RETINAL DYSTROPHY (INCLUDING RETINITIS PIGMENTOSA MACULAR DEGENERATION)

ERIC S. LEBOFF · 2026 · Case ID: 26004143

GRANTED

Summary

The veteran, who served from August 1973 to August 1977, appeals the denial of service connection for several conditions claimed as secondary to his service-connected sarcoidosis. These conditions include bilateral retinopathy, a right eye cataract, a left eye retinal detachment, and peripheral neuropathy in the left upper extremity, right upper extremity, and right lower extremity. The Board reviewed the evidence, including VA examinations from October 2020 and March 2024, and the veteran's service treatment records. The veteran is already rated 100% for sarcoidosis. For the eye conditions, a March 2024 VA examination opined that the retinopathy, cataract, and retinal detachment were at least as likely as not proximately due to sarcoidosis. The Board found this opinion persuasive and, noting the evidence was in equipoise, resolved doubt in the veteran's favor, granting service connection for these conditions. For the peripheral neuropathy claims, the Board initially found a March 2024 VA opinion inadequate because it did not address whether the veteran's sarcoidosis-related weight gain from prednisone contributed to the neuropathy. The Board placed more weight on an October 2020 opinion that linked the neuropathy to sarcoidosis. Finding the evidence in equipoise, the Board resolved doubt in the veteran's favor and granted service connection for the peripheral neuropathy in the upper and lower extremities as secondary to sarcoidosis.

Rationale

Current diagnosis of bilateral retinopathy; Service-connected sarcoidosis; Evidence in equipoise regarding causation; Benefit of the doubt applied

Special Benefit

NO SPECIAL BENEFIT

Docket No.

16-53 402

Full Decision Text

Citation Nr: 26004143
Decision Date: 04/03/26 Archive Date: 04/03/26

DOCKET NO. 16-53 402
DATE: April 3, 2026

ORDER

Entitlement to service connection for bilateral retinopathy as due to service-connected sarcoidosis is granted.

Entitlement to service connection for a right eye cataract as due to service-connected sarcoidosis is granted.

Entitlement to service connection for left eye retinal detachment as due to service-connected sarcoidosis is granted.

Entitlement to service connection for left upper extremity (LUE) peripheral neuropathy (PN) as due to service-connected sarcoidosis is granted.

Entitlement to service connection for right upper extremity (RUE) PN as due to service-connected sarcoidosis is granted.

Entitlement to service connection for right lower extremity (RLE) PN as due to service-connected sarcoidosis is granted.

FINDINGS OF FACT

1. The evidence is at least in equipoise as to whether the Veteran's bilateral retinopathy is due to his service-connected sarcoidosis.

2. The evidence is at least in equipoise as to whether the Veteran's right eye cataract is due to his service-connected sarcoidosis.

3. The evidence is at least in equipoise as to whether the Veteran's left eye retinal detachment is due to his service-connected sarcoidosis.

4. The evidence is at least in equipoise as to whether the Veteran's LUE PN is due to his service-connected sarcoidosis.

5. The evidence is at least in equipoise as to whether the Veteran's RUE PN is due to his service-connected sarcoidosis.

6. The evidence is at least in equipoise as to whether the Veteran's RLE PN is due to his service-connected sarcoidosis.

CONCLUSIONS OF LAW

1. The criteria for service connection for bilateral retinopathy as secondary to sarcoidosis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

2. The criteria for service connection for right eye cataract as secondary to sarcoidosis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

3. The criteria for service connection for left eye retinal detachment as secondary to sarcoidosis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

4. The criteria for service connection for LUE PN as secondary to sarcoidosis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

5. The criteria for service connection for RUE PN as secondary to sarcoidosis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

6. The criteria for service connection for RLE PN as secondary to sarcoidosis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from August 1973 to August 1977.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from an October 2012 rating decision by the agency of original jurisdiction (AOJ) of the Department of Veterans Affairs (VA).

This case was previously before the Board in March 2024, on which occasion the claims were remanded.

1. Entitlement to service connection for bilateral retinopathy as due to service-connected sarcoidosis.

2. Entitlement to service connection for a right eye cataract as due to service-connected sarcoidosis.

3. Entitlement to service connection for left eye retinal detachment as due to service-connected sarcoidosis.

The Veteran asserts that his current eye disabilities were caused by his service connected disabilities. At the outset, the Board notes that the Veteran is currently in receipt of a schedular 100 percent rating for his service connected sarcoidosis effective September 22, 1995. (4/23/2022, Rating Decision, p. 1).

