Citation Nr: 22018011
Decision Date: 03/27/22	Archive Date: 03/27/22

DOCKET NO. 09-47 900
DATE: March 27, 2022

REMANDED

Entitlement to service connection for an eye/vision disability, to include as secondary to service-connected traumatic brain injury/head injury is remanded.

REASONS FOR REMAND

The Veteran served on active duty from August 1964 to August 1968. 

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision dated in October 2007 by a Department of Veterans Affairs (VA) Regional Office (RO).

This matter was previously denied in an August 2017 Board decision. The Veteran timely appealed and pursuant to a Joint Motion for Remand, (JMR) the Court of Appeals for Veterans Claims (Court) issued an order in July 2018, vacating the Board decision and remanded it for further action. This case was returned to the Board and where it was remanded for additional development in February 2019 and August 2020. 

Service connection for an eye/vision disability, to include as secondary to service-connected TBI/head injury is remanded.

The Veteran contends his vision disabilities are due to his service-connected TBI and migraine headaches. 

In its August 2020 remand, the Board found that the February 2020 VA medical opinion failed to provide a medical opinion that clearly addressed whether eye disability was aggravated by service connected disability.  The opinion also did not meaningfully address the Veteran's lay statements regarding worsening vision during migraines. The Board instructed the RO to obtain an addendum opinion.

A subsequent December 2021 report includes another confusing opinion indicating an eye condition is proximately due to a service connected condition, but the rationale does not correspond with that conclusion.  

In addition, the 2018 Joint Motion/Court Order, indicated it was necessary to address whether any of the Veteran's service connected disabilities aggravated the Veteran's eye disabilities.  This was not fully accomplished.  Unfortunately, another opinion is necessary 

The matters are REMANDED for the following action:

1.  Provide the claims file to an appropriate clinician who should offer an opinion as to the following: 

a.) whether any of the Veteran's identified eye disabilities (dry eye; cataracts/pseudophakia; macular degeneration) have increased in severity due to the Veteran's service connected: 

i. migraine-tension headaches; 

ii. TBI with vertigo;

iii. respiratory failure; 

iv. diabetes mellitus, type II;

v. left lower extremity peripheral neuropathy;

vi. right lower extremity peripheral neuropathy;

vii.  hearing loss; or

viii. GERD.  

b.) whether the Veteran has vision changes associated with the "migraine-tension headache" disability, and if so, whether the changes may be properly considered a component of a characteristic prostrating attack of migraine headache disability.  

If vision changes associated with migraine-tension headaches are not a component of a characteristic prostrating attack of migraine headache disability, the functional impairment these vision changes produce should be described.   

The examiner should include the reasoning supporting the conclusions expressed.  

2.  Re-adjudicate the appeal.  

 

M. KILCOYNE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	B. Jaigirdar, 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.