Citation Nr: 1323669 Decision Date: 07/24/13 Archive Date: 08/01/13 DOCKET NO. 07-11 036 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Detroit, Michigan THE ISSUE Entitlement to service connection for an eye disability. REPRESENTATION Appellant represented by: The American Legion WITNESSES AT HEARING ON APPEAL The Veteran and M. J. ATTORNEY FOR THE BOARD L. Kirscher Strauss, Counsel INTRODUCTION The Veteran served on active duty from September 1961 to September 1965. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2005 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Detroit, Michigan. The Veteran and his cousin, M. J., testified at a hearing before a Decision Review Officer (DRO) in July 2008. A transcript of the hearing is of record. In December 2010, the Board reopened a previously denied claim of service connection for an eye disability and remanded the matter for additional development. In December 2012, the Board again remanded the matter for additional development. FINDING OF FACT The Veteran has benign essential blepharospasm that is as likely as not related to his military service. CONCLUSION OF LAW The Veteran has benign essential blepharospasm that is as likely as not the result of disease or injury incurred during active military service. 38 U.S.C.A. §§ 1110, 1131, 5103, 5103A, 5107 (West 2002 & Supp. 2013); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2012). REASONS AND BASES FOR FINDING AND CONCLUSION Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. §§ 1110, 1131 (West 2002); 38 C.F.R. § 3.303 (2012). Evidence of continuity of symptomatology from the time of service until the present is required where the chronicity of a condition manifested during service either has not been established or might reasonably be questioned. 38 C.F.R. § 3.303(b). Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). In order to prevail on the issue of service connection there must be medical evidence of a current disability; medical evidence, or in certain circumstances, lay evidence of in-service occurrence or aggravation of a disease or injury; and competent evidence of a nexus between an in-service injury or disease and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999); see also Barr v. Nicholson, 21 Vet. App. 303 (2007); Pond v. West, 12 Vet App. 341, 346 (1999). The Veteran contends that he has a current eye disability manifested by excessive blinking that began during military service due to using hydrogen tetrachloride, which occasionally got sprayed in his face while working as an aircraft electronics navigation equipment repairman. Service treatment records reflect that in June 1965 the Veteran presented for evaluation for complaints of blinking a lot and burning of his eyes off and on for three years. The same day, he was evaluated by optometry for complaints of "hard blinking" of the eyes. It was believed that he had conjunctivitis. There were no earlier entries relating to any type of injury to the eyes and no further entries regarding complaints involving the eyes. The Veteran's separation physical examination was negative for any abnormalities of the eyes in August 1965. He had 20/20 uncorrected distant vision in each eye, the same as recorded on his entrance physical examination in September 1961. In his original December 1998 claim for service connection, the Veteran complained of having pain in his eyes. At his July 1999 VA eye examination he reported that he had radiator equipment explode in his eye in 1962. The Veteran had distant vision corrected to 20/20 for each eye. In general, the physical examination was normal, to include a visual field test. The diagnosis was floppy lid syndrome, worse on the right. The examiner identified this as a congenital condition. The Veteran submitted his current claim in July 2005. New private and VA treatment records showed that the Veteran had a diagnosis of a chronic problem--blepharospasm for which he received Botox injections for treatment of the eye spasms or involuntary blinking, in addition to the prior diagnosis of a congenital floppy lid disorder, cataracts, and refractive error. Moreover, the Veteran and his cousin, M. J., testified regarding continued, progressive eye symptomatology manifested by hard blinking since service. In December 2012, the Board remanded the claim to obtain an additional medical opinion regarding the nature and etiology of the Veteran's claimed eye disability. This was done because then-existing medical opinions of record were insufficient to decide the claim. The Veteran presented for a VA eyes examination in April 2013 and described a history of using and occasionally getting sprayed in the face with hydrogen tetrachloride during military service and experiencing excessive blinking that began in service. Following examination, the diagnosis was essential blepharospasm. The examining optometrist explained that essential blepharospasm is a benign disorder of the eye that tends to be idiopathic with the onset in early to middle age individuals. The examiner opined, however, that due to the Veteran bringing up the irritant that was sprayed in his eyes, it was at least as likely as not that the eye problem was aggravated by the constant use of the cleaner. In a June 2013 addendum, the examining optometrist indicated that he had reviewed the claims file and there were no changes to his report. With resolution of reasonable doubt in the Veteran's favor, the Board concludes that the evidence of record establishes that the Veteran's essential blepharospasm is as likely as not traceable to his active military service. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C.A. § 5107 (West 2002); 38 C.F.R. § 3.102 (2012). Here, a complaint of intermittent excessive eye blinking for a period of three years is documented in service, and the Board finds credible the Veteran's report of chemical exposure and contemporaneous eye problems related to his military duties because the duties he described during the hearing and in correspondence appear to be consistent with his military occupational specialty. Moreover, the Board finds that the Veteran is competent to describe his perception of excessive eye blinking and a continuity of such symptomatology during and after military service. In addition, his cousin testified regarding his knowledge and observations of excessive eye blinking since military service. The Board finds that these statements tend to corroborate the Veteran's account of experiencing excessive eye blinking since military service. When, as here, there is documentation of a problem with excessive blinking and burning eyes in service and of recurring symptoms since, this supports a finding that the Veteran's current problems are traceable to military service. There is no suggestion by competent evidence that any other eye problem is attributable to military service. In reaching its decision, the Board also has taken into account the conclusions provided by the VA examiners in July 1999 and November 2006, and the VA ophthalmologists in January 2011 and March 2012, but finds that the evidence in its entirety is in equipoise as to whether the current benign essential blepharospasm had its origin during the Veteran's military service. Accordingly, service connection for benign essential blepharospasm is warranted. ORDER Service connection for benign essential blepharospasm is granted. _______________________________ MARK F. HALSEY Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs