Citation Nr: 21026135
Decision Date: 04/29/21	Archive Date: 04/29/21

DOCKET NO. 15-45 337
DATE: April 29, 2021

REMANDED

Entitlement to service connection for a bilateral eye disability (to include glaucoma, cataracts, and uveitis) is remanded.

Entitlement to service connection for diabetes mellitus, as secondary to the bilateral eye disability, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from February 1978 to February 1981.

This case is before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO).

In January 2019, the Veteran testified at a Board videoconference hearing.  The transcript of the hearing has been associated with the record.

The Board remanded this matter for further development in June 2019 and in August 2020.  A Board remand confers on the Veteran, as a matter of law, the right to compliance with the remand orders.  Stegall v. West, 11 Vet. App. 268, 271 (1998). 

Unfortunately, although the Veteran was provided with an additional VA medical opinion regarding her service connection claim for diabetes mellitus, an addendum etiological opinion considering the comprehensive record was not obtained.

1. Bilateral eye disability (to include glaucoma, cataracts, and uveitis).

The October 2019 VA examination and opinion is inadequate and has no probative value as it failed to consider or address the Veteran’s in-service complaints of eye trouble as recorded in the Service Treatment Records associated with the record in May 2015 and as the Veteran has noted, including during the Board hearing.  The factual basis upon which a medical opinion rests is essential.  See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that a medical opinion based upon an inaccurate premise has no probative value).  Another remand is required.

2. Diabetes mellitus.

The Board finds that the claim of service connection for diabetes mellitus is inextricably intertwined with the service connection claim for a bilateral eye disability.  Indeed, a February 2021 VA examiner opined the Veteran’s diabetes mellitus was at least as likely as not secondary to her bilateral eye disability specifically, that her continuous steroid use for her bilateral eye disability caused her blood sugar and A1C level to rise, which led to the development of diabetes. Accordingly, consideration of the matter is deferred.  See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (stating that two issues are “inextricably intertwined” when they are so closely tied together that a final Board decision on one issue cannot be rendered until the other issue has been considered).

The matters are REMANDED for the following action:

Obtain an addendum medical opinion concerning the nature and etiology of the Veteran’s bilateral eye disability (to include glaucoma, cataracts, and uveitis).  The file must be made available.  To this end, the examiner must consider and discuss the Veteran’s in-service complaints of eye pain, blurred vision, and sensation of a foreign body under the lids, and treatment shortly after service in August 1981 for a detached retina and retrobulbar optic neuritis.  A rationale should be provided for any opinion offered.

 

 

R. FEINBERG

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	S. Costa, 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.