"According to information on file, you do have some loss of wage-earning capacity due to your injury. Therefore, the [Office] is making you a tentative loss of wage-earning capacity rating of 50 percent commencing effective January 14, 1965, the day after your scheduled award expired. As soon as information is obtained showing you have completed your schooling ... consideration will be given to determining your actual earning capacity at that time and, if indicated, your rating will be adjusted on and after that date."

Appellant was instructed to inform the Office of his election between benefits under the Federal Employees' Compensation Act and benefits under the Civil Service Retirement Act.

By letter dated April 13, 1965, appellant requested clarification on the manner in which his compensation benefits had been computed and stated that he did not retire voluntarily but "was forced out due to my loss of vision in my right eye."

By letter dated April 26, 1965, the Office explained how benefits were calculated and advised appellant that his wage-earning capacity could be adjusted at the completion of his vocational training.

By letter dated May 24, 1965, appellant commented that he did not understand the calculations and stated, "[A]t this time, I will stay put where I am."

By letter dated June 30, 1965, the Office stated, "Your weekly pay at the time of injury was $92.00 per week. You have been awarded compensation based on three fourths of a tentative loss of earning capacity of $46.00 per week." The letter reiterated the manner in which appellant's compensation would be computed and informed appellant that authorization for medical treatment would be furnished.

In an internal memorandum dated October 26, 1967, the Office noted that appellant was not receiving compensation.

By letters dated February 22 and May 1, 1978, appellant requested "forms to open up my compensation case." By letter dated May 16, 1978, the Office stated that medical expenses for treatment of appellant's condition sustained on February 22, 1960 continued to be authorized but that "[s]ince your injury was before July 1974 and you drew a scheduled award for 100 percent loss of your right eye no further compensation is payable."

By undated letter received by the Office on February 9, 1979, appellant stated that he was totally disabled from his 1960 work injury and requested that his benefits be changed from civil service disability retirement to workers' compensation.

By letter dated February 28, 1979, the Office notified appellant that "review of your case file indicates that you were rated in April 1965 at a 50 percent loss of wage-earning capacity and that you chose to elect benefits of the Civil Service Retirement Act." The Office requested medical and factual information to support appellant's claim of total disability.

By letter dated December 5, 1986, appellant stated that he could not currently work due to his vision problems, indicated that he had completely stopped working in 1977 and requested compensation benefits.

By letter dated December 16, 1986, the Office informed appellant that he had received the full amount of compensation payable for loss of use of his right eye and that he had requested in his May 24, 1965 letter to remain on disability retirement. The Office informed appellant that additional factual and medical information was necessary to support appellant's claim of total disability and that after such information was received appellant's wage-earning capacity, described in 1965 as a tentative loss of wage-earning capacity of 50 percent of full capability, would be reviewed.

By letters received by the Office on July 16, October 8 and October 30, 1987, appellant submitted wage information for the years 1965 through 1977, noting that no information was available with respect to his earnings from his former employer.

Contained in the record is the February 9, 1978 report of Dr. Jack A. Dillahunt, a Board-certified ophthalmologist, who noted findings upon physical examination, and stated that appellant had worn a contact lens in his right eye until 1972 but discontinued the lens due to irritation. Dr. Dillahunt noted that appellant then used his left eye vision, leaving the right eye uncorrected until "the left was disturbed by [a] developing cataract in 1977, impelling him to try to obtain satisfactory correction of the aphakic right eye." In a December 19, 1979 report, Dr. Bruce W. Parker noted that appellant underwent cataract surgery on the left eye and recommended a new prescription for appellant's eyeglasses. By report dated January 31, 1987, Dr. Dwight Thibodeaux, an optometrist, noted findings upon physical examination and related reasons for appellant's "lack of ability to fulfill the requirements of heating/air conditioning repair" due to the following factors:

"(1) With rigid lenses the environment associated with heaters and air conditioners [is] too dusty to maintain comfort and consistent vision clarity, due to the pain and tearing experienced

when dust particles are trapped between the lens and the

cornea.

"(2) With aphakic spectacle correction, the peripheral distortions induced by the extremely high power lenses results in a dangerous lack of balance and spatial awareness that precludes the use of ladders needed for maintenance of many of the heating or air conditioning units he works on. . . .

"He cannot, due to his limited prescription options, fully perform the duties of a heating/air conditioning repair person."

By letter dated November 30, 1987, the Office referred appellant, together with a statement of accepted facts and the medical evidence of record, to Dr. Jerome W. Bettman, a Board-certified ophthalmologist, for an evaluation and a rationalized opinion on whether or not appellant is totally disabled from performing the duties of heating and air conditioning repair and, if so, whether his disability is the result of his February 22, 1960 injury.

