Citation Nr: 22018956 Decision Date: 03/30/22 Archive Date: 03/30/22 DOCKET NO. 14-02 472 DATE: March 30, 2022 ORDER Entitlement to service connection for a corneal scar, as secondary to the service-connected herpes simplex keratitis of the right eye, is granted. REMANDED Entitlement to a compensable rating for herpes simplex keratitis of the right eye prior to March 25, 2019, is remanded. Entitlement to a disability rating in excess of 10 percent for herpes simplex keratitis of the right eye since March 25, 2019, is remanded. Entitlement to a disability rating in excess of 10 percent for residuals of a right thumb fracture is remanded. FINDING OF FACT The Veteran's corneal scar is proximately due to his service-connected herpes simplex keratitis of the right eye. CONCLUSION OF LAW The criteria for service connection for a corneal scar, as secondary to the service-connected herpes simplex keratitis of the right eye, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active military service from May 1988 to July 2008. The increased rating claims are on appeal from a July 2010 rating decision. The Board of Veterans' Appeals (Board) previously remanded the increased rating claims in February 2018, February 2020, and January 2021 for further development. Based on the evidence of record, the Board has added the issue of service connection for a corneal scar to the appeal as a residual of the service-connected herpes simplex keratitis of the right eye issue that is currently on appeal. 1. Entitlement to service connection for corneal scarring, as secondary to the service-connected herpes simplex keratitis of the right eye. The March 2019 VA examination shows the Veteran has a current diagnosis of a corneal scar. The March 2019 VA examiner opined that the Veteran's corneal scar is secondary to his history of herpes simplex keratitis of the right eye, which was diagnosed and treated during military service. There are no other nexus opinions of record. Upon review of the record, the Board finds the evidence supports that the Veteran's current corneal scar is proximately due to his service-connected herpes simplex keratitis of the right eye. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for a corneal scar is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Entitlement to a compensable rating for herpes simplex keratitis of the right eye prior to March 25, 2019, is remanded. 2. Entitlement to a disability rating in excess of 10 percent for herpes simplex keratitis of the right eye since March 25, 2019, is remanded. Unfortunately, there has not been substantial compliance with the Board's previous remand directives regarding the keratitis issues. The Board remanded these issues, in pertinent part, for the Veteran's VISTA Imaging records related to his eyes and dated since 2009 to be obtained and associated with the claims file. The Agency of Original Jurisdiction (AOJ) made several attempts to obtain these records, and received a negative reply in September 2021. However, the AOJ did not thereafter inform the Veteran of the unavailability of these records. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). Also, the March 2019 VA examiner determined that the Veteran's decreased visual acuity of the right eye was secondary to his corneal scar. The Board granted service connection for a corneal scar in this decision. The adjudication of this service connection issue by the AOJ, to include a possible eye and/or scar examination(s), could significantly impact a decision on the keratitis issues. Thus, the issues are inextricably intertwined. A remand of the keratitis claims is required. 3. Entitlement to a disability rating in excess of 10 percent for residuals of a right thumb fracture is remanded. At the March 2021 VA Hand and Finger examination, the Veteran reported numbness and tingling in his right thumb. To date, the Veteran has not been afforded a peripheral nerves examination. The Veteran should be provided an opportunity to report for a VA peripheral nerves examination to ascertain the current severity and manifestations of his service-connected residuals of a right thumb fracture. Also, at the March 2021 VA examination, the VA examiner found that the Veteran does not have any additional loss of function or range of motion after three repetitions during the observed repetitive use testing. The examiner then determined that the Veteran has loss of endurance with repetitive right hand and right thumb movements. These findings are contradictory, and another medical opinion is warranted upon remand. The matters are REMANDED for the following actions: 1. Inform the Veteran that his VISTA Imaging records related to his eyes and dated since 2009 are unavailable. Allow the Veteran the opportunity to submit his own copies of these records. 2. Adjudicate the grant of service connection for a corneal scar, as secondary to the service-connected herpes simplex keratitis of the right eye, as contained in this Board decision. 3. Schedule the Veteran for a peripheral nerve examination by an appropriate clinician to determine the current severity of his service-connected residuals of a right thumb fracture. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. 4. Obtain an addendum opinion from an appropriate clinician regarding the Veteran's service-connected residuals of a right thumb fracture. The examiner must attempt to provide a medical opinion regarding the degree of functional loss or range of motion, if any, during observed repetitive use. The examiner is asked to specifically discuss the March 2021 VA examiner's statement that the Veteran has loss of endurance with repetitive right hand and right thumb movements. If it is not possible to provide a specific measurement based on the evidence of record, the examiner should provide an estimate, if at all possible, of the additional impairment due to observed repetitive use based on the other evidence of record and the Veteran's statements. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). 5. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal, including the inextricably intertwined issues of entitlement to a compensable rating for herpes simplex keratitis of the right eye prior to March 25, 2019, and entitlement to a disability rating in excess of 10 percent for herpes simplex keratitis of the right eye since March 25, 2019. If the benefits sought are not granted to the Veteran's satisfaction, send the Veteran a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. K. R. Laffitte Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. M. Watkins, 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.