EYE IMPAIRMENT OF

JOHN R. DOOLITTLE, II · 2026 · Case ID: A26019601

GRANTED

Summary

The veteran, who served from August 1988 to August 1992, appeals the denial of an increased disability rating for his bilateral eye condition, specifically chorioretinal scars with diplopia, previously rated as cataracts. The veteran sought a 30 percent rating, contending his visual impairment warranted a higher evaluation. The Board reviewed multiple VA eye examinations conducted between 2017 and 2024. While earlier examinations noted diplopia and functional vision loss, later examinations found no diplopia and attributed vision changes to chorioretinal scars, keratoconus, and cataracts, with conflicting findings on the cause and impact of these conditions. The Board found the October 2024 VA examination most persuasive, noting corrected distance vision of 20/70 in both eyes. This finding aligns with the criteria for a 30 percent rating under Diagnostic Code 6066 for bilateral visual impairment. The Board determined this rating was warranted from October 11, 2024, when the increase became factually ascertainable. The veteran's claim for a higher rating based on incapacitating episodes was denied as the evidence did not support the required treatment visit frequency. Service connection for chorioretinal scars with diplopia is granted at 30 percent.

Rationale

October 2024 VA examination showed corrected distance vision of 20/70 in both eyes.; This visual acuity meets the criteria for a 30 percent rating under DC 6066.; Rating granted from October 11, 2024, when the increase became factually ascertainable.

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

6066

Docket No.

250305-528120

Full Decision Text

Citation Nr: A26019601
Decision Date: 03/04/26 Archive Date: 03/04/26

DOCKET NO. 250305-528120
DATE: March 4, 2026

ORDER

Entitlement to a disability rating of 30 percent, but no higher, for chorioretinal scars with diplopia (previously rated as cataracts) is granted.

FINDINGS OF FACT

1. The Veteran's impairment of central visual acuity is 20/70 in both eyes.

2. The Veteran's bilateral eye disability was not manifested by incapacitating episodes as defined by pertinent regulations, which required at least 3 but less than 5 treatment visits for an eye condition during the past 12 months.

3. The Veteran's diplopia is intermittent and infrequent.

CONCLUSION OF LAW

The criteria for an evaluation of 30 percent, but no higher, rating for chorioretinal scars with diplopia (previously rated as cataracts) have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7,4.7, 4.79, Diagnostic Code 6066.

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The Veteran served on active duty from August 1988 to August 1992.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2025 rating decision issued by the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ).

In the March 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket.

Therefore, the Board may only consider the evidence of record at the time of the January 2025 AOJ decision on appeal, as well as any evidence submitted by the Veteran [or representative] with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Procedural History

This claim began in the legacy appeals system. In a June 2012, rating decision, the AOJ granted service connection for cataracts (claimed as decrease in visual acuity in both eyes) with an evaluation of 0 percent effective March 11, 1996. The Veteran did not appeal the decision; and it became final one year later.

In a July 2015 VA Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, the Veteran sought an increased rating for his bilateral eye disability among other claims. In a November 2017 rating decision, the AOJ increased the evaluation of chorioretinal scars with diplopia from 0 percent disabling to 10 percent effective April 4, 2017. In a December 2017 VA Form 21-0958, Notice of Disagreement (NOD), the Veteran disputed the evaluation and claimed he was entitled to a 20 percent rating for each eye. In a February 2019 Statement of the Case (SOC), the AOJ continued the 10 percent evaluation. In February 2019, VA Form 9, the Veteran appealed to the Board. In a February 2020 decision, the Board remanded the increased rating claim for the bilateral eye disability.

In an October 2020, Supplemental Statement of the Case (SSOC), the AOJ denied the claim. In a November 2020 VA Form 10182, the Veteran appealed to the Board and opted his legacy appeal claim into the Appeals Modernization Act (AMA) appeals system, which was assigned to appellate stream Docket No. 201108-117149. During the pendency of the Board appeal, in December 2023, the AOJ issued
Case (SOC), the AOJ continued the 10 percent evaluation. In February 2019, VA Form 9, the Veteran appealed to the Board. In a February 2020 decision, the Board remanded the increased rating claim for the bilateral eye disability.

