Christian McTarnaghan: Hi everybody and welcome to another edition of CCK Live. My name is
Christian McTarnaghan and today I am joined with Bethany Cook and Kaitlyn Degnan and we
are going to talk about eye conditions. So we are going to start basically right from
the beginning which is a question that you guys might have which is how can I get service-connected
for an eye condition. We are going to focus on the two main ways. One way is direct service
connection and I am going to talk about that briefly and then I am going to turn it over
to Bethany to talk about the other sort of major way that you can get service-connected
for an eye condition, which is secondarily service connection. So what is direct service
connection? It might be the most straightforward way to get service-connected. You get an eye
injury in service. You have a current eye disability and then there is a Nexus or a
connection between that in-service eye injury and the eye disability that you have now.
If you can meet all those three elements, then you should get a direct service connection
for the eye condition because it is directly related to an injury that you had in service
but that is not the only way. Bethany, you want to talk a little bit about secondary
service connection?
Bethany Cook: Sure. So a secondary service connection is a little bit different. Essentially
an eye condition can get service-connected on a secondary basis if it is caused or aggravated
by a separate condition that is already service-connected. So for example certain medications can cause
eye disabilities; a major one coming up recently is hydroxychloroquine, which the Department
of Defense has used as an anti-malarial drug for troops. This is one medication that can
cause for example ocular toxicity as well as issues with the corneas. Specific conditions,
like Parkinson's disease or erectile dysfunction, have medications that can be linked to eye
disabilities. So if you are service-connected for Parkinson's disease or EDI and are prescribed
a medication that causes an eye disability, that eye disability might be able to get service-connected
but just like you would need a medical Nexus with a direct service connection you would
also need a medical Nexus linking your eye disability to the medication prescribed for
your service-connected disability as well. Other examples would be blood pressure medications.
They can be linked to worsening of glaucoma for example, and veterans who suffer a TBI
in service might also experience eye disabilities. So if you are service-connected for a TBI,
and eye disability results from the TBI you might be able to
get service-connected for the eye condition as well. Other service-connected conditions,
like diabetes sarcoidosis, thyroid conditions and multiple sclerosis all of these can cause
either changes in vision or eye disabilities. So if you do develop an eye condition a secondary
to any of these conditions and you are service-connected for them, then you might also be able to get
a service-connected for the eye disability on a secondary basis.
Kaitlyn Degnan: Many veterans are interested in what kind of eye conditions that they can
get service connection for. Some of the common ones that we see our loss of one eye with
reduced vision and the other veterans can also get service-connected for chronic conjunctivitis.
Another frequent one is blindness in one or both eyes, impaired vision in one or both
eyes, and unhealed eye injury or dry eyes.
Christian: Yes, so that is sort of maybe some of the most common ones. Certainly, there
are a lot of other eye conditions out there and so that is sort of the service connection
part. So you can either get service connection because you have an eye injury in service
or you have another service-connected disability such as diabetes like you mentioned Bethany
that then causes an eye problem. So the next topic that we want to talk about is in something
that you all might be interested in is so how do we get rated? So once you are service-connected
then the VA has a duty to determine what rating you should get for that disability. So VA
rates eye conditions on three main measurements. There is going to be the Central Visual Acuity,
the visual field, and then muscle functions. So Bethany you want to talk about that first
way the central visual acuity?
Bethany: Sure. So Central Visual Acuity is the ability to distinguish shapes and details
of objects at a given distance. So how focused or weary something is but you can think of
as a nearsighted or farsighted on both of which refer to a person's visual acuity. So
how VA measures that is using the basic eye chart examination measurements of visual acuity
range from 20/20 vision to 5/200. If a veteran Central Visual Acuity is worse than 5/200,
they are considered to be blind. So VA rates both eyes together. So veterans are going
to receive one combined reading. A veteran's ratings are based on their corrected vision
if it can be corrected. Meaning they will be rated based on how good or bad vision is
with glasses or contacts. So if you have 5/200 hundred vision without using corrective lenses,
but it can be improved to a better result than VA is going to use the corrected result
and assigning the rating.
Kaitlyn: Another method that VA will use to rate eyes is the visual field which is the
range of vision that can be seen when looking straight ahead which includes peripheral vision
without moving the eyeballs. So there is eight meridians that VA will use to test the eyesight
upward downwards nasally which is looking towards the nose temporarily which is looking
away from the nose and then once midway between each of these. The test will attach a number
to each of the visual fields, which is then added together. The normal field of vision
is about 500 degrees. So when a veteran visual field does not match this they are assigned
a rating based on the extent of the vision loss.
Christian: The last way that they would rate is like I noted at the beginning of this part
of the discussion is muscle function. That is much easier to say than visual acuity.
I do not know why I botched that but anyway, basically I think it is pretty self-explanatory.
It is about how well the muscles of your eye movement and its measured similarly to visual
fields just like the visual field chart muscles, test looking up looking down easily and temporally.
It is going to do the same thing as how your eyes move. They are going to rate the eyes
using scales that combine the measurements for both eyes and something to keep in mind
is when you are going to get rated you are going to need an exam and it is important
to know that only an optometrist or an ophthalmologist is qualified to take these measurements. This
is something we remind veterans in all of these CCK live presentations is go to your
exam and if it is being conducted by someone who is not an optometrist or an ophthalmologist,
that is something that you should write to VA about. That is something that you should
complain about because you are not getting an adequate and examination if you are not
getting it from those two qualified medical professionals. It is sort of like your general
rating if you get it ten or twenty percent for your eyes, but there is also other types
of compensation available for those with eye trouble, right Bethany?
Bethany: So the major one is special monthly compensation. We can talk a little bit about
special monthly compensation at the K level which if a veteran is eligible for it it would
result in a small bump to their monthly compensation check. So a veteran is eligible for SMC-K.
If they have a physical loss of one eye, total blindness in one eye, and there are also many
levels of higher SMC benefits a veteran also might be eligible for. For example, if they
have total blindness in both eyes, then they would be eligible for a higher level of SMC.
We have other CCK live videos talking about SMC especially these higher levels so I definitely
recommend taking a look at those to get more information about if you might be eligible
for a higher level of SMC than not the K1.
Christian: These are things that VA should be taking a look at really no matter what.
If you satisfy the requirements, they should be looking at it.
The fact of the matter is it sometimes they miss it and so it is helpful to know that
you might be eligible for this additional compensation per month. So if VA might miss
it, then it is something that you can bring up, and hopefully, have VA adjudicate for
you. So before we close today, I just wanted to open it up to the group to see if there
is any closing thoughts you all have or any tips for VA claims.
Kaitlyn: I would just reiterate how important exams are in this claim especially as far
as rating goes. Eye ratings are rated pretty mechanically. So it is very important in these
cases to show up for your exam and you honestly participate in the examination to make sure
that the person conducting the exam is getting full and accurate ratings for your eyes and
then I would also say that If I were to approach one of these cases the first thing I would
do is look at who conducted the exam and to make sure that it is a properly accredited
person.
Bethany: I would just add that it can be difficult to get a scheduler one hundred percent rating
especially for an eye disability alone. So I would encourage veterans if they are unable
to work due to their eye disability to look into other forms of compensation that might
be available to them like TDIU which we have covered extensively in the past. But that
is one way that a veteran can get compensated at the one hundred percent rate if they are
unable to work due to their eye disability even if the eye disability does not warrant
a rating of one hundred percent on its own.
Christian: Great. Well, thank you very much, Bethany and Kaitlyn, and thank you very much
for everyone who tuned in to this edition of CCK live and hope to see you again.