Citation Nr: 21025128 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 16-23 264 DATE: April 27, 2021 REMANDED Entitlement to a compensable evaluation of left eyelid myokymia with epiphora is remanded. REASONS FOR REMAND The Veteran served on active duty from February 2003 to February 2004. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision. The Board remanded the issue on appeal for further development in August 2019. There has not been substantial compliance with the remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to a compensable evaluation of left eyelid myokymia with epiphora is remanded. When the Secretary undertakes to provide a veteran with a VA medical examination or opinion, it must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Thus, while further delay is regrettable, the Board finds that a new VA examination is needed to properly rate the Veteran’s left eyelid myokymia with epiphora. In this case, it appears that the Veteran was administered an improper examination for his left eyelid disability. Pursuant to the Board’s August 2019 remand, the Veteran was afforded a new VA examination in December 2019; however, the examination for “eye conditions” did not evaluate paralysis of the seventh cranial nerve, which is necessary to contemplate the rating criteria for the Veteran’s left eyelid disability under diagnostic code 8207. An assessment is needed regarding whether the Veteran’s disability presents with an incomplete or complete paralysis and if so, the level of severity. The examination previously administered did not make these assessments and thus is inadequate for rating purposes. In requesting a new VA examination, the Board encourages the RO to consider whether the Veteran’s left eyelid twitch would be more accurately rated under diagnostic code 8103, as his primary symptom – twitch is interchangeable with ‘tic.’ The matter is REMANDED for the following action: 1. The RO should reconsider the current diagnostic code (DC) assigned to the Veteran’s left eyelid myokymia with epiphora, currently rated under DC 8207 and assess whether DC 8103 is more appropriate. 2. Once the above development is complete, schedule the Veteran for a VA examination with an appropriate clinician for his left eyelid myokymia with epiphora. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner is asked to solicit from the Veteran the severity of his left eyelid disability along with its frequency and duration per episode, specifically, the examiner should note if the Veteran has complete or incomplete paralysis, and if incomplete, whether it is moderate or severe. A. J. Spector Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Telamour, 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.