Citation Nr: 25005383 Decision Date: 04/22/25 Archive Date: 04/22/25 DOCKET NO. 12-31 389 DATE: April 22, 2025 REMANDED Entitlement to service connection for an eye disability, to include macular degeneration and dry eye, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1985 to February 1962. This matter comes before the Board of Veterans' Appeals from a February 2011 decision. In October 2023, the Veteran testified before the Board. The appeal was most recently before the Board in December 2024 and remanded for further development. As the Board finds less than substantial compliance with the prior Remand instructions, another remand is required. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Notably, the Board directed the AOJ to arrange an examination of the Veteran to determine the extent of his disability and to obtain a medical nexus opinion. The March 2025 supplemental statement of the claim (SSOC) indicated the matter continued to be denied as the Veteran failed to appear for the examination without good cause; however, that is factually inaccurate. Some documentation in the claims file reveals that the facility in which the Veteran is incarcerated would not allow him to be examined outside the facility. It was additionally noted that the facility did not have the equipment needed to perform an eye examination and that an examiner would not be allowed to bring the necessary equipment to the facility. See January 2025 Exam Request, 2nd Entry. However, an April 2025 VA Form 21-4138, Statement in Support of Claim, from the Veteran's representative indicated that a provider, AD, was available to examine the Veteran at his housing unit with sufficient notification prior to the scheduled examination. Thus, it does not appear that the agency of original jurisdiction (AOJ) exhausted all possible avenues for obtaining access to the incarcerated Veteran. Bolton v. Brown, 8 Vet. App. 185 (1995); Veterans Benefits Administration (VBA) Fast Letter 11-22 (Sept. 8, 2011); M21-1, III.iv.3.F.2.d. Moreover, should all avenues be exhausted for in person examination, the AOJ should have referred the claim file for a review and to obtain a medical opinion by an appropriate clinician to satisfy the duty to assist. 38 C.F.R. § 3.159. In this case, given that medical records associated with the claims file contain diagnoses of macular degeneration and dry eye, the Veteran's military occupational specialty of demolition specialist (MOS) has been verified, and the Veteran has competently and credibly maintained he has experienced problems with his eyes since being subjected to shockwaves and debris from demolition during active service, failure to exhaust all avenues and/or obtain such an opinion is an error that must be corrected. Id. Thus, the matter is REMANDED for the following action: 1. Schedule the Veteran for (a) an in person VA examination for the claimed eye disability taking all appropriate steps to comply with relevant procedures regarding scheduling VA examinations for incarcerated veterans with the provider, AD, identified by the Veteran's representative in the April 2025 VA Form 21-4138 or if in-person examination is not feasible, (b) send the claims file to an appropriate provider to review the claim file to obtain a medical opinion without examination. In either case, after reviewing the file and a copy of this Remand, the provider must then opine for each diagnosed eye disability, to include macular degeneration and dry eye, whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher), that the diagnosed disability had an onset in service or is otherwise related to service, to include being hit by shockwaves and debris from demolitions. In providing the requested opinion, consider the Veteran's description of the in-service injury and symptoms as well as post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of the current disability, this should be noted. Stated another way, do the Veteran's reports about the symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? Complete rationales must be provided for all opinions expressed. If the clinician advises that the requested opinions cannot be provided, the clinician must provide the reasons why. Is it due to a lack of training and experience of the clinician, or due to a lack of knowledge in the medical community at large? 2. If upon completion of the foregoing the claim remains ? denied, the matter must be returned to the Board after compliance with appellate procedures. K. L. WALLIN Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Snyder, William 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.