Citation Nr: 22019101 Decision Date: 03/31/22 Archive Date: 03/31/22 DOCKET NO. 19-23 775 DATE: March 31, 2022 REMANDED Service connection for bilateral cataracts is remanded. REASONS FOR REMAND The Veteran was a member of the Army National Guard (ARNG) and was on active duty for training (ACDUTRA) from August 1974 to December 1974. This matter is before the Board of Veterans' Appeals (Board) on appeal from an October 2016 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran and his son provided testimony at a hearing before the undersigned Veterans Law Judge in December 2020; a transcript of the hearing is associated with the claims file. This matter has been remanded by the Board two times previously to obtain VA examinations and medical opinions, most recently in December 2021. Service connection for dry eye with bilateral meibomitis and tylosis, secondary to eczema, was granted in a January 2022 rating decision. As this was a full grant of the issue on appeal, that matter is no longer before the Board. Grantham v. Brown,114 F.3d 1156, 1158 (Fed. Cir. 1997). A remand by the Board confers upon the Veteran, as a matter of law, the right to compliance with the remand instructions and imposes upon the VA a concomitant duty to ensure compliance with the terms of the remand. Stegall v. West, 1 Vet. App. 268, 271 (1998). Where the remand orders of the Board are not complied with, the Board errs as a matter of law when it fails to ensure compliance. As such, another remand is warranted. Once VA undertakes to provide an examination, VA must provide an adequate examination and opinion. Barr v. Nicholson, 21 Vet. App. 303 (2007). In the December 2021 remand, the Board directed the VA examiner to provide an addendum opinion as to whether the Veteran's cataracts were at least as likely as not caused or aggravated by service or the Veteran's service-connected disabilities. In addition, the examiner was directed to consider whether treatment, including Clotrimazole, for any of the Veteran's service-connected disabilities caused or aggravated any currently diagnosed eye conditions. The examiner was directed to provide a full and complete rationale for all opinions. The VA examination provided an addendum opinion in January 2022. In it, the examiner concluded that the Veteran's cataracts were not caused or aggravated by his service-connected conditions, including madarosis with loss of eyelashes and eyebrows. His rationale for both conclusions was that cataracts are an age-related eye condition and the Veteran's cataracts are caused by aging. These new nexus opinions are inadequate as they do not fully comply with the December 2021 remand instructions, and are not supported by adequate rationale. First, the December 2021 order instructed the examiner to consider whether any of the Veteran's service-connected disabilities caused or aggravated his cataracts. The VA examiner did not render an opinion as to whether the Veteran's cataracts were at least as likely as not (50 percent or greater) caused or aggravated by the Veteran's now service-connected disabilities of dry eye, tylosis and meibomitis. Second, the only rationale provided for the conclusion that the Veteran's cataracts were not proximately caused or aggravated by his service-connected disabilities or treatment therefore was that cataracts are caused by aging. These rationales amount to a generalized statement of causation and not and analysis specific to the Veteran's particular circumstances and claim. See Jones v. Shinseki, 23 Vet. App. 382, 390 (2010). Unfortunately, another remand is required. The matters are REMANDED for the following action: 1. Obtain an addendum nexus opinion from a different clinician regarding the Veteran's bilateral nuclear cataracts. The claims folder must be reviewed in conjunction with the examination; provision of a new physical examination is at the discretion of the reviewer. The examiner must opine as to whether the Veteran's bilateral nuclear cataracts are at least as likely as not (50 percent or greater) caused or aggravated by service or the Veteran's service-connected disabilities. A full and complete rationale is required for all opinions provided. Jones v. Shinseki, 23 Vet. App. 382 (2010). The examiner must specifically consider and comment on whether the Veteran's service-connected tylosis, meibomitis, or dry eye syndrome caused or aggravated his bilateral cataracts. If the cataracts are determined to be age-related, explanation of why this Veteran's cataracts are more consistent with such is required. 2. Then, readjudicate the claims on appeal. If any benefit sought remains denied, issue an appropriate supplemental statement of the case and return the appeal to the Board. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Megan-Brady Viccellio 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.