Citation Nr: 25006540 Decision Date: 05/14/25 Archive Date: 05/14/25 DOCKET NO. 19-37 918 DATE: May 14, 2025 REMANDED Entitlement to service connection for left eye disability is remanded. Entitlement to service connection for bilateral pes planus is remanded. REASONS FOR REMAND The Veteran served in the United States Air Force from July 1961 to April 1965. This appeal stems from a November 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In January 2021, the Veteran testified at the Board hearing before a Veterans Law Judge who is no longer employed at the Board. A copy of the hearing transcript is of record and has been reviewed. In March 2021, the Board denied both claims. The Veteran timely appealed the denial to the United States Court of Appeals for Veterans Claims (Court). In a November 2022 Memorandum Decision, the Court vacated the March 2021 Board decision, and remanded the appeal for further development and adjudication; specifically, for the Board to consider the presumption of soundness regarding the Veteran's claimed left eye condition and to determine if a medical examination was warranted for the Veteran's claimed foot disability. This appeal was before the Board in November 2023, at which time the Board remanded both claims for further development consistent with the Memorandum Decision. Of note, the Board's November 2023 remand requested, as relevant here, VA examinations to help determine the likely etiology of the claimed left eye and pes planus disabilities. In response, a VA examination for pes planus was scheduled in February 2024 and an examination for the left eye disability was scheduled for May 2024; however, the Veteran did not report to his scheduled examinations. See February and May 2024 Examination Requests. Nevertheless, the Board finds that the Veteran certainly had good cause for not reporting to the VA examinations because the evidence shows that the Veteran was to start receiving home health care options through hospice in early 2024. See January 2024 Mental Health Secure Messaging; 38 C.F.R. § 3.655(a). In October 2024, the Board found that based upon good cause being shown, in lieu of an examination, the Veteran should be given an opportunity to have his claims reviewed by a medical examiner to address the likely etiology of any currently diagnosed left eye disabilities, to include the presence of any preexisting eye disability, and to address whether the Veteran's preexisting pes planus was aggravated beyond its natural progression during service. A remand was issued with those directives. Upon review of the record, there has been no substantial compliance with the October 2024 Board remand. Stegall v. West, 11 Vet. App. 268, 271 (1998) [holding that substantial compliance with remand directives must occur as a matter of law]. In March 2025, the agency of original jurisdiction (AOJ) issued a Supplemental Statement of the Case (SSOC) that denied both claims due to the Veteran's failure to appear for examinations scheduled in December 2024 and March 2025. The SSOC determined that the Veteran did not provide good cause for his failure to report for his examinations. Review of the October 2024 remand directives shows that no examinations were requested. Rather, medical opinions about the etiology of the Veteran's left eye disability and bilateral pes planus were requested. Additionally, the Veteran demonstrated good cause, as documented in the record, for failure to appear at the scheduled examinations due to receiving hospice care. See 38 C.F.R. 3.655. As substantial compliance with the October 2024 Board remand has not occurred, a new remand is issued to determine the etiology of the Veteran's left eye disability and bilateral pes planus. The matters are REMANDED for the following action: 1. Obtain an addendum VA medical opinion from an appropriate examiner to address the etiology of the Veteran's left eye disability. Arrange for the Veteran's claims file, including a copy of this Remand, to be made available to, and reviewed by, the examiner. NO examination is required. Please expedite this claim as the Veteran is currently receiving hospice care. After a thorough review of the entire claims file, the examiner is asked to respond to the following: (a) Identify all currently diagnosed left eye disabilities since the date of claim in October 2018, including glaucoma and blindness. (b) Review the Veteran's history for all signs and symptoms associated with the claimed left eye disability prior to service, during service, and since separation from service. (c) Opine whether the left eye hyphema clearly and unmistakably preexisted service, and if so, whether it clearly and unmistakably was not aggravated beyond its natural progression during service. In doing so, the examiner is asked to consider and address: (i) July 1961 Report of Medical Examination in the Service Treatment Records (enlistment eye examination with no issues documented) (ii) March 1965 Report of Medical History in the Service Treatment Records (separation examination showing enlarged pupil with decreased sensitivity to light, which the medical examiner attributed to probable hyphema from an incident in 1955 prior to service) (iii) November 2018 Notice of Disagreement (Veteran's statement that his four years of looking at fine print in the military (as a clerk typist) weakened his eyesight) (d) If the answer to (c) is in the negative, provide an opinion as to whether the current left eye disability as likely as not that had its onset during service or is otherwise related to it. **Address the Veteran's statement that four years of looking at fine print in the military and exposure to sunlight weakened his eyesight. In doing so, consider and address (i) the normal induction examination and symptomatic separation examination showing enlarged pupil with decreased sensitivity to light, which the medical examiner attributed to probable hyphema from an incident in 1955 prior to service (ii) the Veteran's lay reports. A complete rationale with clear conclusions, citations to medical evidence, and a reasoned medical explanation connecting the two must be provided for all expressed opinion. 2. Obtain an addendum VA medical opinion from an appropriate examiner to address the etiology of the Veteran's bilateral pes planus. Arrange for the Veteran's claims file, including a copy of this Remand, to be made available to, and reviewed by, the examiner. NO examination is required. Please expedite this claim as the Veteran is currently receiving hospice care. After a review of the record, the examiner is asked to respond to the following: (a) Review the Veteran's history for all signs and symptoms associated with the claimed bilateral pes planus prior to service, during service, and since separation from service. (b) Provide an opinion as to whether it is at least as likely as not that the preexisting pes planus was aggravated beyond its natural progression during service. In doing so, please address: (i) July 1961 Report of Medical Examination in the Service Treatment Records (enlistment examination documenting asymptomatic, non-disabling pes planus) (ii) November 2018 Notice of Disagreement (Veteran's statement about having to run and walk miles a day during basic training in leather military boots with no inserts, and that such aggravated his condition as his feet hurt all the time) (iii) January 2021 VA Hearing Transcript (Veteran's reported self-treatment of the feet in service and statement he was given inserts) (iv) December 2019 Article titled Effects of Wearing Different Personal Equipment on Force Distribution at the Planter Surface of the Foot, that was submitted by the Veteran. A complete rationale with clear conclusions, citations to medical evidence, and a reasoned medical explanation connecting the two must be provided for all expressed opinion. S. B. MAYS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Elsbach, E. R. 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.