Citation Nr: 21039721 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 16-47 657 DATE: July 1, 2021 REMANDED Entitlement to service connection for a right eye disability is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for diverticulosis, to include diverticulitis, is remanded. Entitlement to service connection for gastroenteritis is remanded. REASONS FOR REMAND The Veteran had active military service from May 1979 to May 1999. This matter comes to the Board of Veterans' Appeals (Board) on appeal from May 2013 and July 2014 rating decisions issued by the Department of Veterans Affairs. The Board has recharacterized the Veteran claim of diverticulitis, to diverticulosis, as reflected on the title page to include consideration of all the related conditions reasonably raised by the record. See Clemons v. Shinseki, 23 Vet. App. 1, 6 (2009). 1. Entitlement to service connection for a right eye disability is remanded. The Veteran presented for a VA examination in November 2019. The Veteran was diagnosed with bilateral anatomical narrow angles. The examiner opined that this condition was not related to service, as it is genetic in nature with no ocular pathology, and that the cornea completely recovered from the scar abrasion in August 1982. In response to this examination and subsequent August 2020 supplemental statement of the case (SSOC), the Veteran submitted a statement. See August 2020 Correspondence. In the statement he emphasized that his claim was specifically regarding his conceded right eye injury he sustained during active duty while welding and/or a blow to the eye, noting a subsequent growth, indicating it may or may not be cancerous. He also indicated that further testing was to be done and emphasized that his claim was about the loss of vision in his right eye and the growth in his right eye since 2013. He also argues the validity of the examination, but the Board need not address this claim as he is not prejudiced in this regard as the Board is remanding this claim. The Board finds thee November 2019 VA examination inadequate, as it does not address the most essential reason for the claim; whether any current diagnosis, i.e., a corneal abrasion or choroidal nevus, is related to the Veteran's conceded right eye injury incurred during service. As such, the matter is remanded to seek an addendum opinion. Barr v. Nicholson, 21 Vet. App. 303, 310-11 (2007). Any updated and private treatment records should also be secured, to include any subsequent testing, treatment, or examinations the Veteran has received regarding his right eye condition. 2. Entitlement to service connection for hypertension is remanded. The Veteran presented for a VA examination in December 2019. The examiner opined that the Veteran's hypertension was not related to service and reasoned that the isolated documentation of high blood pressure did not meet the criteria for a diagnosis of hypertension and that it is most likely idiopathic. The Board notes that if hypertension is manifested in service, or symptoms begin in service, and there is continuity of symptomatology, it is irrelevant if the cause of hypertension is unknown. The Board finds that the examiner did not opine as to the elevated readings during service, to include whether they were initial manifestations of hypertension in service. An addendum opinion is needed to address these findings and deficiencies. 3. Entitlement to service connection for diverticulosis, to include diverticulitis, is remanded. 4. Entitlement to service connection for gastroenteritis is remanded. The Veteran presented for VA examinations for his diverticulitis and gastroenteritis in November 2019. As the record indicates diagnoses during the appeal period for diverticulitis and gastroenteritis, these conditions, and thus current disabilities, are conceded by the Board. See March 2014 VA examination. Due to the November 2019 VA examiner opining on the Veteran's diverticulosis, as opposed to the Veteran's diverticulitis, the claim is simultaneously expanded and found to be inadequate due to the same, as the VA examiner did not address the Veteran's original claim of diverticulitis in rendering the opinion. As the record, including the November 2019 VA examination notes a diagnosis of diverticulosis, that diagnosis is conceded by the Board as well. The Board also finds that the examiner did not actually opine on the Veteran's gastroenteritis. In response to this examination and subsequent August 2020 SSOC, the Veteran submitted a statement. See August 2020 Correspondence. In that statement the Veteran references the notations of diverticulitis, chronic abdominal pain, and gastroenteritis the service treatment records and post-service treatment records that were not addressed by the examiner, emphasizing that he has that the same symptomatology since service and continuing to today. It is for the outlined reasons that addendum opinions are warranted on remand. See Barr, supra. Any updated treatment records should also be secured. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. With any necessary assistance from the Veteran, obtain any outstanding relevant private treatment records, to include from Emory Eye Center and CHS Surg Eye Retina MD 4, including any treatment notes (i.e., ultrasound) from 2013 and January 2021, respectively. 3. Then obtain an addendum opinion from a VA examiner(s), as to the etiology of the Veteran's right eye disorder. The claims file should be made available to and should be reviewed by the examiner. No additional examination of the Veteran is necessary, unless the examiner determines otherwise. The examiner must provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's current right eye disorder began during active service or is related to an incident of service, to include: (a) a corneal abrasion to the right eye due to an August 1982 welding accident, which caused vision loss on his right eye and/or (b) the growth on the backside of his eye/choroidal nevus due to the same. In addressing this question, the examiner must discuss and accept as true the Veteran's statement that he has had vision loss as a continuation of his in-service eye injury, beginning in service and since he separated from service, and determine whether a relationship between his current diagnoses and in service injury is "medically plausible". See August 2020 Correspondence. Please also respond to the Veteran's statements contained in his August 2020 correspondence. 4. Obtain an addendum opinion from a VA examiner as to the etiology of the Veteran's hypertension. The claims file should be made available to and should be reviewed by the examiner. No additional examination of the Veteran is necessary, unless the examiner determines otherwise. For diagnosed hypertension, the examiner must opine as to whether it is at least as likely as not (a 50 percent or greater probability) that such disorder had its onset during active service or is otherwise related to the Veteran's service, to include elevated blood pressure readings during service, which should be discussed. Please note that it only need be found that the hypertension manifested during service or that there is continuity of symptomatology since service to establish service connection, not that there be a specific etiology for the disability. 5. Obtain an addendum opinion from a VA examiner as to the etiology of the Veteran's conceded diagnoses of diverticulosis, diverticulitis, and gastroenteritis. The claims file should be made available to and should be reviewed by the examiner. No additional examination of the Veteran is necessary, unless the examiner determines otherwise. For diagnosed diverticulosis, diverticulitis, and gastroenteritis, the examiner must opine as to whether it is at least as likely as not (a 50 percent or greater probability) that such disorder had its onset during active service or is otherwise related to the Veteran's service. In addressing this question, the examiner must discuss and accept as true the Veteran's lay statements regarding the onset and continuity of his symptoms and treatment for nausea, vomiting, abdominal pain, and stomachache pain, with the onset in service and continuing since separation from service and determine whether a relationship between his current diagnoses and symptoms in service are "medically plausible". See Service Treatment Records; August 2020 Correspondence. Please also respond to the Veteran's statements contained in his August 2020 correspondence. 6. Then, readjudicate the claims on appeal. Romina A. Casadei Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. J. Rogers, 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.