Citation Nr: 1319822 Decision Date: 06/19/13 Archive Date: 06/27/13 DOCKET NO. 09-49 319 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Portland, Oregon THE ISSUES 1. Entitlement to service connection for traumatic brain injury (TBI), claimed as head injury with episodes of dizziness and nausea. 2. Entitlement to service connection for defective vision to include as due to TBI. 3. Entitlement to service connection for a mood disorder to include as due to TBI. REPRESENTATION Appellant represented by: Oregon Department of Veterans' Affairs ATTORNEY FOR THE BOARD J.B. Freeman, Counsel INTRODUCTION The Veteran, who is the appellant in this case, served on active duty from September 1972 to July 1978. This case comes before the Board of Veterans' Appeals (Board) on appeal from a December 2007 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Portland, Oregon, which, in pertinent part, denied the reopening of service connection for TBI, and defective vision and a mood disorder, to include as due to TBI. The Board reopened and remanded these issues in November 2012. The Board has not only reviewed the Veteran's physical claims file but also the file on the "Virtual VA" system to insure a total review of the evidence. The Board remanded this case in relevant part twice, in July 2011 and November 2012. It returns now for appellate consideration. FINDINGS OF FACT 1. The Veteran sustained an in-service physical assault of being beaten with head trauma to the right temple in April 1977. 2. The Veteran did not sustain an occipital or brain stem injury during the in-service assault. 3. Symptoms of TBI, such as dizziness and nausea, were not chronic in service. 4. Symptoms of TBI, such as dizziness and nausea, have not been continuous since service separation. 5. The Veteran's TBI, claimed as residuals of a head injury such as dizziness and nausea, is not related to any incident of service, to include the 1977 assault. 6. The Veteran has been diagnosed with a mood disorder. 7. The Veteran's mood disorder is not related to any incident of service, to include the 1977 assault. 8. A chronic disability manifested by defective vision has not been demonstrated at any time during service or thereafter. CONCLUSIONS OF LAW 1. The Veteran's TBI, claimed as residuals of a head injury such as dizziness and nausea, was not incurred in active service. 38 U.S.C.A. §§ 1101, 1110, 1131, 1154(b), 5107 (West 2002); 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309 (2012). 2. A mood disorder was not incurred in active service. 38 U.S.C.A. §§ 1101, 1110, 1131, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.9 (2012). 3. A disability manifest by defective vision was not incurred in or aggravated by active service. 38 U.S.C.A. §§ 1101, 1110, 1131, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.9 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Duties to Notify and Assist VA has met all statutory and regulatory notice and duty to assist provisions as to the Veteran's claims for service connection for TBI, defective vision, and a mood disorder. See 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326 (2012). When VA receives a complete or substantially complete application for benefits, it is required to notify the claimant and his representative, if any, of any information and medical or lay evidence that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b). VA must inform the claimant of any information and evidence not of record (1) that is necessary to substantiate the claim; (2) that VA will seek to provide; and (3) that the claimant is expected to provide. Compliance with the first element requires notice of the five service connection elements: (1) veteran status; (2) existence of a disability; (3) a connection between the veteran's service and the disability; (4) degree of disability; and (5) effective date. See 38 U.S.C. § 5103(a); see also Dingess v. Nicholson, 19 Vet. App. 473, 490 (2006). A May 2007 letter fully satisfied the duty to notify provisions as to the claim for service connection for TBI, with episodes of dizziness and nausea, prior to initial adjudication of the Veteran's claims in December 2007. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b)(1). A September 2012 letter fully satisfied the duty to notify provisions after to initial adjudication of the Veteran's claims for service connection for defective vision and a mood disorder in December 2007. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b)(1). The September 2012 letter was not sent prior to initial adjudication of the Veteran's claims for service connection for defective vision and a mood disorder; however, he was subsequently provided adequate notice in September 2012, an opportunity to respond with additional argument and evidence, and the claims were readjudicated and an additional supplemental statement of the case (SSOC) was provided to the Veteran in October 2012. The Veteran also received an additional opportunity to submit evidence following a November 2012 Board remand. He was provided another SSOC in February 2013. The Board finds that no prejudice as to the Veteran's claims for service connection for defective vision and a mood disorder resulted from the timing of the notice. See Prickett v. Nicholson, 20 Vet. App. 370 (2006). The Board also concludes VA's duty to assist has been satisfied. The Veteran's service treatment records and VA medical records are in the file. Private medical records identified by the Veteran have been obtained, to the extent possible. The Veteran's Social Security Administration records have been associated with the file. The Veteran has at no time referenced outstanding records that he wanted VA to obtain or that he felt were relevant to the claims. The duty to assist also includes providing a medical examination or obtaining a medical opinion when such is necessary to make a decision on the claim, as defined by law. The Veteran was not afforded a VA examination or medical opinion in conjunction with any of his service connection claims. A medical examination or opinion is required when (1) there is evidence of a current disability, (2) evidence establishing an "in-service event, injury or disease," or a disease manifested in accordance with presumptive service connection regulations occurred which would support incurrence or aggravation, (3) an indication that the current disability may be related to the in-service event, and (4) insufficient competent medical evidence to decide the case. 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159(c); McLendon v. Nicholson, 20 Vet. App. 79, 81-82 (2006). The Board finds that the duty to assist does not require VA medical examinations or opinions with regard to any of his claims for service connection. The Board finds that a VA examination or medical opinion is not required for the Veteran's claim for service connection for a TBI, claimed as residuals of a head injury such as dizziness and nausea, or his claim for service connection for a mood disorder. Competent and credible lay or medical evidence is required to establish "an indication" that the Veteran's current disability "may be" related to the in-service event on which the Veteran relies as the cause of his current disability. See Waters v. Shinseki, 601 F.3d 1274, 1277-78 (Fed. Cir. 2010). The types of evidence that "indicate" that a current disability "may be associated" with military service include, but are not limited to, medical evidence that suggests a nexus but is too equivocal or lacking in specificity to support a decision on the merits, or credible evidence of continuity of symptomatology such as pain or other symptoms capable of lay observation. McLendon, 20 Vet. App. at 83. As will be discussed below, the Board has found that the Veteran's lay evidence is not credible as to the nature of the in-service injury, chronicity of symptoms during service, and continuity of symptoms thereafter. The Board has also rejected the Veteran's mother's statements as incompetent to address the necessary questions in either the TBI or mood disorder issues: whether his changed behavior was not a manifestation of a personality disorder. Incompetent