Citation Nr: 21013320 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 03-12 995 DATE: March 9, 2021 ORDER Entitlement to service connection for chalazion of the left eye, as secondary to service-connected retinal detachment, bilateral, visual field loss, is granted. FINDING OF FACT After affording the Veteran the benefit of the doubt, the Veteran’s chalazion of the left eye was caused by his service-connected retinal detachment, bilateral, visual field loss. CONCLUSION OF LAW The criteria for entitlement to service connection for chalazion of the left eye, as secondary to service-connected retinal detachment, bilateral, visual field loss have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1979 to June 1997. In an August 2017 decision, in pertinent part, the Board denied service connection for chalazion of the left eye, including as secondary to service-connected sickle cell retinopathy. The Veteran appealed the decision to the U.S. Court of Appeals for Veterans Claims (Court). In an Order dated in June 2018, pursuant to a Joint Motion for Partial Remand (Joint Motion), the Court vacated the Board’s August 2017 decision as to the issue of entitlement to service connection for chalazion of the left eye as secondary to service-connected sickle cell retinopathy and remanded the issue to the Board. In December 2018, when the case came back to the Board, it remanded the claim for a medical opinion to determine if the chalazion was caused or aggravated by the service-connected sickle cell retinopathy. An eye opinion was obtained in November 2019, and a supplemental statement of the case was issued in July 2020. In an October 2019 rating decision, the agency of original jurisdiction recharacterized the service-connected sickle cell retinopathy as retinal detachment, bilateral, visual field loss. Thus, that is the characterization that the Board will use for the service-connected disability. In December 2020, the Veteran provided testimony before the undersigned Veterans Law Judge at a virtual hearing. A transcript of the hearing is of record. The Board observes that the Veteran does not dispute the adequacy of the VA examination reports relied upon by the August 2017 Board decision as to the matter of direct service connection for chalazion of the left eye. Although the June 2018 Joint Motion vacated the issue of entitlement to service connection for chalazion of the left eye, including as secondary to service-connected sickle cell retinopathy, the Board observes that the Joint Motion does not dispute the Board’s finding that the Veteran’s chalazion was not incurred in or aggravated by the Veteran’s military service. As such, the Board finds that the Veteran has effectively conceded that the Board’s August 2017 decision was correct as to this point and thus, the Board recharacterized the issue as stated below. Entitlement to service connection for chalazion of the left eye, as secondary to service-connected retinal detachment The Veteran contended that his chalazion of the left eye was caused by his service-connected retinal detachment, bilateral, visual field loss. See December 2020 hearing. Service connection may be granted for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). When service connection is established for a secondary disability, the secondary disability shall be considered a part of the original disability. Id. 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). When all the evidence is assembled, the Board is then responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Board has carefully reviewed the evidence of record and finds that, resolving all reasonable doubt in favor of the Veteran, service connection for chalazion of the left eye is warranted. The reasons follow. Regarding the first element of secondary service connection, the record shows that the Veteran was diagnosed with chalazion of the left eye during the appeal. For example, the underwent left-eye chalazia excisions in August 2015, September 2016, April 2017, December 2017, and May 2019. An October 2019 VA examination shows that the Veteran was diagnosed with left eye chalazion. Thus, the facts establish that the first element of secondary service connection is met. Regarding the second element of secondary service connection, i.e., whether the Veteran’s left eye chalazion was proximately caused by or proximately aggravated by a service-connected disability, the record includes VA medical opinions in July 2015, July 2016, and October 2019 VA examinations, and a January 2021 private medical opinion discussing the causal connection between the left eye chalazion disability and the service-connected retinal detachment, bilateral, visual field loss. The July 2015 VA examiner stated the chalazion is not secondary to sickle cell retinopathy. The July 2016 VA examiner provided a rationale for that opinion, and stated chalazion occurs when the oil glands in the eyelid become congealed and the oil secretions "back up;" these blockages occur in association with acne, seborrhea, allergies, dry eyes, poor hygiene, and improper use of make-up, not sickle cell disease. The October 2019 VA examiner stated a chalazion is not secondary or aggravated by sickle cell retinopathy due the underlying evidence of chalazion not having a pathophysiological relationship to sickle cell. At the December 2020 hearing, the Veteran explained that he was not alleging that the chalazion was caused by the sickle cell retinopathy, but that because of his eye discomfort from the service-connected disability, he would rub his left eye, and it was the rubbing of his left eye that caused him to develop a chalazion. Following the hearing, the Veteran proffered a January 2021 medical opinion from a private provider that offered an alternative explanation for how a chalazion could be caused by the Veteran’s service-connected eye disability. The provider stated the Veteran’s chalazia were not caused by sickle cell, but ocular discomfort and eye rubbing can predispose him to these issues. As stated above, the Veteran testified that his service-connected eye disability causes him to frequently rub his eyes. The Veteran is competent to establish the presence of observable symptomatology such as his eye rubbing. Also, given his significant history of eye disability of bilateral retinal detachment and surgeries going back to when service connection was first established in July 1997, the Veterans testimony of rubbing his eyes frequently is credible. Given this evidence, and after affording the Veteran the benefit of the doubt, the Board concludes the evidence is at least in equipoise in showing that his left eye chalazion was caused by the service-connected retinal detachment, bilateral, visual field loss. Thus, service connection for chalazion of the left eye is granted. A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Patton 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.