Service connection may be?established?on a?secondary?basis?where there is evidence of: (1) a current disability
-connected sarcoidosis.

2. Entitlement to service connection for a right eye cataract as due to service-connected sarcoidosis.

3. Entitlement to service connection for left eye retinal detachment as due to service-connected sarcoidosis.

Service connection may be?established?on a?secondary?basis?where there is evidence of: (1) a current disability (for which?secondary?service connection is sought); (2) a service-connected disability; and (3) that the current disability was either caused or aggravated by the service-connected disability.? 38 C.F.R. § 3.310(a);?see also Allen v. Brown,?7?Vet. App.?439?(1995).???

The question for the Board is whether the Veteran's?current eye disabilities were caused or aggravated by his?service connected sarcoidosis.??The Board concludes that the Veteran has current diagnoses of eye disabilities, including bilateral retinopathy, right eye cataract, and left eye retinal detachment, that were caused by his service connected sarcoidosis. 38 C.F.R. § 3.310(a).???

To this point, the Veteran was diagnosed with bilateral retinopathy, right eye cataract, and left eye retinal detachment during an October 2022 VA eye conditions examination. (11/7/2022, C&P Exam, p. 2). The Board?therefore?finds that the first element of?secondary?service connection?is?met.????

Regarding whether the Veteran has?a service-connected disability, he?is?service connected for sarcoidosis. (7/8/1992,?Rating Decision, p. 1-2). Accordingly, the Board finds that the second element of?secondary?service connection?is?met.?????

The Board will?next?consider?whether the Veteran's?current eye disabilities were caused or aggravated?by?his?service connected sarcoidosis. To this point, in March 2024 a VA examiner opined that the Veteran's claimed retinopathy and cataract are at least as likely as not proximately due to or the result of his service connected sarcoidosis. (3/25/2024, C&P Exam, p. 2).

The probative value of medical opinion evidence is based on the medical expert's personal examination of the patient, the physician's knowledge and skill in analyzing the data, and the medical conclusion that the physician reaches. Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). Whether a physician provides a basis for a medical opinion goes to the weight or credibility of the evidence in the adjudication of the merits. See Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). Other factors for assessing the probative value of a medical opinion are the physician's access to the claims folder and the thoroughness and detail of the opinion. See Prejean v. West, 13 Vet. App. 444, 448-9 (2000); Nieves-Rodriguez, 22 Vet. App. 295 (2008); Prejean v. West, 13 Vet. App. 444, 448-9 (2000).

Here, the March 2024 opinion was provided by a VA medical professional who possesses the necessary education, training, and expertise to provide the requested opinions. Additionally, the opinion is shown to have been based on a review of the Veteran's record and is accompanied by a sufficient explanation as to why the Veteran's eye disabilities were caused by his service connected sarcoidosis. Furthermore, there is no competing medical opinion of record addressing whether his eye disabilities were caused by sarcoidosis. The Board thus finds that the March 2024 opinion is dispositive of the issues at hand.

Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's bilateral retinopathy, right eye cataract, and left eye retinal detachment are proximately due to his service-connected sarcoidosis. ?Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for bilateral retinopathy, right eye cataract, and left eye retinal detachment is warranted. ?See?38 U.S.C. §
osis. Furthermore, there is no competing medical opinion of record addressing whether his eye disabilities were caused by sarcoidosis. The Board thus finds that the March 2024 opinion is dispositive of the issues at hand.

4. Entitlement to service connection for LUE PN as due to service-connected sarcoidosis.

5. Entitlement to service connection for RUE PN as due to service-connected sarcoidosis.

6. Entitlement to service connection for RLE PN as due to service-connected sarcoidosis.

The Veteran asserts that his current diagnoses of bilateral upper extremity PN and RLE PN were caused by his service connected sarcoidosis. (9/29/2020, VA 21-526EZ, p. 2). The Board notes that the AOJ granted service connection for left common peroneal neuropathy as related to his service connected sarcoidosis. (4/21/2010, Rating Decision, p. 3).