In an October 2020, Supplemental Statement of the Case (SSOC), the AOJ denied the claim. In a November 2020 VA Form 10182, the Veteran appealed to the Board and opted his legacy appeal claim into the Appeals Modernization Act (AMA) appeals system, which was assigned to appellate stream Docket No. 201108-117149. During the pendency of the Board appeal, in December 2023, the AOJ issued a rating decision continuing the 10 percent rating. In a June 2024 decision, the Board remanded the claim for an adequate examination to address the Veteran's 2016 diplopia diagnosis.

In the January 2025 rating decision currently on appeal, the AOJ again denied the claim for an increased rating. In March 2025, the Veteran filed the instant VA Form 10182 in disagreement with the January 2025 rating decision.

Entitlement to a disability rating of 30 percent but no higher for chorioretinal scars with diplopia (previously rated as cataracts), is granted.

The Veteran contends that he is entitled to a 30 percent rating for his bilateral eye disability. See March 2025 VA Form 10182.

Disability evaluations are determined by the application of a schedule of ratings, which is based on average impairment of earnings capacity caused by the given disability. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. When a question arises as to which of two ratings shall be applied under a particular diagnostic code, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for the higher rating; otherwise, the lower rating will be assigned. See 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining, including regarding degree of disability, is resolved in favor of the Veteran. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3.

An increased rating may be assigned for up to one year prior to receipt of a formal claim for increase, when it is factually ascertainable that an increase in disability had occurred during that period. 38 C.F.R. §§ 3.157, 3.400(o)(2). Consequently, the evaluation period for consideration of the Veteran's bilateral eye disability is from July 30, 2014, (a year prior to the July 30, 2015, date of claim). The Board notes that the Veteran continuously pursued his claim after the November 2017 denial by filing a December 2017 NOD.

The Veteran's bilateral eye disability is rated under DC 6080, which indicates that such eye disorder is to be evaluated under the General Rating Formula for Diseases of the Eye. The General Rating Formula instructs that eye disorders are to be evaluated on the basis of either visual impairment due to a particular condition or on incapacitating episodes, whichever results in a higher evaluation.

Regarding incapacitating episodes, where there are documented incapacitating episodes requiring at least one but less than three treatment visits for an eye condition during the past 12 months, a 10 percent rating is warranted.

Where there are documented incapacitating episodes requiring at least three but less than five treatment visits for an eye condition during the past 12 months, a 20 percent rating is warranted.

Where there are documented incapacitating episodes requiring at least five but less than seven treatment visits for an eye condition during the past 12 months, a 40 percent rating is warranted.

Where there are documented incapacitating episodes requiring seven or more treatment visits for an eye condition during the past 12 months, a 60 percent rating is warranted.

Note (1) indicates that, for the purposes of evaluations under 38 C.F.R. § 4.79, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes. Note (2) indicates that examples of treatment may include but are not limited to: systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions. 38 C.F.R. § 4.79 (2020).

The Board also has to consider whether and to what degree the Veteran's eye disability has impacted his visual acuity. The evaluation of visual impairment is based on impairment of visual acuity (excluding developmental errors of refraction), visual field, and muscle function. C.F.R. § 4.75(a
§ 4.79, an incapacitating episode is an eye condition severe enough to require a clinic visit to a provider specifically for treatment purposes. Note (2) indicates that examples of treatment may include but are not limited to: systemic immunosuppressants or biologic agents; intravitreal or periocular injections; laser treatments; or other surgical interventions. 38 C.F.R. § 4.79 (2020).

The Board also has to consider whether and to what degree the Veteran's eye disability has impacted his visual acuity. The evaluation of visual impairment is based on impairment of visual acuity (excluding developmental errors of refraction), visual field, and muscle function. C.F.R. § 4.75(a). To determine the evaluation for visual impairment when both decreased visual acuity and visual field defect are present in one or both eyes and are service connected, visual acuity and visual field defects are evaluated separately, and then combined under the provisions of 38 C.F.R. § 4.25.

Ratings for impairment of central visual acuity range from noncompensable to 100 percent. Evaluation of visual acuity is based on corrected distance vision with central fixation. 38 C.F.R. § 4.76(b)(1). The measurements for each eye are applied to the table for Impairment of Central Visual Acuity. Generally, the table is divided into steps corresponding to different levels of visual acuity for one eye, and each step is further divided into subsections of visual acuity for the other eye, with corresponding ratings. Where a reported visual acuity is between two sequentially listed visual acuities, the visual acuity which permits the higher evaluation will be used. 38 C.F.R. § 4.76(c).

