Citation Nr: 21024205 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 15-00 707 DATE: April 22, 2021 REMANDED Entitlement to service connection for a bilateral eye disability. Entitlement to special monthly compensation (SMC) based on blindness in one eye, having only light perception. REASONS FOR REMAND The Veteran served on active duty from August 1968 to November 1971. This appeal comes to the Board from a September 2012 rating decision. The Veteran died in January 2013, and the appellant is his surviving spouse and substitute party. In September 2018 and July 2020, the Board remanded these claims to obtain a medical opinion on whether each diagnosed eye disorder was caused and/or aggravated by the Veteran’s service-connected heart disease. In the July 2020 remand order, the Board noted that aggravation in the secondary service connection context is defined as any increase in disability. See Ward v. Wilkie, 31 Vet. App. 233 (2019). In pertinent part, the Ward decision found that any incremental increase in disability (any additional impairment of earning capacity) in non-service-connected disabilities resulting from a service-connected condition regardless of its permanence may be a basis for secondary service connection under 38 C.F.R. § 3.310. While VA obtained an additional opinion in August 2020, it focuses on causation and does not address aggravation under Ward. Additionally, the Board finds the rationale for the opinion to be inadequate. While the examiner indicates hypertension caused retinal hemorrhages, it is not entirely clear from the opinion whether the hemorrhages resulted in any residuals that existed during the period at issue. The appellant’s representative argues the rationale is inadequate in the March 2021 Written Brief Presentation. VA should obtain additional opinions addressing these deficiencies before readjudicating the service connection claim and the intertwined SMC claim. The matters are REMANDED for the following actions: VA should obtain an addendum opinion from an appropriate medical professional addressing the claim for service connection for bilateral eye disabilities. VA should provide the examiner with a copy of the claims file and ensure the opinion addresses the following: 1. The VA eyes examiner should identify all disabilities of the eyes that affected the Veteran at any point in his life. The examiner should note the record shows the Veteran experienced retinal hemorrhages and cataracts. 2. The VA examiner should identify all residuals of the Veteran’s retinal hemorrhages and opine whether it is at least as likely as not (50 percent or greater probability) they caused or aggravated the Veteran’s other eye disabilities to include cataracts. The aggravation does not have to be permanent. It includes any incremental increase in the severity of the disability to include temporary worsening. 3. The VA examiner should opine whether the service-connected disabilities including coronary artery disease and associated hypertension at least as likely as not (50 percent or greater probability) caused or aggravated each eye disability. The aggravation does not have to be permanent. It includes any incremental increase in the severity of the disability to include temporary worsening. The examiner should consider medication side-effects. For example, did changes in the Veteran’s blood pressure associated with his hypertensive coronary artery disease affect his vision in any way? Even if the disabilities were mostly caused by other factors such as age and sun exposure, the Board must still determine whether the heart disease and hypertension made the conditions even slightly or temporarily worse. See Ward v. Wilkie, 31 Vet. App. 233 (2019). Michael Duffy Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Miller, 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.