Citation Nr: 22017384 Decision Date: 03/24/22 Archive Date: 03/24/22 DOCKET NO. 16-56 517 DATE: March 24, 2022 REMANDED Entitlement to service connection for a left eye disability, to include as secondary to service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1964 to June 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in July 2012 by the Department of Veterans Affairs (VA) Regional Office (RO). In November 2021, the Veteran testified before the undersigned at a hearing. A transcript of that hearing has been associated with the record. Corneal scarring of the left eye is remanded. The Veteran asserts, generally, that he developed shingles, and then a herpes zoster rash on his face as a result of the shingles, as a result of his military service. Specifically, he contends that the conditions developed as a result of his service-connected diabetes and posttraumatic stress disorder (PTSD); or in the alternative, that these service-connected disabilities caused his immunity to lower, which in turn triggered the shingles and caused the rash on his face, and impairment to his left eye. See November 2021 Board Hearing Transcript p.16. The Veteran has a diagnosis of corneal scarring of the left eye at his March 2012 VA examination for the eyes. The Veteran is service connected for diabetes and PTSD. At his March 2012 VA examination, the examiner rendered an opinion that indicated the corneal scarring, a sequelae of the stromal keratitis which occurred in 2010, could be associated with the Veteran's previously diagnosed herpes zoster. Although the examiner's Google and Medline searches did not reveal any evidence of a direct link between PTSD and herpes zoster, he did note that herpes zoster often has an underlying inciting event, including trauma, advanced age, infection, irradiation, stress or chemical exposure. He also stated that immunocompromise is a common hallmark of herpes zoster patients. The examiner noted the Veteran's history could be associated with several of these factors, but he was unable to determine which one without resorting to speculation. No other medical opinion is of record. Accordingly, the Board has determined that a remand is necessary to obtain adequate medical opinions regarding whether the Veteran is entitled to service connection on an aggravation basis for a left eye disability. The matter is REMANDED for the following action: Obtain an addendum opinion by an appropriate examiner to determine the nature and etiology of the left corneal eye scarring. If determined necessary, an examination should be scheduled. The examiner should provide the following opinions: Is it at least as likely as not (50 percent or greater probability) that left corneal eye scarring was aggravated by the Veteran's service-connected diabetes or PTSD? Please explain why or why not. (Continued on the next page) If the examiner finds that the disability was aggravated, the examiner must identify the baseline level of the disability that existed before aggravation by the service-connected disability occurred. S. HENEKS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Nadia Kamal, 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.