A 10 percent disability rating is warranted for impairment of central visual acuity in the following situations: (1) if corrected visual acuity is 20/100 in one eye and 20/40 in the other eye; (2) if corrected visual acuity is 20/70 in one eye and 20/40 in the other eye; (3) if corrected visual acuity is 20/50 in one eye and 20/40 in the other eye; (4) or when corrected visual acuity is 20/50 in both eyes. 38 C.F.R. § 4.79, DC 6066.

A 20 percent disability rating is warranted for impairment of central visual acuity in the following situations: (1) if corrected visual acuity is 15/200 in one eye and 20/40 in the other eye; (2) if corrected visual acuity is 20/200 in one eye and 20/40 in the other eye; (3) if corrected visual acuity is 20/100 in one eye and 20/50 in the other eye; (4) or when corrected visual acuity is 20/70 in one eye and 20/50 in the other eye. 38 C.F.R. § 4.84a, Code 6067, 6078; 38 C.F.R. § 4.79, DC 6066.

A 30 percent disability rating is warranted for impairment of central visual acuity in the following situations: (1) corrected visual acuity in both eyes is 20/70; (2) corrected visual acuity is 20/100 in one eye and 20/70 in the other eye; (3) corrected visual acuity is 20/200 in one eye and 20/50 in the other eye; (4) corrected visual acuity is 15/200 in one eye and 20/50 in the other eye; (5) corrected visual acuity in one eye is 10/200 and 20/40 in the other eye; (6) corrected visual acuity in one eye is 5/200 and 20/40 in the other eye; or (7) blindness of one eye and corrected vision to 20/40 in the other eye. 38 C.F.R. § 4.84a, DCs 6070, 6074, 6076, 6066, 6078; 38 C.F.R. § 4.79, DCs 6064, 6065, 6066.

A 40 percent disability rating is warranted for impairment of central visual acuity in the following situations: (1) corrected visual acuity of one eye is 20/200, and 20/70 in the other eye; (2) corrected visual acuity of one eye is 15/200 and 20/70 in the other eye; (3) corrected visual acuity in one eye is 10/200 and 20/50 in the other eye; (4) corrected visual acuity of one eye is 5/200 in one eye and 20/50 in the other eye; or (5) blindness or anatomical loss of one eye and corrected vision in the other eye to 20/50 and 20/40, respectively, in the other eye. 38 C.F.R. § 4.84a, DCs 6066, 6070, 6073, 6076; 38 C.F.R. § 4.79, DCs 6064, 6065, 6066.

A 50 percent disability rating is warranted for impairment of central visual acuity in the following situations: (1) corrected visual acuity is 20/100 in both eyes; (2) corrected visual acuity of one eye is 10/200 and 20/70 in the other eye; (3) corrected visual acuity in one eye is 5/200 and 20/70 in the other eye; (4) blindness or anatomical loss of one eye and corrected vision in the other eye to 20/70 and 20/50, respectively, in the other eye. 38 C.F.R. § 4.84a, DCs 6065, 6069, 6073, 6076, 6078; 38 C.F.R. § 4.79, DCs 6064, 6065, 6066.

A 60 percent disability rating is warranted for impairment of central visual acuity in the following situations: (1) corrected visual acuity of one eye is to 20/200 and the other eye is 20/100; (2) corrected visual acuity of one eye is 15/200 and 20/100 in the other eye; (3) corrected visual acuity in one eye is 10/200 and 20/100 in the other eye; (4) corrected visual acuity of one eye is 5/200 and 20/100 in the other eye; or (5) blindness or anatomical loss of one eye and corrected vision in the other eye to 20/100 or 20/70 or 20/100, respectively. 38 C.F.R. § 4.84a, DCs 6065, 6069, 6073, 6076; 38 C.F.R. § 4.79, DCs 6064, 6065, 6066.

A 70 percent disability rating is warranted for impairment of central visual acuity in the following situations: (1) corrected visual acuity of one eye is to 20/200 and the other eye is 20/200; (2) corrected visual acuity of one eye is 15/200 and 20/200 in the other eye; (3) corrected visual acuity in one eye is 10/200 and 20/200 in the other eye; (4) corrected visual acuity of one eye is 5/200 and 20/200 in the other eye; or (5) blindness or anatomical loss of one eye and corrected vision in the other eye to 20/200. 38 C.F.R. § 4.84a, DCs 6064, 6068, 6072, 6075; 38 C.F.R. § 4.79, DCs 6064, 6065, 6066.

