for cataracts, with a “corrected” effective date of March 2, 2005. The Board notes that the Veteran filed a claim for an increased rating for diabetes on March 1, 2011. Based on this increased rating claim, the Veteran was separately service-connected for cataracts. Under DC 7913, for rating diabetes mellitus, a compensable complication of diabetes should be separately evaluated and noncompensable complications of diabetes should be considered as part of the diabetic process. As the Veteran’s cataracts was noncompensable, it should have been considered under his diabetes rating (e.g. “diabetes mellitus, type II, with cataracts is rated 20 percent”). As the RO separated the cataracts, but did not provide a compensable rating, the effective date was assigned from the date the Veteran’s diabetes was initially granted service-connection. In August 2013, the Veteran testified before a Veterans Law Judge (VLJ) who is no longer with the Board. In May 2018, the Veteran testified again at a hearing before the undersigned VLJ; transcripts of both hearings are contained in the record. This claim was previously before the Board in August 2018, December 2019, and July 2020. In August 2018, the Board remanded the claim for an updated VA examination as the Veteran had testified his vision had worsened since his 2016 examination. In December 2019, the Board remanded the claim to obtain missing treatment records, and for the Veteran to receive and updated VA examination. In July 2020, the Board remanded the claim for an addendum opinion and ongoing treatment records. The Board notes that in March 2021, the Veteran’s representative argued for an increased rating for the Veteran’s eye disabilities based on the residuals of a stroke. The Veteran is currently service-connected for cataracts (secondary to service-connected diabetes) and diplopia (caused by cataract surgery). The Veteran is not service-connected for his 1990 stroke. The representative has argued that the Veteran’s stroke is a result of his diabetes and/or PTSD. The representative has not argued, and the record does not show, that his stroke was related to his service-connected cataracts/diplopia. As such, the residuals of a stroke argument is not a downstream issue or intertwined with the Veteran’s increased cataracts rating claim. An April 1993 rating decision initially denied entitlement to residuals of a stroke, to include “eye impairment.” Subsequently, an August 2009 rating decision denied entitlement to residuals of a stroke, right homonymous hemianopsia. The Veteran was notified of the August 2009 rating decision on August 21, 2009. The Veteran did not submit a notice of disagreement or submit new and material evidence within one year of the decision, and it became final. Although the Veteran’s representative is requesting that the Veteran’s eye disability rating include consideration of residuals of a stroke, the Veteran’s prior claims for residuals of a stroke have been denied, there is no current claim on appeal for residuals of a stroke, and the representative and/or medical evidence have not indicated that the stroke was a result of the cataracts/diplopia. The Board did not locate a current claim (on appropriate claim forms) or an informal claim (prior to 2015) for residuals of a stroke following the 2009 denial. As such, a claim of entitlement to service connection for residuals of a stroke are not currently on appeal, and the resultant visual field impairment will not be considered with the Veteran’s cataracts and diplopia. This is discussed below, with citation to clinical records which noted the Veteran’s visual field impairment was due to his stroke, and his lay statements regarding the onset and static nature of his visual field impairment. In Rice v. Shinseki, 22 Vet. App. 447 (2009), the United States Court of Appeals for Veterans Claims (Court) held that a claim for a TDIU is part of an increased or initial rating claim when such claim is expressly raised by the Veteran or reasonably raised by the record. The Veteran is in receipt of a schedular 100 percent rating for posttraumatic stress disorder (PTSD) from September 9, 2017. Neither the Veteran, nor his representative, have submitted a claim of entitlement to TDIU. Regarding the issue on appeal, neither the Veteran nor his representative have alleged that his cataracts/diplopia resulted in his inability to obtain or maintain substantially gainful employment. The record indicates that the Veteran stopped working following his stroke in 1990, prior to his diagnosis of cataracts. The Veteran vision impairment, from cataracts and diplopia, has not been noted to cause significant functional impairment. Additionally, the Veteran’s service-connected disabilities (other than his PTSD) do not combine to 60 percent. As such, entitlement to TDIU has not been reasonably raised by the record neither has the ancillary issue of SMC per 38 U.S.C. § 1114; 38 C.F.R. § 3.350(i). 