Citation Nr: 22019964 Decision Date: 04/03/22 Archive Date: 04/03/22 DOCKET NO. 17-00 760 DATE: April 3, 2022 REMANDED Entitlement to service connection for an eye disability, including dry eye and photophobia, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1988 to July 1991 and from October 1992 to October 1995, including service in the Persian Gulf. This matter comes before the Board of Veterans' Appeals (Board), on appeal from a January 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In January 2019 and November 2021 decisions, the Board remanded this claim for additional development. Entitlement to service connection for an eye disability, including dry eye and photophobia. Regrettably, additional development is necessary before the Veteran's claim can be adjudicated. The Veteran contends that he has chronic dry eye and photophobia incurred during service in the Persian Gulf as a result of sun exposure and the dry, arid, dusty, and smoke-filled conditions. As discussed in the prior Board remands, there has been some difficulty obtaining an adequate medical opinion regarding the nature and etiology of the Veteran's claimed eye disability as manifest by dry eye and photophobia. See 38 U.S.C. § 5103(a); Barr v. Nicholson, 21 Vet. App. 31 (once VA undertakes the effort to provide an examination when developing a claim for service connection, even if not statutorily obligated to do so, it must provide an adequate one). Unfortunately, the December 2021 VA examination for eye conditions appears to have mischaracterized the Veteran's claim and limited its findings to the Veteran's recently diagnosed cataract and paving stone degeneration of the eyes. In a January 2022 statement, the Veteran clarified that he is not seeking entitlement to service connection for cataracts. Rather, the Veteran reaffirmed that his claim is for dry eye and photophobia incurred during service in the Persian Gulf due to sun exposure and dry, arid, dusty, and smoke-filled conditions. The RO obtained an addendum opinion in February 2022 to specifically address the Veteran's photophobia and dry eye as related to his service in the Persian Gulf. However, the brief addendum provided an inconclusive and seemingly contradictory opinion regarding the onset and etiology of the Veteran's dry eye and photophobia conditions. Thus, the Board finds that a remand for an additional addendum opinion is necessary to obtain a clear medical opinion as to the nature and etiology of the Veteran's claimed eye disability, including dry eye and photophobia. The Board also notes that the Veteran and his representative recently submitted additional medical literature in support of an association between his eye disability and service in the Persian Gulf. These matters are REMANDED for the following action: 1. Obtain the Veteran's updated VA treatment records and associate them with the evidence of record. If possible, the Veteran himself should submit these records (if any), and any other new treatment for this problem, himself, to expedite the case. Any assistance on this issue would be appreciated. 2. Obtain an addendum opinion from an appropriate clinician to determine the nature and etiology of the Veteran's claimed eye disability, to include photophobia and dry eye. Specifically, the examiner should opine whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's claimed eye disabilities, including photophobia and dry eye, had their onset during active service or are otherwise related to active service, including as due to sun exposure and the dry, arid, dusty, and smoke-filled conditions in the Persian Gulf. A complete rationale for any opinions expressed should be provided. The report should set forth all complaints, findings, and diagnoses relating to the Veteran's eye disability and provide a rationale for all conclusions reached. If the requested opinions cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge, i.e., no one could respond given medical science and the known facts, or by a deficiency in the record or the examiner, i.e., additional facts are required, or the examiner does not have the needed knowledge or training. 3. After completion of the aforementioned, the AOJ should readjudicate the issues on appeal. If the benefit sought on appeal is not granted, then the AOJ should provide the Veteran with a supplemental statement of the case and afford him the appropriate opportunity to respond thereto. Thereafter, the case must be returned to the Board for further appellate review. John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. VanValkenburg 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.