BVA9500388 DOCKET NO. 93-04 340 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to service connection for peripheral vascular disease. 2. Entitlement to service connection for headaches. 3. Entitlement to service connection for arteriosclerosis. 4. Entitlement to service connection for bilateral hallux valgus. 5. Entitlement to service connection for chronic obstructive pulmonary disease. 6. Entitlement to service connection for Paget's disease of the left hip. 7. Entitlement to service connection for bilateral hearing loss. 8. Entitlement to service connection for degenerative changes of the thoracic spine. 9. Entitlement to service connection for residuals of a left ankle injury. 10. Entitlement to service connection for photophobia with post vitreous detachment of the right eye. 11. Entitlement to service connection for amoebic dysentery and tapeworm. 12. Entitlement to service connection for residuals of gall bladder removal. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD James J. Dunphy, Counsel INTRODUCTION The veteran had verified active service with the American Merchant Marine, from October 1942 to May 1943. Pursuant to Pub. L. 95-202, such service has been certified as active military service, under 38 C.F.R. § 3.7(x)(15) (1993), conferring veteran status for Department of Veterans Affairs (VA) benefit purposes. This appeal to the Board of Veterans' Appeals (Board) arises from a November 1990 rating decision by the St. Petersburg, Florida, VA Regional Office (RO). For reasons set forth below, all issues except that of entitlement to service connection for photophobia with post vitreous detachment of the right eye will be discussed in the remand section of this decision. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he has photophobia with post vitreous detachment of the right eye as a result of his experiences during World War II. His ship was sunk and he was forced to survive in a lifeboat for over 30 days. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the evidence supports the grant of service connection for photophobia with post vitreous detachment of the right eye. FINDING OF FACT Photophobia with post vitreous detachment of the right eye was the result of exposure to sunlight after the veteran was shipwrecked during service. CONCLUSION OF LAW Photophobia with post vitreous detachment of the right eye was incurred in wartime service. 38 U.S.C.A. §§ 1110, 5107 (West 1991). REASONS AND BASES FOR FINDING AND CONCLUSION Initially, the Board concludes that the veteran has presented a well-grounded claim with regard to this issue. Moreover, the Board finds that the VA has met its statutory duty to assist the veteran in the development of his claim and that no further action is required to meet the provisions of 38 U.S.C.A. § 5107 (West 1991). The veteran's medical records during his pertinent service do not reflect that the claimed disability was present in service, and it is not otherwise contended. The veteran's claim is principally predicated on the theory that, although the claimed disorder was not present during his Merchant Marine service during World War II, it is the result of the sinking of his ship during service in April 1943. There are only a few medical records from this period on file for the veteran. The records indicate that the veteran's ship was struck by a torpedo in April 1943 and was sunk. He apparently survived on a lifeboat for 30 days. Thereafter, he reportedly spent three months in a hospital in South Africa and was under treatment for seven months at a Marine Hospital. In support of the veteran's claim, he has submitted numerous articles about his experiences during service. He has also submitted copies of medical records showing his treatment since that time. The records of the veteran's treatment by his brother, who is an optometrist, reflect that he was seen on several occasions in August 1943. The presence of an acute retinitis and an unusually extreme amount of photophobia was noted. It was noted that the veteran had been aboard a life raft for 31 days after a torpedo explosion and that he had not had anything to shade his eyes from the bright sun and cold winds during that time. The optometrist found that he had a permanent scar as a result of the very unusual form of acute retinitis. The Board notes the 1973 treatment report, by I. D. Okamura, M.D., along with follow-up reports by William H. Annesley, M.D., and Jerome A. Montana, M.D., dated in 1991. These reports indicate that the veteran had vitreous detachment with vitreous opacities in the right eye. This leads the Board to conclude that the veteran has met the first requirement for the grant of service connection, the presence of a current disability. The initial 1973 treatment report indicates that the retinas were burned during World War II when the veteran was shipwrecked. This is consistent with the service history given. The veteran has demonstrated a present disability, along with a precipitating incident in service. In view of the history given by the veteran, and the conclusions of Dr. Montana, the Board further concludes that the veteran has established an etiological relationship between the incidents in service and the current disability. Under such circumstances, and resolving reasonable doubt in the veteran's favor, the Board finds that entitlement to service connection for photophobia with post vitreous detachment of the right eye is warranted. ORDER Service connection for photophobia with post vitreous