1. Entitlement to a rating of 10 percent for cataracts prior to June 2, 2013 is granted. 2. Entitlement to a compensable rating for cataracts with diplopia prior from June 3, 2013 is denied. The Veteran argues that he is entitled to a compensable rating for his bilateral cataracts. He has argued that his diplopia is due to his cataract surgeries in 2013. As will be discussed below, the Board will resolve reasonable doubt in the Veteran’s favor and finds that his current diplopia is due to his 2013 cataract surgery. The Board finds that entitlement to a 10 percent rating is warranted prior to June 3, 2013 due to his impairment of central visual acuity due to cataracts. After surgery, his central visual acuity improved. Although he developed diplopia, it is intermittent and correctable with prism spectacles, which is not compensable. As such, from June 3, 2013, a compensable rating is not warranted. During his May 2018 Board hearing, the Veteran testified that “about three or four years ago” he had his cataracts “taken care of.” He stated he used to be able to go to a baseball game and see “up close a little bit” but he could not read the scoreboard. Then, he had his “cataracts fixed at the Billings Clinic” but that he believed his cataracts had “come back.” He reported that he “still see[s] double.” He was given eye drops, but they did not fix the diplopia and he “still see[s] double.” He explained that although the cataract surgery was 3 to 4 years ago, he was given the eye drops a month ago, but that they only helped “a little bit, but not for long.” He stated he had to keep putting the eye drops in “all the time.” He was using corrective lenses, and he had “20/20 vision, but [he could not] read the newspaper.” So, the only glasses he wore were reading glasses. During the pendency of the appeal, VA issued a final rule revising the portion of the VA Schedule for Rating Disabilities that addresses the organs of special sense and schedule of ratings-eye. 89 Fed. Reg. 15316 (Apr. 10, 2018). The final rule went into effect May 13, 2018. Where there is a change in the rating criteria during the appeal period, the Board will consider the claim in light of both the former and revised schedular rating criteria, although an increased evaluation based on the revised criteria cannot predate the effective date of the amendments. Both the former and revised criteria distinguish preoperative and postoperative cataracts. For preoperative cataracts, the former criteria instructed to evaluate based on visual impairment and the revised criteria instruct to evaluate under the General Rating Formula for Diseases of the Eye. For postoperative cataracts, both the former and revised rating criteria distinguish between pseudophakia and aphakia. If there is a replacement lens present (pseudophakia) as here, then the former criteria instructed to evaluate based on visual impairment whereas the revised criteria instruct to evaluate under the General Rating Formula for Diseases of the Eye. The Board notes that the General Rating Formula for Diseases of the Eye instructs to evaluate a condition based on visual impairment or its rating criteria for incapacitating episodes. Thus, the primary difference between the former and revised criteria is consideration of incapacitating episodes. With regard to visual impairment, the amendments made no substantive changes to how visual acuity is rated. Note (1) to the General Rating Formula indicates that, for the purposes of evaluations under 38 C.F.R. § 4.79, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes. Note (2) indicates that examples of treatment may include but are not limited to: systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions. Evaluation of impairment of muscle function is based on the degree of diplopia. The examiner must record test results for the four major quadrants (upward, downward, and right and left lateral) and the central field (20 degrees or less). 38 C.F.R. § 4.78(a). In accordance with 38 C.F.R. § 4.31, diplopia that is occasional or that is correctable with spectacles is evaluated at 0 percent. An evaluation for diplopia will be assigned to only one eye. When diplopia extends beyond more than one quadrant or range of degrees, evaluate diplopia based on the quadrant and degree range that provides the highest evaluation. 