BVA9502725 DOCKET NO. 93-27 971 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in San Juan, Puerto Rico THE ISSUE Entitlement to an increased (compensable) disability evaluation for bilateral pterygium. REPRESENTATION Appellant represented by: Gladys M. Rivera González, Attorney at Law WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD K. Keyes, Associate Counsel INTRODUCTION The veteran served on active duty from April 1941 to November 1945. This matter comes before the Board of Veterans' Appeals (Board) from a May 1993 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in San Juan, Puerto Rico, which denied an increased (compensable) disability rating for bilateral pterygium. REMAND The veteran contends that the RO committed error in denying his claim for an increased (compensable) disability rating for his service-connected bilateral pterygium. Specifically, he contends that loss of vision in his right eye is due to an eye hemorrhage which in turn was caused by his service-connected pterygium. It is noted that the RO has denied the veteran's claim on the grounds that his loss of vision is not related to his service connected pterygium. The Board notes that the January 1993 VA examination report reflects a loss of vision in the right eye and that the examiner diagnosed neovascular retinal disease most probably secondary to central venous occlusion. The examiner did not comment on the veteran's pterygium. The veteran's own statement that his loss of vision is caused by a hemorrhage which is caused by his pterygium is not competent evidence. Espiritu v. Derwinski, 2 Vet.App. 492, 495 (1992) (lay persons are not competent to offer medical opinions). However, this issue is inextricably intertwined with the issue of an increased rating for service-connected pterygium given that the VA Schedule for Rating Disabilities bases its ratings for pterygium on loss of vision. 38 C.F.R. § 4.84a, Diagnostic Code 6034 (1994); see Harris v. Derwinski, 1 Vet.App. 180 (1991). During his personal hearing, the veteran testified that he had eye surgery in July 1993 at a VA hospital; and that he had been seen by a private doctor at the Mennonite hospital. It is not clear whether all records of treatment are on file. Accordingly, to ensure that VA has met its duty to assist the claimant in developing facts pertinent to the claim and to ensure full compliance with due process requirements, the case is REMANDED to the RO for the following developments: 1. The veteran should be asked to provide the names and addresses of all private doctors or medical facilities where he had been treated for his eye disorder since 1990. All records not already on file should be obtained and made part of the claims folder. The RO should make sure that all treatment records from doctor Salvador Rodriguez and the Mennonite hospital pertaining to the veteran are obtained. If some records are not available, that fact and the reason(s) should be noted in the claims folder. 2. The RO should obtain all records from the VA hospital pertaining to the surgery performed in July 1993 and all records of subsequent treatment at the VA Outpatient Clinic, if any. 3. Subsequently, the RO should schedule the veteran for a VA special ophthalomogical examination. The claims folder and a copy of this remand must be made available to and reviewed by the examiner prior to the examination. The report of examination should include a detailed account of all manifestations of eye pathology found to be present. All necessary tests should be conducted, including a vision test with results for both corrected and uncorrected vision recorded in the report. The examiner should review the results of any testing prior to completion of the report. The examiner must provide diagnoses of any current eye pathology and express an opinion as to the likelihood that the veteran's service-connected pterygium has caused any other eye disorder or pathology found. In addition, the examiner must render an opinion as to the likelihood that the veteran's service-connected pterygium has caused loss of vision as opposed to another factor or factors. If the veteran's service-connected pterygium is one of several factors that has contributed to his loss of vision, the examiner should express an opinion as to the extent to which the service-connected pterygium has contributed to the loss of vision as opposed to other contributing factors. The examiner must provide a comprehensive report including a complete rationale for all opinions and conclusions reached. 4. The RO must review the examination report and determine whether it is adequate for rating purposes and in full compliance with this remand. If the report is not, it must be returned to the examiner for correction. 5. Subsequently, the RO should adjudicate the veteran's claim for an increased rating for his service-connected pterygium. In addition, the RO should adjudicate the claim for service connection for a hemorrhage of the eye or eyes, including central venous occlusion and neovascular retinal disease, on a secondary basis under 38 C.F.R. § 3.310 (1994). If the decision remains unfavorable following completion of these actions, the veteran and his representative should be provided with a supplemental statement of the case, citing all applicable laws and regulations including 38 C.F.R. § 3.310 (1994), and afforded a reasonable period of time in which to respond. Thereafter, in accordance with the current appellate procedures, the case should be returned to the Board for completion of appellate review if in order No action is required of the veteran until further notice. JOAQUIN AGUAYO-PERELES 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).