detachment of the right eye is granted. REMAND The available service medical records reflect that the veteran was hospitalized for enteritis and gastritis in March 1943. Service connection has been granted for post-traumatic stress disorder and fungus infection of the toenails and fingernails, residuals of immersion foot. In an August 1951 statement, a private physician indicated that the veteran had been treated in 1948 for possible amoebic dysentery. When the veteran was treated in May 1950, it was noted that he had been treated for a parasitic infection while aboard ship in service and that he had been treated at a U.S. Army Hospital in the Persian Gulf. He also reported the shipwreck and subsequent malnutrition. Several days after admission, the veteran passed a proglottid of a tapeworm. He was treated for tapeworm infestation, following which the passage of a 9-foot-long tapeworm was reported. The diagnoses upon discharge from hospitalization included infection of the small intestine. In a May 1950 statement, a private physician reported that the veteran had a marked secondary macrocytic anemia. In December 1951, a private physician noted macrocytic anemia. The Board notes that when the veteran was examined in November 1990 for compensation purposes by the VA, the status of the intestinal infestation was to be determined after stool samples were available. A handwritten note indicated that this examination report was not available. As the veteran has submitted a well-grounded claim with regard to this issue, the duty to assist arises. With regard to the veteran's claim for service connection for an ankle disorder, the evidence before the Board indicates that when the veteran's ship was hit and sunk he injured his ankle. In a sworn statement in April 1945, it was reported that a torpedo blast had thrown the veteran against the bulkhead. When he tried to stand, he had to drag his leg. He reported extreme pain in his left leg from injury and exposure. The diagnosis was torn ligaments in ankle. A record in October 1943 reflects that the veteran sustained an injury to the "right" ankle and that he was forced to use a cane while walking. The most recent examination by the VA, in November 1990, did not reflect any pertinent findings. X-ray films of the ankle were negative for osseous or joint pathology. The veteran testified that he has had continuing complaints with regard to his ankle. The veteran also contends that he has peripheral vascular disease as a result of his lifeboat experiences during service. In a May 1950 statement, a private physician reported that the veteran had been under his treatment since July 1949 for immersion foot. He indicated that the veteran had had at least 15 periodic severe episodes of painful, persistent edema, and thrombophlebitis necessitating the stopping of work and requiring bed rest. When the veteran was afforded a general medical examination by the VA in November 1990, the diagnoses included probable peripheral vascular disease of the feet, secondary to water immersion as described. On the physical examination, it was noted that he had superficial varicosities, probably Grade I. To resolve the issue of whether peripheral vascular disease was in fact present, the veteran's case was referred to an additional VA specialist examiner in February 1991. At that time, the examiner concluded that there was no demonstrable evidence of peripheral vascular disease "of any significance." Since that examination was almost four years ago, and the findings appear to be in conflict with those on the earlier examination, it is felt that a more current evaluation should be obtained to determine whether he has any peripheral vascular disease. In light of the above, the case is REMANDED for the following action: 1. The veteran should be requested to provide the names and locations of all health care providers who have treated him for the claimed disabilities since 1991. Any records identified should be obtained and associated with the claims folder. 2. Thereafter, the veteran should be afforded a special gastrointestinal examination to determine if he has any residuals of his amoebic dysentery or tapeworm. All indicated tests and studies should be obtained. The veteran's claims folder should be made available to the examiner for study in the case. 3. The veteran should also be afforded an orthopedic examination to determine if he has any current disability of the left ankle. All indicated tests and studies should be accomplished. The veteran's claims folder should be made available to the examiner for study in the case. 4. The veteran should also be afforded a special vascular examination to determine if he has peripheral vascular disease as a result of his experiences aboard the lifeboat or his immersion foot. All indicated tests and studies should be accomplished. The veteran's claims folder should be made available to the examiner for study in the case. When this development has been completed, the claim should be reviewed by the RO. If any benefit sought on appeal is not granted, the appellant and his representative should be given a supplemental statement of the case with regard to the additional development and should also be afforded an opportunity to respond. The record should be returned to the Board for further appellate consideration, if in order. No action by the appellant or his representative is required until further notice is received. V. L. JORDAN Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1993).