By report dated January 12, 1988, Dr. Bettman noted appellant's history of injury, cataract surgery to the right eye in 1961, and cataract surgery to the left eye in 1977 at which time he stopped working. Dr. Bettman noted appellant's complaints that he could not drive or read with his aphakic spectacles, and that he had trouble intermittently with his contact lenses in windy and dusty weather. Dr. Bettman noted the following history:

"When [appellant] was a unilateral aphake after removal of the right cataract, he stated that he had to get along with just one eye when he was working as a civilian firefighter because of the dusty and smoky environment. . . . He stated that he actually had to change jobs from a firefighter to refrigeration and air conditioning repair because of the use of the unilateral contact lens when he was a unilateral aphake."

Dr. Bettman diagnosed bilateral aphakic open angle glaucoma; history of contusion injury to right eye, "but without current evidence of contusion angle deformity or . . . evidence of contusion ocular damage"; bilateral vitreous detachments without evidence of peripheral retinal tear or retinal detachment formation; surgical aphakia of the right and left eye; bilateral aphakic refractive error correctable to 20/20 in both eyes, at distance and near, with hard contact lenses; bilateral high corneal astigmatism; loose vitreous strands not clinically significant; and moderate bilateral keratitis

sicca. Dr. Bettman requested that appellant return for additional testing and opined:

"The claimant is not totally disabled from performing duties of a heating and air conditioning repairman. He could wear contact lenses and a protective pair of glasses over the contact lenses to protect against dust, or he could undergo secondary insertion of intraocular lenses if that were deemed desirable. He could even learn to function with his aphakic spectacles, although this would be more difficult for him. However, many people in the past have functioned well with aphakic spectacles without contact lenses and held down different kinds of jobs."

By letter dated February 26, 1988, the Office acknowledged Dr. Bettman's request for additional testing and noted that he had "stated in [his] report that [appellant] is not disabled from performing his duties." Dr. Bettman was authorized to perform any additional testing needed to resolve the issue of whether appellant is disabled from performing his duties as a heating and air conditioning repairman.

By report dated March 14, 1988, Dr. Bettman noted that the purpose of his second examination was to determine formal visual fields and diagnosed the following:

"Formal visual fields were interesting. Both visual fields were spiral in nature. This was done with the patient's contact lenses on. Visual acuity with contact lenses was 20/20, right eye, and 20/30, left eye.

"Spiral visual fields are interpreted as nonphysiologic. They either mean that the patient has a functional overlay or that he is malingering. There is no disease process that can cause them. They are certainly not indicative of glaucoma, but of course do not mean that the patient does not have glaucoma.

"Spiral visual fields can be seen in people who want to try to impress the physician with their defect and are trying for a secondary gain. In this particular case, the patient told me more than once on the reexamination visit of March 14, 1988, that he wanted me to support his claims. As mentioned, spiral visual fields may also be interpreted as a functional overlay or a form of hysteric reaction.

"There was nothing on the visit of March 14, 1988 to give me cause to change my original conclusion that the patient is not

totally disabled from performing duties of a heating and air conditioning repairman."

Dr. Bettman recommended use of contact lenses with overlying spectacle shields to prevent dust from getting between the contact lens and the cornea or a secondary intraocular lens implant for both eyes.

In an internal memorandum dated April 6, 1988, the Office stated that a conflict existed between appellant's treating physician, Dr. Thibodeaux, who opined that appellant could not perform the duties of a heating and air conditioning repairman, and Dr. Bettman, who opined that appellant was not disabled from performing those duties.

However, by letter dated April 26, 1988, the Office requested a supplemental report from Dr. Bettman which addressed the issue of the percentage of permanent partial impairment of appellant's right eye due to the injury of February 22, 1960.

By report dated May 1, 1988, Dr. Bettman stated that he reviewed appellant's medical records and the American Medical Association's Guides to the Evaluation of Permanent Impairment, Chapter 6, The Visual System, and concluded that appellant had zero percentage of visual impairment. Dr. Bettman listed the three criteria for evaluation of vision: corrected visual acuity for objects at distance and near, visual fields, and ocular motility without diplopia. Of these three criteria, Dr. Bettman concluded that ocular motility was "entirely normal" and measurement of visual fields could not be relied upon as the findings in appellant's case were not physiologic but due to "functional overlay or due to malingering." Dr. Bettman stated the following with respect to the third criterion:

"[C]orrected visual acuity for objects at distance and near, is one of two of the criteria that is open to some debate and question. The patient is correctable . . . to 20/20 with his contact lenses both at distance and near. The AMA criteria give 50 percent impairment of loss of central vision if the patient is a monocular aphake. However, since that time . . . the left eye underwent cataract extraction (1977), so he is no longer a monocular aphake. The criteria are very specific in this regard. Since the patient is a binocular aphake, he is not awarded the 50 percent visual impairment that he would have been awarded had he remained a monocular aphake. Had he been evaluat