38 C.F.R. § 4.78(b)(2). *** Initially, the Board notes that the Veteran has a visual field defect of homonymous hemianopsia due to a stroke in 1990, prior to his diagnosis of cataracts (and prior to his diagnosis of diabetes). Both the lay statements from the Veteran regarding the onset of his loss of peripheral vision on one side and ongoing VA and private treatment records and examinations note that the Veteran’s homonymous hemianopsia is due to his cerebrovascular accident (CVA)/stroke. As noted in the introduction, the Veteran previously sought entitlement to service connection for residuals of a stroke/homonymous hemianopsia, and was denied service connection in 1993 and 2009 rating decisions. The Veteran did not appeal the 2009 rating decision, and it became final. As the Veteran’s visual field loss due to homonymous hemianopsia is not service-connected and there has been no lay argument or clinical evidence that his stroke/visual field defects were caused or aggravated by his cataracts, or cataract surgery (his homonymous hemianopsia has remained constant since onset), his visual field impairment will not be considered for this increased rating evaluation. A March 18, 2009 Helena Eye Clinic record noted that the Veteran had bilateral nuclear sclerosis 1+ cataracts and left cortical changes. The ophthalmologist noted that the Veteran had “mild cataracts that affected his vision to some degree; vision is 20/25 best-corrected in each eye.” He did not have diabetic retinopathy. His cataracts were at least as likely as not due to his diabetes. Following a March 1, 2011 claim for an increased rating for his diabetes mellitus, the Veteran participated in a VA diabetes examination on March 25, 2011. At that time, the Veteran denied having cataracts and stated he was not seeking an increased rating for cataracts. He was seeking an increased rating for his diabetes had he had an increase in medications to treat his diabetes. He had no eye complaints. He did not have his glasses at the time of the examination, but he denied changes in vision. His most recent test for retinopathy was negative. The examination included that the Veteran’s vision was 20/200 bilaterally. There was no indication if this was corrected or uncorrected distance vision. He denied having prescription glasses and did not report any changes in his eyes. If the Veteran’s vision in this March 2011 evaluation was corrected distance vision, under DC 6066 it would warrant a 70 percent rating. However, the evaluation does not indicate that this is corrected distance vision, and instead notes that the Veteran “did not have glasses” during the examination. Given that his vision was noted to be 20/40 during his August 2012 evaluation, the Board finds, when looking at other relevant evidence, that the 20/200 vision reported in the March 2011 evaluation was the Veteran’s uncorrected distance vision. An August 16, 2012 eye Disability Benefits Questionnaire (DBQ) included a diagnosis of cataracts from March 18, 2009. He reported that his vision had been declining in recent years. His corrected distance vision was 20/40 or better for both eyes. He did not have diplopia at that time. He had bilateral cataracts without aphakia or dislocation of the crystalline lens. He had not had any incapacitating episodes and did not have any functional impairment due to his eye condition. The examiner remarked that the Veteran had cataracts, likely due to his diabetes given his “relatively young age.” A September 19, 2012 addendum included that the Veterans reduction in visual acuity was due to his cataracts, and that his vision was 20/40 for both eyes at near and far. It was confirmed that the cataracts were due to the Veteran’s diabetes. Under DC 6066, corrected distance vision of 20/40 or better in both eyes warrants a noncompensable rating. On December 3, 2012, the Veteran submitted a notice of disagreement with his initial noncompensable rating for cataracts, noting that his cataracts required surgery. A March 3, 2013 VA diabetic eye evaluation included the Veteran’s report that 3 to 4 years ago he was told he had cataracts. On evaluation, his corrected distance vision was 20/40 right and 20/80 left. He had 1+ nuclear sclerotic and trace cortical cataracts. His left eye had cortical with vacuoles centrally and early central PSC (posterior subcapsular cataract). He was assessed with cataracts, left worse than right, “impacting his vision.” Under DC 6066, corrected distance vision of 20/80 is not specifically included in the rating criteria; under 38 C.F.R. § 4.76 (b)(4) when reported visual acuity is between two sequentially listed visual acuities, use the