Citation Nr: 22028126 Decision Date: 05/12/22 Archive Date: 05/12/22 DOCKET NO. 16-27 427 DATE: May 12, 2022 REMANDED Entitlement to service connection for a left eye disability is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1974 to October 1976. On appeal is a July 2013 rating decision issued by a Department of Veteran Affairs (VA) Regional Office (RO) that, among other things, denied service connection for a left eye injury. The Veteran timely appealed and requested a hearing before the Board of Veterans' Appeals (Board). When this matter was initially before the Board in November 2021, the Board remanded for additional development. The matter has now been returned to the Board for further appellate review. Entitlement to service connection for a left eye disability is remanded. The Board regrets any further delay in this matter, but finds additional development is required. As explained in detail below, the issue of whether the Veteran's left eye disability has been aggravated by his service-connected epilepsy still has not been adequately addressed. When VA undertakes to obtain an examination/opinion, it must ensure that the examination/opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). A medical opinion/examination is considered adequate "where it is based on consideration of the veteran's prior medical history and examinations and also describes the disability, if any, in sufficient detail so that the Board's evaluation of the claimed disability will be a fully informed one." Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). The Veteran seeks service connection for a left eye disability, which he claims is secondary to his service-connected epilepsy (claimed and referred to by the Veteran as a seizure disorder). More specifically, the Veteran stated in his initial claim, "After my seizure in February, my left eye had become injured. I was told by my doctor that my retina had become detached and that it could have been caused by the seizure." When this matter reached the Board in November 2021, the Board acknowledged that an April 2013 VA examiner diagnosed the Veteran with mature cataract, retinal detachment by history, and glaucoma angle closure. However, that examiner's opinion indicated a retinal surgeon would be needed to determine whether the Veteran's left eye disability is proximately due to his generalized epilepsy. Further, this opinion does not explain whether the Veteran's left eye disability was aggravated by his generalized epilepsy. As such, on remand a new VA medical opinion was to be obtained, and the examiner was to opine whether the Veteran's left eye disability is either caused or aggravated by his use of medications for any of his service-connected disabilities. A new medical opinion was obtained in March 2022 from an ophthalmologist. In response to the question of whether the Veteran's left eye disability was caused or aggravated by his use of medications for any of his service-connected disabilities, the examiner stated that the Veteran had his left eye enucleated in 2013 due to pain and blindness following a 2012 retinal detachment and has had difficulty with his prosthesis. By way of providing an opinion, however, the examiner merely stated, "Neither of these two issues would be related or aggravated by any in service events, trauma or diseases or medication. He more than likely requires a new prosthesis fitting." First, the Board notes that the examiner did not use the correct standard in providing his nexus opinion. Second, the Board notes that the examiner did not provide a nexus opinion that specifically addressed whether the Veteran's left eye disability was related to his service or to his service-connected epilepsy. Instead, the examiner simply reported that the Veteran had had his left eye enucleated in 2013 and as rationale, stated only that "neither of these two issues would be related or aggravated by any in service events, trauma or diseases or medication," without any supporting rationale. It is also unclear to the Board what specific "two issues" the examiner is referring to in rendering this opinion. A remand by the Board confers on the claimant a legal right to compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). A failure by the Board to ensure that its remand orders are complied with constitutes legal error. Id. On remand, a new medical opinion that addresses all of the Board's remand directives must be obtained. The matter is REMANDED for the following action: Obtain an addendum opinion from a retinal surgeon, or a physician with equivalent expertise, regarding the etiology of the Veteran's left eye disability. If the examiner determines the Veteran should be given another examination (including via telehealth if an in-person examination is not possible) to answer the below questions, one should be scheduled. The examiner must clearly identify each left eye disability present at any potin during the appeal period. For each diagnosed disability, the examiner must offer an opinion on each of the following: (1) Whether it is at least as likely as not that the Veteran's left eye disability began in service, within one year of service separation, or is otherwise related to his service. (2) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's left eye disability was caused by his service-connected epilepsy or the medication taken for his service-connected epilepsy. (3) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's left eye disability was aggravated by his service-connected epilepsy or the medication taken for his service-connected epilepsy. A complete rationale must be given for all opinions and conclusions expressed. The examiner is advised that the Veteran is competent to report history and symptoms, and that his reports must be considered in the requested opinion. The examiner must specifically discuss the Veteran's report that he was told by his physician following his left retinal detachment that such may have been caused by a seizure. If the examiner rejects the Veteran's reports, the examiner should provide a rationale for doing so. Caroline B. Fleming Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Bess, T. 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.