A 80 percent disability rating is warranted for impairment of central visual acuity in the following situations: (1) corrected visual acuity of one eye is to 15/200 and the other eye is 15/200; (2) corrected visual acuity of one eye is 10/200 and 15/200 in the other eye; (3) corrected visual acuity in one eye is 5/200 and 15/200 in the other eye; or (4) blindness or anatomical loss of one eye and corrected vision in the other eye to 15/200.
6075; 38 C.F.R. § 4.79, DCs 6064, 6065, 6066.

A 90 percent disability rating is warranted for impairment of central visual acuity in the following situations: (1) corrected visual acuity of one eye is to 10/200 and the other eye is 10/200; (2) corrected visual acuity of one eye is 5/200 and 10/200 in the other eye; or (3) blindness or anatomical loss of one eye and corrected vision in the other eye to 10/200. 38 C.F.R. § 4.84a, DCs 6064, 6068, 6072, 6075; 38 C.F.R. § 4.79, DCs 6064, 6065, 6066.

A 100 percent disability rating is warranted for impairment of central visual acuity in the following situations: (1) corrected visual acuity of one eye is to 5/200 and the other eye is 5/200; (2) blindness or anatomical loss of one eye and corrected vision in the other eye to 5/200; or (3) blindness or anatomical loss of both eyes. 38 C.F.R. § 4.84a, DCs 6061, 6062, 6063, 6067, 6071; 38 C.F.R. § 4.79, DCs 6064, 6065.

The Board also has to consider whether and to what degree the Veteran's eye disability has impacted his visual field.

Impairment of field of vision is evaluated pursuant to 38 C.F.R. § 4.79; DCs 6080-81. Compensable ratings are provided for loss of temporal half of visual field, loss of nasal half of visual field, loss of inferior half of visual field, loss of superior half of visual field, or concentric contraction of visual field with the remaining field of at most 60 degrees. 38 C.F.R. § 4.79.

The normal visual field extent at eight principal meridians is 85 degrees temporally; 85 degrees down temporally; 65 degrees down; 50 degrees down nasally; 60 degrees nasally; 55 degrees up nasally; 45 degrees up; and 55 degrees up temporally. The extent of visual field contraction in each eye is determined by recording the extent of the remaining visual fields in each of the eight principal meridians.

Under both the former and revised criteria for Diagnostic Code 6080, when the remaining visual field is 46 to 60 degrees bilaterally or unilaterally, a 10 percent disability rating is assigned, or each affected eye may be evaluated as 20/50. 38 C.F.R. § 4.79.

When the remaining visual field is 31 to 45 degrees unilaterally or bilaterally, 10 percent and 30 percent disability ratings are assigned respectively, or each affected eye may be evaluated as 20/70. Id.

When the remaining visual field is 16 to 30 degrees unilaterally or bilaterally, 10 percent and 50 percent disability ratings are assigned respectively, or each affected eye may be evaluated as 20/100. Id.

When the remaining visual field is 6 to 16 degrees unilaterally or bilaterally, 20 percent and 70 percent disability ratings are assigned respectively, or each affected eye may be evaluated as 20/200. Id.

