Citation Nr: 21024697 Decision Date: 04/23/21 Archive Date: 04/23/21 DOCKET NO. 16-20 443 DATE: April 23, 2021 REMANDED Entitlement to service connection for right eye disorder, to include as secondary to the Veteran's service-connected headaches and blurred vision of the left eye is remanded. Entitlement to total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from November 1973 until his honorable discharge in September 1976. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a July 2016 rating decision by the Regional Office (RO) of the United States Department of Veterans Affairs (VA). In October 2019, the Board remanded the case to the RO for further development. Specifically, the Board directed the RO to obtain an opinion on whether “any currently diagnosed right eye disorder was caused by the Veteran’s service-connected left eye disorder. In response, in January 2020, the RO obtained an opinion that the Veteran’s right eye disorders are less likely than not (less than 50 percent probability) due to or the result of the Veteran’s service-connected left eye disorder because there is no diagnosis of a left eye disorder. In June 2020, the Board remanded the case to the RO again for further development. Specifically, the Board directed the RO to because the January 2020 opinion was based upon an inaccurate rationale that the negative nexus opinion was because the Veteran did not have a left eye disability, despite being service connected for a left eye disability. As will be addressed in greater detail below, the Board finds that there has not been substantial compliance with the Board’s previous remand directives regarding the issue on appeal and the case must once again be remanded to the RO. Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Entitlement to service connection for right eye disorder, to include as secondary to the Veteran's service-connected headaches and blurred vision of the left eye is remanded. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives regarding the issue of entitlement to service connection for right eye disorder, to include as secondary to the Veteran’s service-connected headaches and blurred vision of the left eye. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). Where VA provides the veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board notes that the January 2021 VA examiner clearly believes that the Veteran’s right eye disorder is not related to the Veteran’s service nor his left eye disabilities. However, the January 2021 VA examiner failed to provide a detailed rationale to support all of the opinions provided. The RO obtained an addendum opinion in January 2021. The January 2021 VA examiner opined that the claimed condition is less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s service-connected condition. Within the “rationale” portion of the Medical Opinion disability benefits questionnaire (DBQ), the January 2021 VA examiner opined: (a) Corneal guttata right eye: Less likely than not (less than 50 percent probability) due to the result of the Veteran’s service-connected headaches and blurred vision of the left eye disorder. The Board notes that there is no rationale to this conclusory opinion. (b) Iris/Pupil Sphincter Tear right eye: Less likely than not (less than 50 percent probability) due to the result of the Veteran’s service-connected headaches and blurred vision of the left eye disorder. Less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran’s service-connected left eye disorder. Veteran had a pupil sphincter tear as a result of his retinal surgery from retinal detachment repair per the Veteran and records. The Board notes that there is no rationale to these conclusory opinions as well. (c) Pseudophakia right eye: Less likely than not (less than 50 percent probability) due to the result of the Veteran’s service-connected headaches and blurred vision of the left eye disorder. Less likely than not (less than 50 percent probability) due to or the result of the Veteran’s service-connected left eye disorder. Veteran’s multiple retinal surgeries to repair his retinal detachment is what led to cataract progression. The Board notes that there is no rationale to these conclusory opinions as well. The Board notes that simply asserting successive conclusory statements does not result in a detailed rationale. A detailed rationale must include an explanation as to the basis of the conclusions of the examiner in order to support the opinion(s) provided by the examiner, to include citation(s) to medical literature to support the conclusions and/or the evidence of record where appropriate – not simply providing additional conclusory statement(s). 2. Entitlement to TDIU is remanded. The Board is cognizant of the ruling of the United States Court of Appeals for Veterans Claims (Court) in Rice v. Shinseki, 22 Vet. App. 447 (2009). In Rice, the Court held that a claim for a TDIU due to service-connected disability either expressly raised by the Veteran or reasonably raised by the record, involves an attempt to obtain an appropriate rating for a disability and is part of the claim for an increased rating. In this case, in May 2019, the Veteran submitted a medical report that has asserted that the Veteran is unemployed and unemployable due to his service-connected disabilities. See April 2019 Correspondence (received May 1, 2019). The Board finds that the issue of entitlement to a TDIU has been raised by the record and must be remanded for proper development pursuant to Rice. The RO has not addressed the issue of entitlement to a TDIU in the first instance. The matters are REMANDED for the following action: 1. After any additional records are associated with the claims file, obtain an addendum opinion regarding the etiology of the Veteran’s right eye disability from a VA examiner. The entire claims file must be made available to and be reviewed by the examiner. If an examination is deemed necessary, it shall be provided. An explanation for all opinions expressed must be provided. The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s right eye disability had onset in, or is otherwise related to, active service including but not limited to secondary to his service-connected headaches and blurred vision of the left eye disability. The examiner must specifically address the following: Was the Veteran’s right eye disorder caused by or permanently aggravated beyond its natural progression by his service-connected headache or left eye disabilities? In rendering this opinion, the examiner must address the Veteran’s contentions that his exposure to high G-forces during flight training beginning in November 1973 caused tissue damage to his right eye, which caused or exacerbated the later August 2007 right retinal tear. The examiner must discuss any scientific evidence submitted by the Veteran in support of this assertion. The examiner must provide a detailed rationale for each and every opinion rendered. 2. After the above has been completed, complete any development necessary regarding the claim of entitlement to a TDIU and adjudicate the claim in the first instance based on any responses provided by the Veteran or evidence submitted by the Veteran or his representative. M. Tenner Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Deemer, 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.