The question for the Board is whether the Veteran's bilateral upper extremity PN and RLE PN were caused or aggravated by his?service connected sarcoidosis.??The Board concludes that the Veteran has current diagnoses of bilateral upper extremity PN and RLE PN that was caused by his service connected sarcoidosis. 38 C.F.R. § 3.310(a).???

To this point, the Veteran was diagnosed with polyneuropathy during a November 2022 VA peripheral nerves examination. (11/9/2022, C&P Exam, p. 2). The Board?therefore?finds that the first element of?secondary?service connection is met.

The Board will?next?consider?whether the Veteran's?current diagnoses of bilateral upper extremity PN and RLE PN were caused or aggravated?by?his?service connected sarcoidosis. To this point, in October 2020 the Veteran underwent a peripheral nerves conditions examination during which he complained of neuropathy in both legs and both hands. The examiner indicated that his neuropathy is associated with his diagnosis of sarcoidosis. (10/29/2020, C&P Exam, p. 3).

The Board notes that a VA examiner provided a negative medical opinion regarding whether the Veteran's sarcoidosis caused his claimed bilateral upper extremity PN and RLE PN. In so finding, the examiner noted that the Veteran's sarcoidosis is currently in remission and that he has "non-service connected risk factors" for neuropathy, including obesity and diabetes. (3/25/2024, C&P Exam, p. 3).

The Board finds that the March 2024 medical opinion is inadequate. In this regard, while the Veteran's sarcoidosis is currently in remission, the evidence of record indicates that he began experiencing symptoms related to neuropathy while his sarcoidosis was active. (12/3/1992, Medical Treatment Record, p. 3). See Reonal v. Brown, 5 Vet. App. 458, 460-61 (1993) (holding that an opinion based upon an inaccurate factual premise has no probative value). Further, the examiner noted that the Veteran has non-service connected risk factors for neuropathy, including obesity, but did not address whether his service connected disabilities caused him to become obese. In January 2017, VA's Office of General Counsel (OGC) issued a precedential opinion regarding whether obesity may be considered a "disease" for the purposes of service connection. In effect, OGC concluded that if obesity is the result of a service-connected disability and was a substantial factor in the development of the current disability, entitlement to service connection for the current disability may be warranted. See VAOPGCPREC 1-2017; see also Walsh v. Wilkie, 32 Vet. App. 300 (2020). In the
that the Veteran has non-service connected risk factors for neuropathy, including obesity, but did not address whether his service connected disabilities caused him to become obese. In January 2017, VA's Office of General Counsel (OGC) issued a precedential opinion regarding whether obesity may be considered a "disease" for the purposes of service connection. In effect, OGC concluded that if obesity is the result of a service-connected disability and was a substantial factor in the development of the current disability, entitlement to service connection for the current disability may be warranted. See VAOPGCPREC 1-2017; see also Walsh v. Wilkie, 32 Vet. App. 300 (2020). In the present case, the Veteran's treatment for sarcoidosis included high doses of steroids, specifically prednisone, which resulted in approximately 30 to 40 pounds of weight gain. (10/4/2023, CAPRI, p. 5-6). The Veteran's documented weight gain as a result of taking prednisone for his service connected sarcoidosis, and the examiner's March 2024 medical opinion noting that obesity is a risk factor for neuropathy, raises the issue of whether the Veteran's sarcoidosis caused him to become obese and whether his obesity was a substantial factor in the development of his claimed neuropathy. As the March 2024 examiner did not address the matter, the Board finds that the opinion is inadequate.

Here, the October 2020 opinion was provided by a VA medical professional who possesses the necessary education, training, and expertise to provide the requested opinion. Additionally, the opinion is shown to have been based on a review of the Veteran's record and is accompanied by a sufficient explanation as to the relationship between the Veteran's service connected sarcoidosis and his claimed bilateral upper extremity PN and RLE PN. Conversely, the March 2024 examiner did not acknowledge that the Veteran's neuropathy symptoms manifested while he was being treated for sarcoidosis, nor did the examiner address whether his documented weight gain as a result of taking prednisone for his service connected sarcoidosis was a substantial factor in the development of his claimed neuropathy. The Board thus places more probative weight on the October 2020 medical opinion.

Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's LUE PN, RUE PN, and RLE PN are proximately due to his service-connected sarcoidosis. ?Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for LUE PN, RUE PN, and RLE PN is warranted. See?38 U.S.C. § 5107;?38 C.F.R. § 3.102.

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Glenn, Robert

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.

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