visual acuity which permits the higher evaluation. Visual acuity of 20/80 falls between 20/70 and 20/100. Visual acuity of 20/100 and 20/40 warrants a 10 percent rating. A May 29, 2013 Billings Clinic record noted that the Veteran was seen for cataracts evaluation, with complaints of blurred vision. He reported the onset of the blurred vision was “past couple years.” His left eye was worse. He denied other problems. His corrected vision was 20/30+2 right eye, and 20/60-2 left eye. Under DC 6066, corrected distance vision of 20/60 is not specifically listed in the criteria. The corrected vision will be considered as 20/70 to provide the greater benefit. Corrected distance vision of 20/70 and 20/40 warrants a 10 percent rating. On June 3, 2013, the Veteran underwent left eye cataract surgery with lens implant at the Billings Clinic. On June 10, 2013, he underwent right eye cataract surgery with lens implant. By June 18, 2013, the Veteran’s corrected distance vision was 20/25+2 right and 20/30-2 left. On July 17, 2016, the Veteran participated in another eye DBQ. He was noted to have a prior diagnosis of cataracts, with current intraocular lens replacement. His corrected distance vision was 20/40 or better bilaterally. The examiner marked that the Veteran did not have diplopia. His cataracts were postoperative with replacement intraocular lens. He did not have aphakia or dislocation of the crystalline lens. When asked if the Veteran’s decrease in visual acuity or visual impairment was due to his cataracts, the examiner selected that the Veteran did not have a decrease in visual acuity or other visual impairment. The examiner found that the Veteran had not had any incapacitating episodes in the prior 12 months (under the former definition). “Veterans records were reviewed. He has a history of cataracts that were surgically removed in 2013.” He felt his vision had been good since surgery. His central visual acuity was good on examination. A December 19, 2017 VA treatment record included that the Veteran had not had his eyes checked in 2 to 3 years. He “could not remember the last time.” He also reported he had “cheater” glasses (over-the-counter reading glasses) that he had worn for the past 2-3 years following his cataracts surgery. A February 14, 2018 VA ophthalmology consultation included the Veteran’s report of cataract surgery 3 to 4 years ago without eye examination since surgery. He noted he had been diabetic for years, and was on insulin. He thought his diabetes was “ok.” He reported seeing double vision at far distance, without diplopia of near vision or when reading the eye chart. He did have trouble reading. Distance vision without correction was 20/60+2 right and 20/20 left. He had flick exophoria on alternating cover, orthophoria on cover/uncover. He had diabetes mellitus type II without retinopathy, mild dry ARMD (age-related macular degeneration) of both eyes, pseudophakia of both eyes, right homonymous hemianopsia status post CVA in 1989, and “intermittent diplopia, worse at distance per Veteran.” He was noted to have seen single at near and distance on evaluation with slight flick exophoria at distance, full extraocular movement bilaterally. It was discussed that he “may have mild divergence insufficiency when tired,” but the Veteran did not want to wear glasses and was “usually able to control, symptoms intermittent and only at distance, no treatment needed.” He was also noted to have mild dry eyes and was going to start artificial tears An April 25, 2018 follow-up record was a telephone call with the Veteran where he reported he continued having double vision at distance, monocular diplopia right eye. He stated that it was throughout the day, and he believed it had worsened since his last eye examination. He stated he had it “at times” with near vision as well, but that it “goes away when he puts his reading glasses on.” He had not been using his artificial tears as he did not believe they were helpful. However, he was encouraged to start using them. A December 17, 2018 Eye Clinic Surgicenter record included complaint of double vision. He did not currently wear glasses or contact lenses. He did not wear prism glasses. He noted his diplopia was present when both eyes were open; images separated vertically and horizontally, and his diplopia was worse when looking straight ahead. He had been aware of the diplopia for more than a year and believed it had been fairly stable. He complained of discomfort/ “tearing” of both eyes. He found this symptom to be quite bothersome and it was worse with reading and waking. His discomfort/tearing had been present for 3 to 4 months. His