Citation Nr: 21015625 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 14-16 180 DATE: March 18, 2021 REMANDED Entitlement to service connection for chorioretinitis of the left eye is remanded. Entitlement to service connection for left eye retinal scarring, to include as secondary to chorioretinitis is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from January 1968 to December 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared before the undersigned Veterans Law Judge (VLJ) in a Travel Board hearing in November 2016. A transcript of the hearing has been associated with the record. 1. Entitlement to service connection for chorioretinitis of the left eye is remanded. 2. Entitlement to service connection for left eye retinal scarring, to include as secondary to chorioretinitis is remanded. The above-captioned claims were last before the Board in December 2019, at which time they were remanded to issue a Supplemental Statement of the Case (SSOC). A SSOC was issued in July 2020. The Board finds that remand is necessary to afford the Veteran an addendum medical opinion. The Veteran was afforded a VA examination in July 2018. The examiner concluded that the Veteran’s claimed retinal scarring was a separate disability that was caused by his claimed chorioretinitis. However, the examiner opined that the Veteran’s chorioretinitis was not related to active service, to include as due to: a February 1968 upper respiratory infection; exposure to black fly or onchocerciasis; documented diminution in left eye visual acuity shown between entrance and separation examinations; or any organic disease of the nervous system. In relation to the Veteran’s medical history, the July 2018 examiner noted that the Veteran was diagnosed with histoplasmosis, but indicated that the date of the diagnosis was unknown. In the medical opinion rendered, the examiner did not address the diagnosis of histoplasmosis. The examiner also separately noted that the Veteran had a dramatic loss of visual acuity in the left eye following service in August 1970. The examiner did not associate the loss of visual acuity with any condition in the medical evidence of record or further comment as to whether or how such a rapid loss in vision was related to the Veteran’s currently claimed conditions. A review of the claims file shows that the Veteran was treated in relation to his left eye in August 1970 and was diagnosed with histoplasmosis only 9 months after separation from active service. Additionally, the same August 1970 treatment record shows that the Veteran’s vision was noted to have diminished to 20/200 in relation to the diagnosis of histoplasmosis. See Medical Treatment Record, Non-Government Facility, submitted December 21, 2016. In this case, given that that the July 2018 opinion was rendered without knowledge that the Veteran’s diagnosis of histoplasmosis and related rapid diminution in vision simultaneously occurred within 9 months from separation from active service, the Board finds that the opinion reached was based on an inaccurate factual premise. Additionally, as the examiner did not comment as to whether the histoplasmosis and related rapid diminution in vision in the left eye were related to the Veteran’s currently claimed left eye conditions, the Board likewise finds that the July 2018 opinion is incomplete for adjudicative purposes. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Thus, the Board finds that the Veteran should be afforded an addendum medical opinion on remand. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician to determine the nature and etiology of the Veteran’s chorioretinitis and retinal scarring of the left eye. The electronic claims file must be made available to and be reviewed by the examiner. The examiner is asked to provide an opinion as to the following: a.) Whether it at least as likely as not (50 percent probability or greater) that the Veteran’s treatment for histoplasmosis and related rapid diminution in vision in August 1970 is related to active service. b.) If so, whether it at least as likely as not (50 percent probability or greater) that the Veteran’s chorioretinitis and/or retinal scarring are related to the August 1970 treatment for histoplasmosis and related rapid diminution in vision. (Continued on the next page)   c.) Whether it at least as likely as not (50 percent probability or greater) that the Veteran’s histoplasmosis represents an “organic disease of the nervous system”? If so, please describe the nature and severity of that condition as reflected in the record and in history provided by the Veteran in the year following his separation from service. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Marsh II, 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.