or incredible evidence of continuity of symptomatology does not fall within the types of evidence which "indicate" that his current disability "may be associated" with military service. McLendon. There is one set of medical opinions, all from P.F., which relate a current disability of TBI with dizziness and nausea and behavioral changes to an in-service injury. The P.F. opinions do not lack specificity or are too equivocal to support a decision; they rely on the Veteran's account which the Board has found not credible; therefore these opinions are not entitled to probative value. The Veteran had contemporaneous treatment in service which weighs heavily against the Veteran's contentions. The post-service medical evidence surrounding the Veteran's initial treatment for a brain disorder occurred in 1988. That evidence attributed the brain disorder to alcohol abuse. Veterans can only recover for an alcohol or drug abuse disability secondary to a service-connected disability if they can adequately establish that their alcohol or drug abuse disability is secondary to or is caused by their primary service-connected disability. Allen v. Principi, 237 F.3d 1368 (Fed. Cir. 2001). The Veteran is only service connected for residuals of rib fractures. There is no evidence, either lay or medical, to suggest that the rib fracture residuals resulted in excessive alcohol consumption. The medical evidence does not otherwise indicate that TBI or a mood disorder may be related to service. The Board finds that the record is insufficient to trigger VA's duty to provide a medical examination or nexus opinion. Cf. Duenas v. Principi, 18 Vet. App. 512, 517 (2004). As will be discussed below, the Veteran's service and VA treatment records reflect repeated specific evaluation of the Veteran's eyes in consideration of his complaints of double or blurry vision. These reports do not reflect that there is or ever has been a current eye disability manifest by double or blurry vision. As these examinations are current, thorough and focus on the affected area, the Board finds that the preponderance of the medical evidence is against a current diagnosis of the claimed eye disorder. An examination is not required on the claim for service connection for defective vision because there is competent medical evidence to decide the claim. See McLendon, 20 Vet. App. at 81-82. The Board is obligated by law to ensure that the RO complies with its directives; where the remand orders of the Board are not complied with, the Board errs as a matter of law when it fails to ensure compliance. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board remanded the claims for service connection for TBI, defective vision, and a mood disorder twice. The first remand in July 2011 required that the Veteran be provided adequate notice under 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(c). That notice was accomplished in a September 2012 letter, discussed above. The Board notes that inadequate letters were sent in July and October 2011 and August 2012. Incorrect and confusing information renders 38 U.S.C.A. § 5103(a) notice inadequate. Kent v. Nicholson, 20 Vet. App. 1, 12 (2006). The September 2012 letter stated clearly on the cover page that the prior notice had been incorrect and that the Veteran should disregard them. To the extent that the July and October 2011 and August 2012 were misleading, any misdirection was corrected by the September 2012 letter in a timely fashion. The July 2011 remand also instructed that the Veteran's claims be readjudicated and a SSOC provided if the claims were not granted. An October 2012 SSOC completed that instruction. The Board finds that the RO complied substantially with July 2011 remand instructions. The Board remanded this case again in November 2012. Following issuance of the October 2012 SSOC, the Veteran had indicated that he had more evidence to submit. The Board remanded to allow him the opportunity to submit that evidence and provide readjudication and a SSOC if the claims were not granted. The Veteran did not, ultimately, submit additional evidence. The claims were not granted during readjudication and a February 2013 SSOC was issued. The Board finds that the RO complied substantially with November 2012 remand instructions. Further remand for additional development of the prior remand instructions is not warranted. See Stegall, 11 Vet. App. at 271. Service Connection - Legal Criteria Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131. Service connection connotes many factors but basically means that the evidence establishes that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces, or if preexisted such service, was aggravated therein. 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Establishing service connection generally requires competent and credible evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Other organic diseases of the nervous system are classified as "chronic disease" listed under 38 C.F.R. § 3.309(a); therefore, 38 C.F.R. § 3.303(b) applies. Walker v. Shinseki, 708 F.3d 1331, 1337 (Fed. Cir. 2013). The brain is an organ in the nervous system; therefore, the TBI claim falls within the "other organic diseases of the nervous system" category of "chronic disease." Where the evidence shows a "chronic disease" in service or "continuity of symptoms" after service, the disease shall be presumed to have been incurred in service. For the showing of "chronic" disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With chronic disease as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service-connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally, a showing of "continuity of symptoms" after service is required for service connection. 38 C.F.R. § 3.303(b). Additionally, where a veteran served ninety days or more of active service, and certain chronic diseases, such as organic diseases of the nervous system, become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137 (West 2002); 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. Id. Defective vision is not classified as "chronic disease" listed under 38 C.F.R. § 3.309(a). Mood disorders are not directly listed as "chronic diseases" under 38 C.F.R. § 3.309(a). Psychoses are classified as "chronic diseases," but mood disorders are not among those psychiatric disabilities considered psychoses for VA purposes. 38 C.F.R. § 3.384 (2012). 38 C.F.R. § 3.303(b) does not apply to either the defective vision or mood disorder service connection claim. Walker, 708 F.3d at 1337. For purposes of entitlement to benefits, the law provides that refractive errors of the eyes are congenital or developmental defects and are not a disease or injury within the meaning of applicable legislation. In the absence of superimposed disease or injury, service connection may not be allowed for refractive error of the eyes, including myopia, presbyopia, and astigmatism, even if visual acuity decreased in service, as this is not a disease or injury within the meaning of applicable legislation relating to service connection. 38 C.F.R. §§ 3.303(c), 4.9; see also Winn v. Brown, 8 Vet. App. 510, 516 (1996). Thus, VA regulations specifically prohibit service connection for refractive errors of the eyes unless such defect was subjected to a superimposed disease or injury which created additional disability. VAOPGCPREC 82-90. The Veteran and his mother have submitted statements in support of these claims. They do not have the requisite medical knowledge or training to qualify as medical experts. Accordingly, they are not competent to diagnose any medical disorder or render an opinion as to the cause or etiology of any current disorder. See Rucker v. Brown, 10 Vet. App. 67, 74 (1997). They may provide lay evidence. Lay persons are competent to provide opinions on some medical issues falling within the realm of common knowledge. See Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. See Jandreau, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Even where competent evidence is produced, the Board has an obligation to determine the credibility of all evidence, lay and medical. See Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997). The Board has thoroughly reviewed all the evidence in the Veteran's claims folders. Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, the evidence submitted by the Veteran or on his behalf. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (the Board must review the entire record, but does not have to discuss each piece of evidence). The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claims. The Veteran must not assume that the Board has overlooked pieces of evidence that are not explicitly discussed herein. See Timberlake v. Gober, 14 Vet. App. 122 (2000) (the law requires only that the Board address its reasons for rejecting evidence favorable to the appellant). The Board must assess the credibility and weight of all evidence, including the medical evidence, to determine its probative value, accounting for evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Service Connection for TBI, Claimed as Head Injury with Episodes of Dizziness and Nausea, and for a Mood Disorder The Board must first distinguish these service connection claims from several others. The Veteran has been separately denied service connection for non-psychotic organic brain syndrome (OBS) with brain trauma, passive aggressive personality disorder with intermittent explosive disorder, and posttraumatic stress disorder (PTSD). The Board denied reopening of these claims in July 2011. The Veteran was notified of the decision in the same month and did not appeal those determinations. The Board's July 2011 decision is final as to the brain syndrome, personality disorder and PTSD claims. See 38 U.S.C.A. § 7104 (West 2002). The only remaining service connection claims are for TBI with episodes of dizziness and nausea, for a mood disorder and for defective vision. As the TBI and mood disorder claims involve nearly identical facts, they are addressed together. The defective vision claim will be treated separately below. The Board acknowledges that the Veteran has been diagnosed with multiple psychiatric disorders other than a mood disorder, including PTSD, depression, personality disorder, organic brain syndrome, and organic affective syndrome. The scope of a service connection claim for a mental disability is not restricted to the specific diagnosis alleged by the claimant, but includes any mental disability which may reasonably be encompassed by the claimant's description of the claim, the reported symptoms, and other information of record. Clemons v. Shinseki, 23 Vet. App. 1 (2009). Service connection claims for the Veteran's other psychiatric disorders have been previously adjudicated. The Board denied reopening of service connection for these other disorders in July 2011, in conjunction with this appeal. The mood disorder claim is the only surviving component of a general attempt to reopen his many claims for service connection for a psychiatric disability. The Board finds that the Clemons holding does not apply to the facts of this case, as the facts of Clemons are distinguishable from the facts of this case because of the explicit adjudications of the various psychiatric diagnoses including those by the Board. The Veteran's allegations surround an April 1977 assault during service. He contends that he suffered TBI in a pub fight while stationed in England when he was struck with a bottle. He now contends that he had TBI with episodes of dizziness and nausea as a result of the April 1977 assault. He states that his behavior changed as a result of the blow to the head and that he has had this disorder since service. The Veteran's service treatment records contain an April 25, 1977 note describing his complaints four days after the injury. He reported trauma to his face and complained of blurred vision. An intake note also stated that he had double vision. His EOM's (extra ocular muscles) were intact. His pupils were round, reactive, and equal. There was no evidence of orbital fracture. He was referred to the ophthalmological service. The consultation note clarifies that there was no double vision. He was struck in the right temple. He had blurry vision only in the right eye. He reported headaches since the fight. He had a history of visual field loss. The impression was no ocular damage due to trauma. The Veteran has filed numerous statements to the effect that he was struck in the back of the head, not in the front. He insists that he tried to get the examiners to write down that he was struck in the back of the head but that they ignored him. He has also insisted on many occasions that he had a brain stem injury, repeatedly telling this to treatment providers. The Veteran is competent to report a back of the head trauma, rather than the right temple trauma recorded in his service treatment records; hence, the question is whether his reports are credible. The Veteran testified at a RO hearing in September 1992. He stated that, although his service treatment records showed a facial injury, he had a head injury, that the nurse who examined him at the time did not examine the back of his head where he was hit, and that he could "stick [his] fingers into the second knuckle." In a letter to his United States Senator, dated in March 1997, the Veteran stated that he was provided psychiatric treatment during service, but that the referral for treatment was due to racial discrimination by African-American and Hispanic service members. He reported special assignment to security details and receipt of a medal for marksmanship. He reported that he was assaulted in April 1977 by five British paratroopers and was struck in the back of the head with a beer bottle, and that within six months of this incident he began to experience violent rages and outbursts of physical violence. In a statement, received in February 2000, the Veteran reported that he was assaulted by two fellow servicemen in 1977 and was referred for psychiatric intervention. The Veteran provided a detailed description of the 1977 incident, indicating that he was visiting a Royal Air Force (RAF) member, P.W. He reported that a fight broke out at a local pub between the Veteran and P.W. and five British servicemen. The Veteran stated that he had drunk to "moderation." He stated that the British servicemen followed the veteran and P.W. after they left the pub and attempted to run them down with their vehicle. The Veteran reported that the British servicemen then attacked him and hit him on the back of the head. He reported nausea and dizziness on the remaining walk to the home of P.W. The Veteran stated that following this incident he began to have difficulty with co-workers and developed a defective attitude toward the military. The Board notes that this statement, made more than 20 years after the incident, included a significant amount of detail of the incidents of 1977 and early 1978, including the exact drinks ordered at a dinner, exact times of beginning and ending duty periods on individual dates, and type of vehicle borrowed to take his spouse to the airport. In a statement received in February 2000, the Veteran also reported that he had been attacked several times in bars, all without provocation. He stated that he disliked being in public and that he "hate[s] people, wishing them ill or giving them grief when able to." The Veteran included copies of several articles concerning brain/head injury, including "The Anatomy of a Brain Injury," and "The Road to Rehabilitation," both printed from the Brain Injury Association's website, and articles from "Brain Injury Source." At an October 2001 Board hearing, the Veteran testified that he was assaulted in April 1977 by five British servicemen, who pursued him following a confrontation at a pub. He reported initial symptoms of drowsiness, nausea, and vision problems, and momentary loss of consciousness, and claimed that that after this incident he began to have problems in his marriage and with his coworkers and supervisors. He reported that he began to have violent outbursts, which were "very unusual for me at that point in my life," and that he had problems with anger prior to service, but that, through counseling, this condition had improved. In June 