doubled images were diagonal to each other and he “ha[d] been like this for maybe two years.” He had not had prescription glasses since his cataract surgery, but felt his vision was “bad again.” He was not using eye drops at that time. His vision without correction was 20/40 right and 20/30 left. Following evaluation, the impression was of vertical strabismus left eye, mild, stable, pseudophakia, and diabetes without complication. Under the Veteran’s diagnosis of left strabismus was the notation of diplopia. A January 17, 2019 Eye Clinic Surgicenter was seen for follow-up for diplopia. Again, he reported that images were separated vertically and horizontally, and the diplopia was worse when looking right. He had been aware of the diplopia for 6 to 12 months and believed it was fairly stable since onset. He was wearing “readers” that were more than one year old. He described his vision as “blurry.” He denied flashes, floaters, headache, pain or discomfort, recent head or eye trauma. His eye history included left vertical strabismus, 4 PD LHT (left hypertropia) comitant in all gazes, and diplopia of both eyes, “corrected with prism.” His distance vision without correction was 20/40-2 right and 20/40+2 left. Following external, anterior segment, and posterior segment eye evaluations, the impression was of vertical strabismus left eye, mild, stable, pseudophakia, and diabetes without complication. Regarding LHT (misalignment of the eyes/strabismus whereby the visual axis of one eye is higher than the fellow fixating eye)—longstanding, “for years per patient, denied recent change, comitant with full motility.” The physician discussed possible improvement with prism glasses, and the Veteran was interested in a prescription. He was noted to have scratches on his left cataract replacement lens that may be limiting the visual acuity of his left eye. Under DC 6066, corrected distance vision of 20/40 or better in both eyes warrants a noncompensable rating. In August 1, 2019, the Veteran participated in a VA eye examination. He was diagnosed with vertical strabismus (alternating vertical strabismus with right hypotropia and left hypertropia), right homonymous hemianopsia, bilateral intraocular lens placement, bilateral diplopia (noted to be related to the vertical strabismus), bilateral drusen of macula, and bilateral upper eyelid dermatochalasis. He reported that “starting around February 2018, he [noticed] intermittent diplopia at distance and sometimes at near. He believes this is from the cataract surgery.” He did not wear glasses except for over-the-counter readers. He had diabetes, type II for the past 10 years, and he also reported a stroke 20 years prior resulting in right homonymous hemianopsia. He believed that his diplopia had worsened in the past 6 months. He had diplopia “with both eyes open.” His corrected distance vision was 20/40 bilaterally. Regarding the Veteran’s diplopia, the examiner noted that the Veteran believed his diplopia was due to his cataract surgery, but the examiner was “finding an alternating vertical strabismus at distance and near: alternating right hypotropia.” His diplopia was present at central 20 degrees. It was constant and not correctible with standard spectacle correction, but was correctable with special prismatic correction. Slit lamp evaluation showed bilateral dermatochalasis, which the examiner noted was “normal for age.” His replacement lenses were “centered with trace amounts of posterior capsular opacification superiorly.” His internal/fundus eye evaluation showed bilateral macula with scattered small, hard drusen. Regarding the Veteran’s eyelids, the examiner noted that the Veteran’s “dermatochalasis is within normal range for the Veteran’s age. It is not causing a superior field defect and does not obstruct the visual pathway.” His cataracts were postoperative with replacement lenses. There was no aphakia or dislocation of the crystalline lens. “The intraocular lens is in good condition bilaterally and presents no visual impairment.” His “few macular drusen” of both eyes were noted to be able to cause a decrease in visual acuity. “In this case, due to the few numbers of drusen as well as the absence of RPE mottling, the drusen are likely to contribute minimally to the slight decrease in visual acuity. However, [the Veteran’s vision was] still correctable to” 20/25 both eyes. His right homonymous hemianopsia was “from presumed stroke on left side of brain.” It caused significant visual impairment, but was not the cause of his diplopia. “Right homonymous hemianopsia cause[d] the Veteran to see nothing on the right side.” Under the “other eye