Citation Nr: 21014884 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 14-24 633A DATE: March 16, 2021 REMANDED Entitlement to an initial rating in excess of 10 percent for blepharospasm is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1973 to February 1975, from December 1997 to September 1998, and from October 2004 to January 2006. In December 2019, the Board remanded this case for additional development. The Board finds that there has not been substantial compliance with the remand requests. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to an initial rating in excess of 10 percent for blepharospasm is remanded. In December 2019, the Board requested a medical opinion which addressed “all pertinent symptomatology and findings…to include frequency of spasms, duration of episodes of spasms, and any effect on peripheral vision.” A medical opinion was provided in January 2020. The Board finds the opinion incomplete. The examiner noted that blepharospasm interfered with vision and did not affect activities of daily living, driving, or work. The examiner did not explain how blepharospasm affected vision or reconcile the findings with the previous reports that blepharospasm affected driving and employment. The examiner was specifically asked to discuss whether blepharospasm had any effect on peripheral vision. Peripheral vision was not addressed in the report. The Board notes that a remand confers on the Veteran the right to compliance with the terms of that remand. Stegall v. West, 11 Vet. App. 268 (1998). Despite a cessation of Botox in 2012 and a December 2017 general medicine note which shows that left eye spasms had “almost resolved,” the Veteran stated in September 2019, that blepharospasm affected reading, driving, and facial communication. In January 2020, the Veteran stated that he had hemifacial spasms and “rapid blinking in both eyes.” The Board notes February 2009 records from a private physician and a January 2020 optometry record in which the Veteran reported that he was told that both eyes twitched but he had not noticed it. In December 2020, the Veteran’s representative asserted that blepharospasm affected depth perception. As those assertions have not been addressed, the Board finds additional VA examination is necessary. The matter is REMANDED for the following action: 1. After obtaining any necessary releases, obtain all relevant VA and private treatment records not already associated with the claims file. All attempts to locate records must be documented in the claims file. 2. Schedule the Veteran for a VA examination to determine the current severity of service-connected left blepharospasm. The examiner must review the claims file, to include a copy of this Remand, and should note that review in the report. All necessary testing should be conducted. A clearly stated rationale with references to the record, diagnostic tests, medical literature, etc. should be provided. The examiner should provide the following information: (a.) Discuss whether blepharospasm affects peripheral vision, depth perception, driving, or employment. The examiner must solicit enough information from the Veteran to clearly explain, in detail, all functional impairment. In addition to the Veteran’s lay statements, the examiner should discuss the significance, if any, of the termination of Botox use, and medical records which show an improvement in the disability. (b.) Discuss whether there is a diagnosis of any other facial tics. The examiner must discuss the assertions of hemifacial spasms and bilateral rapid eye blinking. (c.) Describe all pertinent symptomatology and findings of all relevant muscular or neurological disabilities diagnosed, to include blepharospasm. For each diagnosis, the examiner should note the muscle groups involved; frequency and duration of symptoms; and whether symptoms are mild, moderate, or severe. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E.O., 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.