Evidence

In July 2017, the Veteran was afforded an in-person examination for his bilateral eye disability; bilateral chorioretinal scars and diplopia were diagnosed. The Veteran reported a gradual progression of diplopia; he was uncertain of when diplopia began and just started noticing it; objects are double not just shadowed; closing an eye did not help; the Veteran denied treatment, medications or surgery. He also reported bilateral blurry vision distance and near; glasses improved vision only mildly. On evaluation of his visual acuity, the Veteran's right uncorrected distance vision was 20/50; left uncorrected distance vision was 20/40 or better. Uncorrected near vision for the right eye was 20/200; uncorrected near vision of the left eye was 15/200. Corrected distance vision of the bilateral eyes was 20/40. Corrected near vision of the bilateral eyes was 20/40. The Veteran did not have a difference equal to two or more lines on the Snellen test type chart or its equivalent between distance and near corrected vision, with the near vision being worse. His pupil diameter was 2 mm in both eyes; the pupils were round and reactive to light; and no afferent pupillary defect was present. The Veteran did not have anatomical loss, light perception only, extremely poor vision, or blindness of either eye. Astigmatism was not shown; diplopia was shown with an unknown monocular bilateral etiology. Diplopia was present greater than 40 degrees, down, lateral, and up and was constant. Tonometry showed right eye pressure at 15 and left eye pressure at 17. External eye examination was normal. Internal eye exam showed a 0.75 c/d ratio in large right optic disc and 0.65 c/d ratio in large left optic disc; there was laser scarring inferior temporal with no apparent hole/tear/detachment of the right periphery and barricade laser scarring inferior surrounding atrophic hole (-) fluid cuff in the left periphery. The examiner indicated there was no visual field defect; there was bilateral retinopathy. It was noted there was decrease in visual activity or other visual impairment. The examiner indicated that during the past 12 months, the Veteran had not had any incapacitating episodes attributable to any eye condition and opined that the Veteran's eye disability had no functional impact. The examiner opined that a new diagnosis was a correction of the Veteran's previous diagnosis. Chorioretinal scars were observed in each eye that appear to barricade atrophic holes with no other retinal holes/tears/detachments in either eye. These scars are induced by treatment to prevent retinal detachments and are unrelated to cataracts. The retinal holes that required the laser treatment are also not related to cataracts. No cataracts were observed in either eye during the exam; thus, the examiner believed that this diagnosis was initially made in error. Monocular diplopia was subjectively reported in all directions of gaze in each eye, although no structural changes to either eye were observed that could account for these symptoms. Diplopia could be caused by cataracts; however, no cataracts were observed in either eye.

In September 2020, the Veteran was afforded an in-person VA eye examination; bilateral chorioretinal scars were diagnosed. The Veteran reported pain in both eyes; he could see well and saw a doctor every three- to six months. During the examination, the Veteran stated there was no diplopia. The examiner changed the diagnosis from chorioretinal scars with diplopia to chorioretinal scars without diplopia. On evaluation of his visual acuity, the Veteran's uncorrected distance of the right eye was 20/50; the uncorrected distance of the left eye was 20/40. The corrected distance of the right eye was 20/50; and the left was 20/40. The uncorrected near reading was 20/100 for both eyes. The corrected near reading was 20/40 for both eyes. The Veteran did not have a difference equal to two or more lines on the Snellen test type chart or its equivalent between distance and near corrected vision, with the near vision being worse. His pupil diameter was 2 mm in both eyes; the pupils were round and reactive to light; and no afferent pupillary defect was
uity, the Veteran's uncorrected distance of the right eye was 20/50; the uncorrected distance of the left eye was 20/40. The corrected distance of the right eye was 20/50; and the left was 20/40. The uncorrected near reading was 20/100 for both eyes. The corrected near reading was 20/40 for both eyes. The Veteran did not have a difference equal to two or more lines on the Snellen test type chart or its equivalent between distance and near corrected vision, with the near vision being worse. His pupil diameter was 2 mm in both eyes; the pupils were round and reactive to light; and no afferent pupillary defect was present. The Veteran did not have a difference equal to two or more lines on the Snellen test type chart or its equivalent between distance and near corrected vision, with the near vision being worse. His pupil diameter was 5 mm in both eyes; the pupils were round and reactive to light; and no afferent pupillary defect was present. The Veteran did not have anatomical loss, light perception only, extremely poor vision, or blindness of either eye. Astigmatism and diplopia were not shown. Tonometry showed right eye pressure of 15; and left eye pressure of 14. External eye examination was normal; internal eye examination was normal except for the bilateral chorioretinal scars. The examiner noted a decrease in visual acuity or other visual impairment attributable to the retinal scars. The examiner indicated that during the past 12 months, the Veteran had not had any incapacitating episodes attributable to any eye condition and opined that the Veteran's eye disability had no functional impact.

