Kinnaman v. Principi

4 Vet. App. 20, 1993 U.S. Vet. App. LEXIS 1, 1993 WL 2213
CourtUnited States Court of Appeals for Veterans Claims
DecidedJanuary 7, 1993
DocketNo. 90-784
StatusPublished
Cited by14 cases

This text of 4 Vet. App. 20 (Kinnaman v. Principi) is published on Counsel Stack Legal Research, covering United States Court of Appeals for Veterans Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kinnaman v. Principi, 4 Vet. App. 20, 1993 U.S. Vet. App. LEXIS 1, 1993 WL 2213 (Cal. 1993).

Opinion

IVERS, Associate Judge:

Philip A. Kinnaman appeals from a May 2, 1990, Board of Veterans’ Appeals (BVA or Board) decision which denied him service connection for bilateral keratoconus, a cone-shaped protrusion of the cornea. Webster’s Medical Desk DictionaRy 363 (1986). The Court has jurisdiction of the case under 38 U.S.C. § 7252(a) (formerly § 4052(a)). For the reasons set forth below, we reverse the decision of the BVA and remand the case for an award of service connection consistent with this opinion.

FACTS

The veteran served in the United States Coast Guard from April 1974 to July 1977. R. at 105. His preinduction physical examination was conducted on April 11, 1974, and showed the veteran’s uncorrected vision as 20/70 in the right eye and 20/100 in the left. R. at 56. His corrected vision was reported as 20/25 in the right and left eyes. Id. His eyes were reported as normal on the clinical evaluation. R. at 57. On April 30,1974, the veteran underwent a pretraining physical examination during which his uncorrected vision was again recorded as 20/70 in the right eye and 20/100 in the left eye and his corrected vision was recorded as 20/30 in the right and left eyes. R. at 7. There were no clinical findings reported on this examination. R. at 6. On May 23, 1974, Mr. Kinnaman was seen for a routine Coast Guard recruit eye examination which was conducted by J.M. Harmon, O.D., at the Eye Clinic of the United States Public Health Service Hospital in San Francisco. R. at 16, 18, 50, 55. During this examination, the veteran reported that he had received his first pair of spectacles five months before but was now experiencing blurred distance vision. R. at 16, 50. He reported no history of eye injury, disease, or surgery. Id. Dr. Harmon’s diagnosis was “probable early kera-toconus.” R. at 18, 55. The veteran was seen again at the clinic on May 30, 1974, for a keratoconic fitting for contact lenses. R. at 19, 62.

In a letter dated June 3, 1974, Dr. Harmon reported his findings regarding Mr. Kinnaman’s eye condition to the United States Coast Guard. R. at 15, 60. The doctor wrote that “Mr. Kinnaman has an eye condition tentatively diagnosed as kera-toconus, a noninflammatory degenerative disease of the cornea,” the cause of which is unknown. Id. In addition, Dr. Harmon reported that “[hjistory and ocular signs indicate the condition was present prior to C[oast] G[uard] induction.” Id. Throughout the summer of 1974, Mr. Kinnaman continued to be treated and examined for his eye condition. R. at 21-26, 51-54, 64-72. In July, he was seen by Dr. Lee Stewart, an ophthalmological consultant. R. at 25, 50, 67-68. A photo keratograph of the left eye confirmed irregularities of the corneal contour indicative of keratoconus. Id. In an outpatient report dated August 20, 1974, a final diagnosis of early keratoconus of the left eye was confirmed by Dr. Harmon. R. at 50. In his report, Dr. Harmon stated, “Whether or not the condition existed prior to entry into the Coast Guard cannot be stated with absolute certainty, although it is probable that the process began earlier. The condition has not been aggravated by his service in the Coast Guard.” Id. The doctor’s prognosis was that “[t]he condition may progress,” and he [22]*22noted, “Therefore it is reasonable to recommend discharge from the Coast Guard.” Id.

In September 1974, a Coast Guard Medical Board was convened to determine whether Mr. Kinnaman’s eye disorder rendered him unfit for duty. R. at 48-49. The report of the Medical Board, written by Dr. David B. Cook, concluded the following:

There is neither history nor record of physical findings indicative of the existence of [kjeratoconus prior to entry into the Coast Guard. I, therefore, feel that it must be assumed that this condition did not exist prior to service.
Although S[eaman] Apprentice] KIN-NAMAN is strongly motivated to remain in the Coast Guard, phone conversation with Dr. HARMAN [sic] reveals that attempted therapy with hard contact lenses was unsuccessful in SA KINNAMAN’S case. Neither is Dr. HARMAN [sic] enthusiastic about the therapeutic prospects of the use of soft contact lenses and glasses. Other treatment such as the possibility of corneal transplant would not be attempted until much later in the course of the disease.
... It is therefore the recommendation of this Medical Board that SA KINNA-MAN be discharged on the basis of a physical defect incurred during a period of military service.

R. at 49 (capital letters in original).

On November 11, 1974, the findings of the Medical Board were overruled by the Coast Guard Physical Evaluation Board (PEB) which found Mr. Kinnaman fit for duty and ordered him to return to duty. R. at 46. The findings of the PEB were approved by the Coast Guard Commandant on December 16, 1974, and the veteran’s commanding officer was notified that “Seaman KINNAMAN shall not be retired or separated by reason of physical disability.” R. at 45, 137 (capital letters in original). Throughout the remainder of his active service, the veteran underwent numerous eye examinations. R. at 29, 31-44, 77, 79-82, 85-87, 90-92, 95. He suffered, inter alia, from blurred vision and temporal headaches. Id.

In a letter to the Coast Guard dated January 14, 1975, Dr. Harmon reported, “Mr. Kinnaman has been determined to have keratoconus of both eyes. The condition is quite apparent in the left eye but only slightly affect [sic] the right eye.” R. at 14, 76. In addition, Dr. Harmon noted,

[Mr. Kinnaman] has been followed by me since May 23, 1974, and last examined on January 6, 1975. His visual acuity with glasses and corneal curvatures have remained essentially the same since August of 1974. The condition is now stable or progressing very slowly. This stability may persist indefinitely. However, keratoconus is an unpredictable entity and progression could recurr [sic] at any time. Because of this unpredectability [sic] Mr. Kennaman [sic] should be examined by an ophthalmologist or optometrist every four to six months, or sooner if symptoms occur.

Id.

In 1977, another Coast Guard Medical Board met to evaluate Mr. Kinnaman’s condition and determine whether he was fit to remain in service. R. at 99. The Board reviewed a March 17, 1977, outpatient narrative summary submitted by Dr. Harmon. Id. In his summary, Dr. Harmon repeated his opinion of August 1974 with regard to when Mr. Kinnaman’s keratoconus was incurred and whether it was aggravated during service: “Whether or not this condition existed prior to entry into the Coast Guard cannot be stated with certainty, although it is probable that the process began earlier. The condition has not been aggravated by service in the Coast Guard.” R. at 100. On April 12, 1977, the Medical Board forwarded the case, without recommendation, to the PEB for disposition. R. at 99.

On June 8, 1977, the PEB found that Mr. Kinnaman suffered from keratoconus of the left eye, that the disease was incurred while in service, that the disease was the proximate result of his performance of active duty, that the disease was incurred in the line of duty during a time of war or national emergency, and that the disease [23]*23was not the result of willful neglect or intentional misconduct. R. at 97.

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Cite This Page — Counsel Stack

Bluebook (online)
4 Vet. App. 20, 1993 U.S. Vet. App. LEXIS 1, 1993 WL 2213, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kinnaman-v-principi-cavc-1993.