2005 the Veteran testified at another Board hearing. He testified that he sustained a head injury to the back of the head in service in 1977. He claimed that five members of the Royal Army attacked him and his friend. He testified that he had problems with his vision after the head injury, and that when he went for medical treatment in service he indicated that the back of his head was hit, but the medical professionals did not acknowledge this. He claimed that prior to the head injury in 1977 he had only minor problems in service, but that after the head injury his performance in service and his emotional state started to deteriorate. He testified that the symptomatology of his head trauma included visual disturbances and emotional problems. The Veteran has submitted an October 2012 CT scan of his skull, which noted "a generous occipital protuberance." This was offered in support of the proposition that he had a head injury to the back of his head. The Board is not persuaded by the Veteran's statement that he had a back of the head injury, not a facial injury, during service in April 1977. The absence of evidence may not generally be considered as substantive negative evidence. McLendon v. Nicholson, 20 Vet. App. 79, 85 (2006); see also Forshey v. Principi, 284 F.3d 1335, 1363 (Fed. Cir. 2002) (en banc) (Mayer, C.J., dissenting) (distinguishing between the existence of negative evidence and the absence of actual evidence and noting that "[t]he absence of actual evidence is not substantive 'negative evidence' "). In some situations, silence to a condition may be taken as proof that the doctor did not observe the symptom. Buczynski v. Shinseki, 24 Vet. App. 221, 224 (2011). The absence of an entry in a record may be evidence against the existence of a fact if it would ordinarily be recorded. Fed. R. Evid. 803(7). The Veteran alleges that he sought treatment for following a fight and being struck in the head. Specific recording of all locations of injuries would be standard medical practice. Such recording would rely on observation and the patient's report. The fact that medical providers wrote down a right temple injury is strong evidence that a right temple injury, and not occipital injury, occurred. See Kahana v. Shinseki, 24 Vet. App. 428, 438 (2011) (stating that VA may use silence in the service treatment records as evidence contradictory to a veteran's assertions if the service treatment records appear to be complete and the injury, disease, or symptoms involved would ordinarily have been recorded had they occurred). The 2012 CT scan also does not support his claim. Although it states he has an occipital protuberance, it also states that it is a "normal variation." Thus, it is not a traumatically acquired defect of the skull. Moreover, the Veteran's testimony and statements in support of his claim are highly inconsistent and, with his own varied accounts as well as the service treatment records history and findings, not credible. He testified that he could stick a finger into the rear of his skull and that somehow multiple medical treatment providers refused to write down or acknowledge a hole of that magnitude. Such testimony is beyond belief, given the medical providers' duties to accurately and thoroughly record such relevant fact when observing and treating a patient. More recently for compensation purposes, the Veteran has also reported a greater injury than he reported contemporaneously during service; he now reports that he had loss of consciousness, which he specifically denied at his separation examination ever occurring. The Veteran has made a general and unsubstantiated accusation of racial discrimination as the motivation for his in-service psychiatric evaluation in 1978. As will be discussed, the service treatment records show instead his evaluation was motivated by disciplinary problems. The Board finds that the Veteran's accounts of his April 1977 assault lack credibility. The Veteran's account that medical providers refused to write down the correct injury location is contrary to routine medical practice. His account of the severity of the injury strains credulity as well. The contemporaneous medical reports are entitled to great probative weight based on their timeliness, the nature of medical practice, thoroughness, and creation for treatment purposes. Any medical report relying on a back of the head injury will be similarly discounted. Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that the Board may reject a medical opinion based on an inaccurate factual basis). The Veteran's mother has submitted several statements in support of the Veteran's claims, received in March 1997, April 1999, and September 2011. The March 1997 statement indicates that the Veteran had no serious problems relating to behavioral traits. She noted that he was referred for a psychological evaluation by the school counselor following an altercation with other students. She stated, that after service, "at which time he sustained the brain stem injury," the Veteran began to exhibit withdrawal from the family, hostility, and became argumentative. The April 1999 statement indicates that the Veteran began to experience difficulties during service in 1977 and upon discharge in 1978 showed a change in personality. She stated, that the Veteran began drinking in 1982, and she also noted his difficulty in maintaining employment, failure of two marriages, and difficulties in his current marriage. The September 2011 statement indicates that, during his sophomore year of high school, the Veteran was referred by the school counselor to the head of the Psychology Department at the University of Montana who concluded he was a "normal 16 year old." She claimed that he had been bullied throughout junior high and high school and was in many fights, but only in self-defense. She stated that she did not believe that he had an "explosive personality disorder." She reported that he did not exhibit any sign of addiction or use any kind of drugs when he entered the Air Force, though she admitted he experimented with alcohol. The Board must discount the Veteran's mother's statements for two reasons. First, the Veteran's service treatment records show that he had behavioral problems in 1973, well before the 1977 assault. He self-reported a history of conflict in 1973 which a competent medical examiner found significant. Second, she has not established herself as a medical expert. She is competent to report a change in the Veteran's behavior, with withdrawal, hostility, and argumentativeness. See Jandreau. It is not clear from the record if or how she would know that the Veteran's behavior constituted a disability for which service connection may be available. Although she may not believe that he has a personality disorder, her belief is not competent evidence to differentiate such physical and psychiatric diagnoses. Third, she is competent to report that the Veteran was found to be normal by a psychologist, but the probative value of that report is low. To the extent that her statement may be taken to challenge the diagnosis of a personality disorder, she has provided no more than the conclusion. This is greatly outweighed by the other medical records which provide detailed descriptions of history, signs and symptoms, impressions, and rationales. The Veteran's remaining service personnel records and service treatment records are highly probative to these claims. At entry to service, the Veteran had a June 1972 physical examination at which neurologic and psychiatric clinical evaluations were normal. The Veteran requested a psychiatric consultation in August 1973 because of a life-long problem controlling his temper. He reported a recent altercation. He reported that he had been getting into trouble all his life. The examiner reported that the Veteran had a very poor self image. The diagnosis was passive aggressive personality disorder, with immature features, manifested by constant fights with peers and doing a poor job. The examiner recommended the Veteran participate in group therapy, and if his problems could not be worked out, that he should be administratively discharged from service. The