In July 2023, the Veteran was afforded an in-person VA eye examination; chorioretinal scars, keratoconus, lattice degeneration, and atrophic holes OS were diagnosed. The Veteran reported he experiences eye pain daily. On evaluation of his visual acuity, the Veteran's right and left uncorrected distance vision was 20/70; the right and left corrected distance vision was 20/50. The right and left uncorrected near vision was 20/200; the corrected near vision for both eyes was 20/50. The Veteran did not have a difference equal to two or more lines on the Snellen test type chart or its equivalent between distance and near corrected vision, with the near vision being worse. His pupil diameter was 3 mm in both eyes; the pupils were round and reactive to light; and no afferent pupillary defect was present. The Veteran did not have anatomical loss, light perception only, extremely poor vision, or blindness of either eye. Astigmatism and diplopia were not shown. Tonometry showed right eye pressure of 18 and left eye pressure of 19. External eye examination was normal except for mild paracentral cone with slight stromal thinning of the bilateral cornea. Internal eye examination was normal except for peripheral laser scarring inferior temporal, superior lattice of the right eye and laser scarring inferior atrophic hole, superior lattice of the left eye. The examiner noted that the Veteran's decrease in visual acuity or other visual impairment is attributable to keratoconus. The examiner indicated that during the past 12 months, the Veteran had not had any incapacitating episodes attributable to any eye condition and opined that the Veteran's eye disability has a functional impact on his ability to work as there is decreased best correct visual acuity in both eyes.

In October 2024, the Veteran was afforded an in-person VA eye examination; cataracts OU, retinal degeneration OU, and corneal scar RE were diagnosed. The Veteran reported a decline in his visual acuities and having intermittent infrequent diplopia; he did not know when it started but attributed it to his 1992 injury and chorioretinal scarring. On evaluation of his visual acuity, the Veteran's right- and left eye uncorrected distance vision was 20/200. The Veteran's corrected distance vision was 20/70 in both eyes. His uncorrected near vision was 20/200 in the right eye and 15/200 in the left eye. His corrected near vision was 20/100 in both eyes. The Veteran did not have a difference equal to two or more lines on the Snellen test type chart or its equivalent between distance and near corrected vision, with the near vision being worse. His pupil diameter was 2 mm in both eyes; the pupils were round and reactive to light; and no afferent pupillary defect was present. The Veteran did not have anatomical loss, light perception only, extremely poor vision, or blindness of either eye. Astigmatism and diplopia were not shown. Tonometry showed bilateral eye pressure of 3.
His uncorrected near vision was 20/200 in the right eye and 15/200 in the left eye. His corrected near vision was 20/100 in both eyes. The Veteran did not have a difference equal to two or more lines on the Snellen test type chart or its equivalent between distance and near corrected vision, with the near vision being worse. His pupil diameter was 2 mm in both eyes; the pupils were round and reactive to light; and no afferent pupillary defect was present. The Veteran did not have anatomical loss, light perception only, extremely poor vision, or blindness of either eye. Astigmatism and diplopia were not shown. Tonometry showed bilateral eye pressure of 3. External eye examination was normal except for age related nuclear sclerotic cataract of the bilateral lenses. Internal eye examination was normal except for peripheral retinal lattice degeneration superior of the right eye and peripheral retinal lattice degeneration inferior of the left eye. The examiner noted a right corneal opacity but no decrease in visual acuity or other visual impairment attributable to a corneal condition. The decreased vision was without a clear etiology. The cataract condition was preoperative; and there was no decrease in visual acuity or other visual impairment attributable to the cataract condition. There was peripheral degeneration of both eyes without decrease in visual acuity or other visual impairment attributable to a retina, macula, or vitreous condition. The examiner indicated that the Veteran did not have a documented visual field defect. It was noted there was decrease in visual activity or other visual impairment. The examiner indicated that during the past 12 months, the Veteran had not had any incapacitating episodes attributable to any eye condition and opined that the Veteran's eye disability had no functional impact.

Based on the examination, the Veteran's reports, and the medical records, the examiner opined that the Veteran has mild age-related cataracts in both eyes, stable peripheral retinal degeneration in both eyes, and a stable corneal scar in the right eye; and these diagnoses are inconsistent with the reported decline in visual acuity as their severity does not explain any significant vision loss. He has a history of reduced vision in both eyes with an unknown cause; and providers have noted functional vision loss, meaning there is no identifiable organic or physiological reason. Although records from around 1999 noted functional vision loss, a C&P eye exam in 2015 showed that his potential correction in both eyes was 20/20. His visual acuities and visual fields have historically been inconsistent, and do not correlate with any ocular findings. His visual fields upon examination were very reduced. It is also inconsistent with physical examination findings and past medical records. He has a history of being a poor visual field test taker. There is no diagnosis rendered for chorioretinal scars. The chorioretinal scars are related to prophylactic laser treatment for his peripheral retinal degeneration. It is not an ocular pathology and not severe enough to cause functional vision loss. There is no diagnosis rendered for diplopia; no treatment for it; and there was no ocular pathology found during the examination associated with his diplopia. Diplopia is not a known association with chorioretinal scarring from laser treatments for peripheral retinal degeneration or his reported injury.

The Board finds that the VA examinations are adequate for adjudication purposes. Although the VA examinations do not document each diagnosis, in particular, diplopia, in the record or those made by previous VA examiners, the medical opinions are significantly probative in that they show the veteran has a visual acuity disability in both eyes and none of the medical opinions suggest that the Veteran has an eye disorder that meets the criteria under another diagnostic code. Furthermore, the medical opinions are consistent in finding that during the 12 months prior to examination, the Veteran had not had any incapacitating episodes attributable to any eye condition and his eye disability had no functional impact on his ability to work.

The Board reviewed the VA treatment records throughout the period on appeal and the VA examinations indicated that the Veteran did not have a documented visual field defect; therefore, further discussion regarding whether a rating in excess of 10 percent is warranted at any time during the period on appeal for impairment of the Veteran's field of vision is not necessary. Moreover, the VA medical opinions show that the Veteran's diplopia is at best occasional or intermittent, which would be a noncompensable rating under DC 6090. Although the 2017 VA examination showed the Veteran had diplopia at greater than 40 degrees down, lateral and up, the equivalent visual acuity is 20/40, a noncompensable rating under DC 6066. The September 2020 VA examination showed the Veteran's corrected distance of the right eye was 20/50; and the
field defect; therefore, further discussion regarding whether a rating in excess of 10 percent is warranted at any time during the period on appeal for impairment of the Veteran's field of vision is not necessary. Moreover, the VA medical opinions show that the Veteran's diplopia is at best occasional or intermittent, which would be a noncompensable rating under DC 6090. Although the 2017 VA examination showed the Veteran had diplopia at greater than 40 degrees down, lateral and up, the equivalent visual acuity is 20/40, a noncompensable rating under DC 6066. The September 2020 VA examination showed the Veteran's corrected distance of the right eye was 20/50; and the left was 20/40; and the July 2023 VA examination showed right- and left corrected distance vision was 20/50. The corrected distance noted in the September 2020 and July 2023 VA examinations would only warrant a 10 percent rating under DC 6066.

The October 2024 VA examination showed a worsening in the Veteran's corrected distance vision -- 20/70 in both eyes. Under DC 6066, a 30 percent rating is warranted for vision in one eye at 20/70 and in the other eye 20/70. Therefore, a 30 percent rating for chorioretinal scars with diplopia (previously rated as cataracts) is warranted from October 11, 2024, when it became factually ascertainable that an increase in the eye disability had occurred during the period. 38 C.F.R. §§ 3.157, 3.400(o)(2). In this regard, the Board notes that the assignment of a particular diagnostic code is "completely dependent on the facts of a particular case." Butts v. Brown, 5 Vet. App. 532, 538 (1993). One diagnostic code may be more appropriate than another based on such factors as an individual's relevant medical history, the diagnosis and demonstrated symptomatology. Any change in a diagnostic code by a VA adjudicator must be specifically explained. See Pernorio v. Derwinski, 2 Vet. App. 625, 629 (1992). With the above criteria in mind, the Board notes that Diagnostic Code 6066 pertains specifically to the disability at issue rated under the Diagnostic Code created, would be more appropriate and favorable to the Veteran, and is not prejudicial.

Finally, the Board also notes that a review of the record shows that a rating in excess of 30 percent is not warranted because the evidence of record does not show documented incapacitating episodes requiring at least five but less than seven treatment visits for an eye condition during any twelve-month period during the period on appeal.

Accordingly, the greater weight of the evidence is in favor of the Veteran; and a disability rating of 30 percent under DC 6066 for chorioretinal scars with diplopia (previously rated as cataracts) is warranted from October 11, 2024, when it became factually ascertainable that an increase in the eye disability had occurred. 38 C.F.R. §§ 3.157, 3.400(o)(2).

John R. Doolittle, II

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Liza Treadwell

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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