conditions” section, the examiner addressed the Veteran’s bilateral diplopia and vertical strabismus. “Diplopia caused by vertical strabismus is causing visual impairment. This is correctable with prismatic glasses.” He had diplopia “at all distances” which could make words and images double. The Veteran had not had any incapacitating episodes (revised definition) of any eye condition in the prior 12 months. In the remarks section, the examiner noted that the Veteran’s corrected distance vision was 20/25 bilaterally. His diplopia would functionally impact him by making it “difficult to drive, read, or do detailed tasks. However, these symptoms could be alleviated with prism glasses.” On August 17, 2020, the 2019 examiner provided an addendum opinion. The examiner selected a negative (less likely than not) nexus opinion statement with a rationale that diplopia following cataract surgery was an “uncommon finding, with a total incidence of about 1 percent.” “When diplopia occurs after cataract surgery, it will almost always appear within months following the procedure.” The examiner noted that “one of the most common causes for post-operative diplopia [was] when a person ha[d] a decompensating phoria/strabismus.” The examiner explained that someone with a pre-existing phoria/strabismus could have the strabismus aggravated by cataract surgery as the person would have developed adaptations (e.g. monofixation) for the strabismus which would be altered by surgery, when suddenly both eyes can see well. The “aggravation” would be that the improved vision would make binocular fusion issues more apparent. The examiner then noted that the Veteran “does indeed have an alternating vertical strabismus. However, since the diplopia did not occur until years after the surgery, it is unlikely related to the surgery itself.” The examiner did not provide an opinion as to the cause of the Veteran’s diplopia. The Board notes that the Veteran’s corrected distance vision prior to his June 3, 2013 left eye cataract surgery warranted a 10 percent rating. Although the first indication of corrected distance vision warranting a 10 percent rating was March 3, 2013, the Board will provide the 10 percent rating for the period on appeal prior to June 3, 2013. The treatment records from 2012 do not include findings on corrected distance vision. As the Veteran’s increased diabetes rating was filed on March 1, 2011, this is a grant of a 10 percent rating from March 1, 2011 to June 2, 2013. Following cataract surgery, the Veteran’s corrected distance vision improved, and no longer met the criteria for a compensable rating under DC 6066. The available VA and private treatment records additionally did not show that the Veteran had documented incapacitating episodes of cataracts requiring at least 1 but less than 3 treatments in a 12-month period (the criteria for a 10 percent rating under the General Rating formula). As such, a compensable rating for cataracts with diplopia due to visual acuity or incapacitating episodes for the period from June 3, 2013 is not warranted. Although the 2019/20 examiner provided a negative nexus opinion for the Veteran’s diplopia, the examiner noted that cataract surgery can aggravate strabismus by changing the developed adaptations prior to the surgery when binocular fusion of images improves with surgery. The examiner also notes that the Veteran had alternating vertical strabismus. It is not clear from the record when the Veteran’s diplopia occurred following his June 2013 surgery, as the Veteran did not seek treatment for almost five years after surgery. He did not report diplopia to the 2016 examiner, but he was also unclear in reporting when his diplopia was first noted following surgery. The Board will resolve reasonable doubt in the Veteran’s favor, and finds that his diplopia is an aggravation from his cataract surgery. Although the Board considers the diplopia as associated with the Veteran’s service-connected cataracts, a compensable evaluation is not warranted for his diplopia. Under DC 6090 for diplopia, a Note following the rating criteria states that, in accordance with 38 C.F.R. § 4.31, diplopia that was occasional or that was correctable with spectacles is evaluated at 0 percent. The above private treatment records and VA examination indicate that the Veteran’s diplopia was both intermittent (for part of the period on appeal) and correctable with prism spectacles. As such, currently a compensable rating for cataracts with diplopia is not warranted from June 3, 2013. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. H. Stubbs, 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.