Veteran's service personnel records reflect that his performance evaluation scores for January 1975 to October 1975 were a 7, 8's, and 9's, his scores for November 1975 to September 1976 were 8's and 9's, his scores for September 1976 to August 1977 were a 7 and 8's, and his scores for August 1977 to January 1978 were 7's and 8's. His final performance scores for January to May 1978 were a 6, a 5, and 4's. During the January to May 1978 period, the Veteran was disciplined repeatedly for poor performance, failure to report for duty and failure to maintain his appearance. He was sent for counseling sessions, for which he failed to report on multiple occasions. In April 1978, the Veteran's commander ordered a psychiatric evaluation for emotional problems concerning the Veteran's marriage and occupational problems which had caused counseling sessions, verbal reprimands, and extra duty for coming to work late, failing to cut his hair, etc. On psychiatric evaluation it was noted that the Veteran's wife separated from him in February 1978 and was filing for divorce. His commander had become aware that the Veteran might not be able to control his emotions or tolerate normal military demands. Recently, he had shown poor tolerance for supervision and developed strong motivational problems and a clearly defective attitude regarding military standards and bearing. When he was told to have his hair trimmed back, he felt he was going to explode and "react as he did in 1973 and bust a few heads in." He gave a history of many problems as an adolescent in school, due to aggressive behavior. He stated that he was sent to the principal's office on numerous occasions, did a lot of fighting, and felt that he was an outcast. He admitted openly that, despite 5-1/2 years in the service, he now had an extremely poor tolerance of military demand and his attitude towards working constructively had become markedly negative and apathetic. Psychological testing in April 1978 revealed that he was markedly defensive and rebellious with a low frustration tolerance, and that he had impulsive acting out tendencies. On the basis of the clinical evaluation and psychological testing, the diagnosis was explosive personality disorder, severe, characterized by a tendency to react to the stress of military demand, as well as marital problems, with outbursts of rage. He was excitably aggressive and over responsive to environmental pressures. An administrative discharge from service was recommended. At the conclusion of the administrative discharge process, the Veteran underwent a June 1978 physical examination for separation from service. The Veteran had bilateral defective visual acuity, with a history of wearing glasses since 1962. He also had a history of a hit to the right side of his head in April 1977 without loss of consciousness, no treatment sought, and full recovery. The doctor entered NCNS (no complications, no sequelae). The clinical evaluation was normal as to the head, neurological, and psychiatric systems. The Board finds the Veteran's account of continuous symptoms since the injury also not credible. The Veteran did not report any symptoms at his June 1978 separation from service physical examination, despite explicit discussion of the assault. At that time, more than one year had elapsed since the injury, providing time for the Veteran to notice the dizziness and nausea that he later claimed had been continuously present since the injury. The Veteran was hospitalized for psychiatric treatment at a VA medical center in January 1988. He reported a past history of depression of a fairly brief duration in March 1987, when he took an overdose of some "pain relievers." He reported more recent depression related to family and financial problems. He gave a history of drug abuse dating back to military service, and currently used marijuana on a daily basis with alcohol with "rare drunks." A July 1988 VA examination listed possible petit mal seizures and possible brain damage from alcohol and other toxic substances. A psychiatric evaluation was performed in January 1993 by N.T., M.D., at the request of the County Department of Social Services. There is no indication that N.T. reviewed any previous psychiatric treatment records or the Veteran's service medical records. N.T. noted a long and extensive history of polysubstance abuse, dating to approximately 1973. The veteran reported doing well in service, until he began to have marital dysfunction in 1976. He reported a head injury in 1977, in which he sustained a concussion, but no loss of consciousness, and he denied a history of any psychotic symptomatology. N.T. noted a long history of polysubstance abuse/dependence that had been in apparent remission since 1989. N.T. stated that the Veteran did not show any evidence of schizophrenia, and noted that use of certain drugs could mimic symptoms associated with schizophrenia. N.T. stated that the behaviors exhibited during military service were not consistent with a diagnosis of explosive personality disorder. The only current diagnosis noted by N.T. was polysubstance dependence in remission. November 1998 VA outpatient treatment records showed that the Veteran denied previous problems with alcohol and only occasional use of other substances, and he denied current problems with temper, anger, or rage. The Veteran reported that he was struck on the head by a beer bottle in service during a fight with British soldiers and claimed he currently had right eye blurry vision. The examiner deferred an Axis I diagnosis, but stated that a personality disorder was suspected, as well as rule out malingering. A Minnesota Multiphasic Personality Inventory (MMPI) was performed in November 1998, and indicated severe depression, feelings of pessimism, social inadequacy, lethargy, inability to form close relationships, poor impulse control and poor decision- making. The psychologist also reported a high score in the area entitled "organicity." In January 1999, a VA psychiatrist noted an impression of personality disorder with narcissistic and dependent traits, and provisional depression not otherwise specified. The psychiatrist stated that he could not rule out malingering or the possibility of mild head injury effects. The psychiatrist also stated that the Veteran's pursuit of disability from numerous angles spoke to a manipulative goal of disability, since the Veteran did not seem interested in treatment of symptoms. Two weeks later, an impression of an adjustment reaction with anxious mood was noted. On a VA evaluation in March 1999, the assessment was questionable depression vs. Axis II disorder/malingering. The Veteran was then admitted for psychiatric treatment, due to marital and home problems. The psychiatrist provided impressions of dysthymia, adjustment disorder with mixed emotional features and rule out organic brain disorder (explosive type). The Veteran went home for a weekend and returned stating that things were intolerable at home. He stated that he could not take the prescribed psychiatric medication due to being "uniquely different since he was hit on the head." The Veteran complained of depression, visual hallucinations from the blow to the head, and rage. The examiner provided impressions of depression not otherwise specified - likely dysthymia, rule out malingering, adjustment disorder, questionable petit mal disorder, personality disorder - narcissistic personality with rage and mood instability and possible anti-social traits, and estranged marital relationship. A psychology consult during inpatient treatment noted an impression of personality disorder not otherwise specified with narcissistic and borderline traits. A March 1999 VA outpatient treatment record noted that the Veteran refused to comply with medical recommendations for medication. Impressions of depression not otherwise specified, secondary to personality disorder, and rule out organic personality factor and seizure disorder were provided. An electroencephalogram (EEG) was performed in March 1999, which was mildly and non-specifically abnormal. The Veteran obtained several statements from a Dr. P.F. An August 1991 statement reported that the Veteran had nausea, dizziness, and behavior problems after being hit on the head in April 1977 which had lasted to the present. The Veteran told Dr. P.F. that he had been a model airman in his first five years of service. He claimed to have been at the top of the promotion list. He reported behavior problems after the injury and was given a leave for the problem in July 1977. An April 1999 letter is materially identical. A November 1999 letter states that the Veteran had post-traumatic syndrome, a brain injury which has resulted in a variety of disorders including, an organic brain syndrome, neck problems related to the cervical discs, depression and numbness of his extremities. A July 2000 letter states that the Veteran sustained a brain stem injury in April 1977. P.F. indicated that he had reviewed copies of service treatment records and that it was as likely as not that the injury created both PTSD and changes in personality as well. Pre-morbid schizophrenia could not be ruled out and it was possible that the injury could aggravate pre-existent conditions to a debilitating degree. The Board finds that the opinion from P.F. relies on an inaccurate factual predicate. The 1973 psychiatric consultation report establishes that the Veteran was not a model airman in his first five years of service. He had been seen for interpersonal conflicts with peers and for doing a poor job. He had been in a recent altercation. There is, in short, clear evidence of behavioral problems prior to the April 1977 head injury. Similarly, the Board has found that the Veteran did not suffer a brain stem injury. Third, the Board finds the Veteran's account of the injury and his symptoms thereafter to be not credible. The Board affords no probative weight to medical opinions based on an inaccurate factual predicate. Reonal, 5 Vet. App. at 461. By letter, dated in September 1999, T.C., Ph.D., stated that he initially saw the Veteran in July 1994 for a psychological evaluation, with an Axis I diagnosis of PTSD by history. The Veteran was seen again in September 1999 reporting irritability depression, insomnia, suicidal thoughts, loss of weight, and feelings of worthlessness and guilt. T.C. noted that the Veteran met the criteria for major depression, recurrent type. VA outpatient treatment records dated from May 1999 to July 2001 noted diagnoses of depression and personality disorder. The Veteran's depression was attributed to ongoing marital and financial problems. An EEG in July 2000 was within normal limits. A vocational evaluation of the Veteran in January 2000 noted a primary diagnosis of personality disorder with features of an explosive personality disorder, narcissism, borderline, anti-social traits, and a diagnosis of PTSD related to a head injury during service. A VA examination was conducted in August 2000, and the examiner noted that "multiple records were reviewed prior to the evaluation." The Veteran reported a history of head injury, secondary to a fight in 1977, and stated that he had been "a good soldier up to the time of the assault." The examiner noted that review of the records revealed violent episodes prior to the 1977 self-reported head injury and that the Veteran's anger problems appeared to possibly predate the alleged head injury. The Veteran reported a history of drug and alcohol use, but denied any current use. The Veteran denied any significant psychological/emotional problems prior to military service. The examiner provided diagnoses of depressive disorder and rule out intermittent explosive disorder. The examiner noted a history of violence dating back to military service, but preceding any head injury. The examiner stated that there was inconclusive evidence to support an organic brain injury, particularly in light of neurological/psychological testing, which did not confirm cognitive deficits. The examiner also provided a diagnosis of narcissistic personality disorder. The examiner stated that it was difficult to determine the degree to which the Veteran's psychological difficulties were related to military service and noted that the Veteran was discharged from the military because of disobedience of regulations, conflicts with authority and behavioral problems, but the examiner could not determine whether these were related to a psychiatric impairment or to an elected lifestyle. Psychiatric review for Social Security Administration purposes in September 2000 noted disturbance in mood, depressive disorder, recurrent and intrusive recollections of a traumatic experience that are a source of marked distress, seclusiveness or autistic thinking, persistent disturbances of mood or affect, and intense and unstable interpersonal relationships and impulsive and damaging behavior. VA outpatient treatment records dated from March 2002 to May 2003 showed that the Veteran received periodic treatment for depression and a mood disorder. On several occasions he reported a history of head injury in service. In March 2003, he reported that his head injury in service caused a brain stem injury which caused visual disturbances and worsened his mood swings. In attempting to determine whether or not the Veteran's mood swings presented after the head trauma versus before, he was asked questions concerning his childhood. The VA physician noted that it appeared that the Veteran had a long history of moodiness, irritability, and difficulty getting along with others as well as anger outbursts, but that these symptoms worsened after his head injury. The diagnoses were bipolar disorder, PTSD, and rule out mood disorder secondary to a general medical condition, i.e., head trauma exacerbating mood swing disorder. In April 2003, the Veteran was hospitalized for complaints of increasing depression, sleep problems, and suicidal thoughts. The diagnoses upon discharge included organic affective syndrome. VA treatment records showed that from July 2003 to January 2004, the Veteran was treated for depression and borderline personality disorder. He was hospitalized in January 2004 for complaints of depression and suicidal ideation. In the discharge summary it was noted that the Veteran had an organic affective disorder secondary to head injury. The admitting diagnosis was mood disorder. Upon discharge, the diagnosis was organic affective syndrome. In September 2003, the RO received records from the Social Security Administration which showed that the Veteran received disability benefits for his back disability. Included with these records was a July 1994 private psychological evaluation in which it was noted that the Veteran suffered a closed head injury in 1979, and since that time he reported difficulties getting along with others, problems with anger management, and episodic inability to use his intelligence to a capacity consistent with his premorbid functioning. The psychologist noted that the Veteran may suffer from residual consequences associated with a closed head injury. The psychologist also opined that the Veteran's difficulty in getting along with others is more likely the result of brain injury. The working diagnoses were PTSD by history and rule out organic personality disorder. In an April 2000 speech/language pathology evaluation, the Veteran reported he experienced his first head injury in 1973 when a wrench fell from a plane and hit him on the head, but he claimed he had no residual effects from this. The next event, he reported, occurred in 1977, while on leave from service, when he was attacked from behind and hit on the back of the head and did not receive medical attention for two to three days afterward when he returned to base. He reported two episodes of loss of consciousness, being physically ill, and double vision. He claimed that shortly after this he began to have behavioral problems which affected his military career. He reported a third event in 1987 when he was hit over the head with a frying pan by his first ex-wife, but reported no residual effects from this. VA treatment records dated from January 2004 through October 2004 showed that the Veteran continued to receive treatment for a depressive disorder and a borderline personality disorder. Several