Citation Nr: 21031321 Decision Date: 05/21/21 Archive Date: 05/21/21 DOCKET NO. 17-48 069A DATE: May 21, 2021 REMANDED Service connection for vision loss (previously claimed as glaucoma), to includes as due to exposure to contaminated water at Camp Lejeune, is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1960 to February 1964. He also has additional reserve service in the United States Marines Corps from June 1964 to February 1966 and as an Army Reservist from 1972 through 2001. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2016 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in March 2019 and was remanded for additional development. The case is once again before the Board. The Veteran maintains that his glaucoma is related to his service. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active duty. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). In addition, a disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. 38 C.F.R. § 3.310(a). Active service includes active duty, any period of active duty for training (ACDUTRA) during which the individual concerned was disabled or died from a disease or injury incurred or aggravated in line of duty, and any period of inactive duty training (INACDUTRA) during which the individual concerned was disabled or died from an injury incurred or aggravated in line of duty. 38 C.F.R. § 3.6(a). In April 2020, a VA examiner found the Veteran's glaucoma less likely than not related to his exposure to contaminated water at Camp Lejeune. The examiner reasoned that the medical literature did not support a relationship between glaucoma and the toxins which the Veteran was exposed. See April 2020 Camp Lejeune contaminated water opinion. In July 2020, a VA examiner found it was less likely than not that the Veteran's glaucoma incurred in or was caused by his service. The examiner stated that glaucoma was less likely than not caused by the work the Veteran performed on a day to day basis during service and more likely related to his genetic predisposition for the condition. The examiner then stated that the Veteran's eye conditions are as likely as not incurred in or caused by service because they developed when the Veteran was a reservist. The July 2020 examiner also stated that the Veteran was involved in a motor vehicle accident in 1992 that resulted in enucleation of the right eye and monocular left eye. Although attempts were made to verify whether the Veteran was on active duty for training or inactive duty for training on November 4, 1992, such efforts have been unsuccessful so far. However, it does not appear that information from the Veteran's Master Pay Account was sought. With respect to the Veteran's glaucoma, the July 2020 examiner also stated that the Veteran was diagnosed with glaucoma in October 1998 which would support the diagnosis during his time in the reserves. However, it is unclear if the Veteran was on active duty at this time. Moreover, the date of onset is unclear. Specifically, although the examiner indicated that the Veteran was diagnosed in October 1998, an August 17, 1987 treatment record from the Henry Ford Hospital documents that there is no evidence that the Veteran has glaucoma but a September 22, 1988 treatment record from the same facility indicates that he is being treated by an ophthalmologist for glaucoma. Service treatment records document that the Veteran denied having eye problems the following year. As the date of onset for the Veteran's glaucoma is unclear, the Veteran should be asked to submit or authorize VA to obtain records from the ophthalmologist referenced above. The examiner noted that he was unable to determine when he was diagnosed with cataracts and an opinion on the cataract and pseudophakia of the left eye could not be provided. On remand, the Veteran should be requested to supply additional information on his cataract treatment. Additionally, verification of the Veteran's service is necessary. The Veteran's medical records indicate that the Veteran's glaucoma was first diagnosed in 1988. The Veteran was a reservist during that time; thus, verification of whether he served a period of ACDUTRA or INACDUTRA corresponding with this claim is also necessary. The matter is REMANDED for the following action: 1. Obtain verification of any period (specific dates) of the Veteran's ACDUTRA and INACDUTRA service with the Marines Corp reserves and Army Reserves on November 4, 1992, to include obtaining a copy of his Defense Joint Military Pay System-Reserve Component Master Military Pay Account for the relevant period. If the information is not available, the record should be documented as such. 2. Request that the Veteran submit, or authorize VA to obtain, his 1987-1988 medical records from the ophthalmologist who treated him for glaucoma as well as any treatment records related to his cataracts. 3. Arrange for an appropriate health care provider to review the Veteran's claims file and provide an opinion as to the nature and likely etiology of the Veteran's glaucoma. The examiner should indicate whether there is clear and unmistakable evidence that the Veteran entered service with a preexisting eye disability consistent with glaucoma. If the examiner finds it clear and unmistakable that he had a preexisting eye disability, the examiner must also provide an opinion as to whether it is clear and unmistakable that the disability did not undergo a worsening beyond the normal progression of the disability during active duty. The examiner's attention is drawn to the Veteran's February 1960 entrance examination and 1971 diagnosis of iritis. If the examiner does not find that he entered service with a preexisting disability, then the examiner must address whether it is at least as likely as not (a 50 percent probability or greater) the Veteran's currently diagnosed glaucoma began during, is etiologically related to, or was worsened by, any verified period of ACDUTRA or any incident therein. 4. After undertaking any additional development deemed appropriate and giving the Veteran full opportunity to supplement the record, adjudicate the Veteran's pending claim in light of any additional evidence added to the record. If any benefit sought on appeal remains denied, the Veteran and his representative should be furnished with a Supplemental Statement of the Case and be afforded the applicable opportunity to respond before the record is returned to the Board for further review. M. Donohue Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E.V. Palatt, 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.