treatment records show that the Veteran continued to report a head injury in service, after which his problems started. In January 2004 he reported he was assaulted in service at which time he reportedly sustained an injury to his head, and was assaulted on two other occasions. In October 2004 the Veteran was hospitalized to get his anger under control. The discharge diagnoses included mood disorder. In light of the foregoing, the Board finds that the weight of the evidence demonstrates that symptoms of TBI, claimed as residuals of a head injury such as dizziness and nausea, were not chronic during service, have not been continuous since service, and were not manifest within one year of service. The Board makes these findings for the following reasons. Service treatment (medical) records show no report of or finding of a mood disorder. With regard to a head injury, in April 1977 it was noted that the Veteran was "struck in face" four days prior and had a current complaint of blurred vision. Mild facial swelling on the right was reported. He was provided specific evaluation in April 1978 which did not reveal the presence of a mood disorder. During the June 1978 service separation examination, the Veteran indicated he was hit on the right side of the head in April 1977, but did not lose consciousness and a full recovery was noted with no complications and no sequelae. The Veteran's account of an April 1977 head injury is inconsistent with the other competent medical evidence, service treatment records, and subsequent reported history of his symptoms, and is, therefore, not credible. The contemporaneous records do not show complaints of dizziness or nausea. The Veteran did not complain of dizziness and nausea until 1991, when originally seeking service connection. Given his lack of credibility and inconsistent history, the Board places very little probative weight on the Veteran's more recent statements. There are no other accounts of a TBI or neurological disorder present during service, continuously since service, or manifest within one year of service separation that do not rely on his account of the 1977 assault. P.F.'s medical opinions also do not provide probative evidence. They rely on the Veteran's statements that are not credible, so are without probative value. The remaining evidence of record, particularly the service treatment records and his 1987 and 1988 treatment records weigh heavily against his TBI claim. See Reonal. In light of the foregoing, the Board finds that the weight of the evidence demonstrates that symptoms of TBI, claimed as residuals of a head injury such as dizziness and nausea, were not chronic during service, have not been continuous since service, and were not manifest within one year of service. See 38 C.F.R. § 3.303(b). Service connection for a TBI, claimed as residuals of a head injury such as dizziness and nausea, including as a "chronic disease" is not warranted. See Walker. The Board finds further that neither TBI, claimed as residuals of a head injury such as dizziness and nausea, nor a mood disorder is related to any incident of service, to include the April 1977 assault. The Board makes these findings for the following reasons. Again, because the Veteran is not credible in reporting lay symptoms during service or thereafter, the Board considers his statements of very low probative value. The contemporaneous August 1973 and April 1978 medical evidence indicates the presence of a personality disorder. The April 1978 evaluation did not reveal the presence of a mood disorder. The Board also finds the Veteran's mother's statements to be of low probative value. She can competently report a change in behavior, but she cannot explain that the change is other than the manifestation of the personality disorder identified in 1973 and 1978. Her statements also are not relevant to the TBI claim. The medical evidence relating the TBI with dizziness and nausea to the April 1977 assault invariably rely on the Veteran's inaccurate account of the assault. Most of the medical records stating that he had symptoms during and since service are recitations of his lay history. The Board has found that symptoms of TBI were not present during service, continuously present since service, or manifest within one year of the Veteran's separation from service. In sum, the Veteran's account is contrary to the weight of the lay and medical evidence and the findings of the Board. A history given by a veteran that has been found by the Board to be inaccurate is a basis for discounting an opinion based on that history. Kowalski v. Nicholson, 19 Vet. App. 171, 177 (2005). The opinions of P.F., which attempt to relate the symptoms to service do so on the basis of the Veteran's account, which the Board has rejected. See Reonal. In sum, the Board has rejected the lay evidence of a relationship between the in-service assault and the current disability as not credible and rejected P.F.'s medical opinions as of no probative value. The weight of the evidence demonstrates that TBI with dizziness and nausea is not related to any incident of service, to include the April 1977 assault. Service connection for TBI with dizziness and nausea is not warranted. See Shedden. As to the mood disorder claim, the Board has rejected the Veteran's lay evidence as not credible, his mother's lay evidence as incompetent to distinguish between a personality disorder and an acquired psychiatric disorder, and there is no medical evidence to relate the mood disorder to any incident of service. He was seen in 1987 and 1988 without a diagnosis of a mood disorder. Subsequent VA treatment records show treatment for a mood disorder, depression/depressive disorder, and organic affective syndrome. In addition, the record is riddled with diagnoses of personality disorders, which supports the April 1978 opinion of a personality disorder. Although the Veteran continued to report that his emotional and psychiatric problems worsened after his head injury in 1977, there is no competent medical evidence of record linking the Veteran's mood disorder to service, or to a head injury therein. On the contrary, there is an excellent April 1978 evaluation describing the Veteran's downward behavior as tied to his disintegrating marriage. His performance evaluation scores support this conclusion in that he had excellent scores well after the head injury with a marked decline during his last evaluation period, coincident with his pending divorce. The first post-service report of a mood disorder was in VA treatment records dated in April 2003. The Board finds that the preponderance of the evidence shows that there is not a relationship between a mood disorder and any incident of service, to include the April 1977 assault. The Board notes that the Veteran has occasionally made statements to the effect that alcohol consumption was condoned or encouraged in military service. Veterans can only receive compensation for an alcohol or drug abuse disability secondary to a service-connected disability if they can adequately establish that their alcohol or drug abuse disability is secondary to or is caused by their primary service-connected disability. Allen v. Principi, 237 F.3d 1368 (Fed. Cir. 2001). The Veteran is only service-connected for residuals of rib fractures. There is no evidence, either lay or medical, to demonstrate that the rib fracture residuals resulted in excessive alcohol consumption. Service connection on the basis of alcohol abuse is not available here. 38 C.F.R. § 3.301 (2012). As such, the Board finds that the preponderance of the evidence is against the Veteran's claims for service connection for a TBI, claimed as residuals of a head injury such as dizziness and nausea, and a mood disorder. Consequently, the benefit-of-the-doubt rule does not apply, and the claims must be denied. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102. Service Connection for Defective Vision The Veteran contends that he has double vision as a result of having been struck on the back of the head in April 1977. He insists that his service treatment records are incorrect in stating that he was struck on the right temple. He contends further that he had double vision since the April 1977 injury. Review of the Veteran's treatment records also reveals that he has complaints of blurry vision, which he alleges is due to the April 1977 assault. When service connection is claimed on direct, presumptive, or any other basis, a necessary element for establishing such a claim is the existence of a current disability. See Degmetich v. Brown, 104 F. 3d 1328 (1997) (holding that the law requires the existence of a present disability for VA compensation purposes); see also Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998). The presence of a disability at the time of filing of a claim or during its pendency warrants a finding that the current disability requirement has been met, even if the disability resolves prior to the Board's adjudication of the claim. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). As stated above, the Veteran is not a medical expert. As a lay witness, he is competent to report that he has double or blurry vision. Jandreau. The Board is, however, obligated to weigh the Veteran's report of double or blurry vision against the remaining evidence of record to determine whether such assertion is credible. See Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997) (The Board has "authority to discount the weight and probity of evidence in light of its own inherent characteristics and its relationship to other items of evidence."); see also Jandreau, 492 F.3d at 1376 (stating that the "Board retains discretion to make credibility determinations and otherwise weigh the evidence submitted"). The Veteran's service treatment records show some symptoms but do not show a disability associated with double or blurry vision. The Veteran underwent a June 1972 examination for enlistment into service. The report notes that the Veteran had defective vision of both eyes, correctable to normal. In April 1977, he was seen for complaints of double vision of the right eye after he reported being struck in the face four days earlier. He was referred to the ophthalmology clinic where the examiner clarified that he had blurred, not double vision, and had been struck in the right temple not the orbit as described in the intake note. The impression was no ocular damage due to trauma. A September 1977 emergency room note states that the Veteran had low back pain and had an episode of gradual loss of vision peripherally, which he termed a "grey out" lasting approximately five minutes. He had no visual disturbance when at the emergency room. On physical examination, pupils were equal, round, and reactive to light and accommodation (PERRLA) and extraocular movements were intact. His retinal discs were flat, fundi were benign. At a June 1978 service separation examination, the Veteran gave a history of wearing glasses since 1962 for defective visual acuity. The Veteran reported the April 1977 injury; the examiner added that the Veteran had not been unconscious or sought treatment, and had fully recovered. Clinical evaluation showed normal head and eyes except for defective visual refraction, correctable to normal. The Veteran's complaints of double vision have received direct evaluation by medical specialists as shown in the VA treatment records which showed no identified disorder. The Veteran underwent an April 1996 neurological consultation following complaints of daytime facial paresthesias. The Veteran had full finger confrontation fields and his optic fundi were normal. His pupils reacted to light. His eye movements were full without nystagmus, no subtle eye and no abnormal vestibule-ocular reflex (VOR). A July 1998 eye examination was performed. The Veteran again complained of double vision since having been hit in the back of the head in 1977. Although the report of medical history is not fully legible, the Veteran appears to have complained that the right eye was usually affected. On physical examination, the Veteran had 3/3 PERRL, full visual fields, ductions, versions, overaction and underaction. A long hypertrophy of the retinal pigment epithelium was questioned. A December 1999 Rehabilitation Center evaluation indicates that the Veteran's extraocular movements were intact. His peripheral vision was intact. His visual acuity was reported to be 20/20 corrected. An August 2006 History and Physical note was prepared as the Veteran had switched care from one VA medical facility to another. He reported that he had head trauma by assault in 1977 and that he had "lost vision" as a result. Further explanation in the review of systems showed complaints of occasional double vision while using a TENS unit or some type of product using adhesive which the Veteran claimed to sense migrating up his spinal cord and affecting his "meninges." On physical examination, his pupils were equal, round, and reactive. His extraocular movements were intact. No diagnosis was offered for the double vision complaints. An October 2008 optometry consultation note states the Veteran was seen for difficulty focusing near to far with mild distance blur for two years. The Veteran's prescription was noted to be three years old. The Veteran reported a trauma to the back of the head in 1977 causing visual changes of a blurred second image both monocular in either eye and binocular. Previous correction with prism did not correct the problem. The Veteran claimed he had adapted to the problem. On physical examination, pupils were equal, round, and reactive to light (PERRL) and extraocular movements were intact. He did not have an afferent papillary defect (APD) in either eye. Confrontation fields were full to finger counting (FTFC) bilaterally. His corneas and conjunctivae were clear bilaterally. His lenses showed +1 nuclear sclerosis (NS). The assessment was myopia and presbyopia bilaterally. His ocular health was otherwise unremarkable. The Board finds that the preponderance of the evidence is against a finding that the Veteran has a current disability manifest by double or blurry vision. The Veteran is competent to report a symptom of double or blurry vision. Multiple medical professionals have been unable to find any underlying medical malady or cause for his complaints despite direct, repeated examinations in full awareness of the Veteran's complaints. The Board places greater weight on the medical evaluations to determine the existence of a disability. The Board finds that the Veteran has not had a current disability manifest by double vision at any time since the filing of his claim. McClain, 21 Vet. App. at 321. Service connection cannot be granted for a disability manifest by double vision regardless of the theory of entitlement. According to the Veteran's service treatment records, the only diagnosable vision disorder was refractive error of the eyes. This has been confirmed by later medical evaluations. For example, the October 2008 optometry consultation note found myopia and presbyopia, both of which are refractive errors of the eye. Refractive error of the eye cannot be service-connected as a matter of law. 38 C.F.R. §§ 3.303(c), 4.9. The Board notes that, in the absence of service connection for TBI, claimed as head injury with episodes of dizziness and nausea, service connection on a secondary basis is not available for this claim. See 38 C.F.R. § 3.310 (2012). The theory need not be addressed. In this case, the preponderance of the evidence is against the existence of a current eye disability manifest by double or blurry vision at any time since the filing of the instant claim. Accordingly, service connection for a disability manifested by double or blurry vision is not warranted. The preponderance of the evidence is against the claim; therefore, the benefit of the doubt doctrine is inapplicable. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102. ORDER Service connection for TBI, claimed as head injury with episodes of dizziness and nausea, is denied. Service connection for defective vision to include as due to TBI is denied. Service connection for a mood disorder to include as due to TBI is denied. ____________________________________________ J. PARKER Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs