Citation Nr: 18145377 Decision Date: 10/26/18 Archive Date: 10/26/18 DOCKET NO. 15-13 960 DATE: October 26, 2018 ORDER Entitlement to service connection for an eye condition, claimed as blocked tear ducts, to include dry eyes is denied. FINDING OF FACT The Veteran’s currently diagnosed blocked tear ducts, to include dry eyes, started many years after service and is not etiologically related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for an eye condition, claimed as blocked tear ducts, to include dry eyes have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served from February 1983 to April 1986. The Veteran testified at a June 2017 travel board hearing before the undersigned Veterans Law Judge. A hearing transcript is of record. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). VA must give due consideration to all pertinent medical and lay evidence in a case where a veteran is seeking service connection. 38 U.S.C. § 1154(a). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the veteran. 38 U.S.C. § 5107(b). 1. Entitlement to service connection for an eye condition, claimed as blocked tear ducts, to include dry eyes The Veteran contends that the sinus surgery she underwent while in service resulted in her currently diagnosed blocked tear ducts. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. After a review of all the lay and medical evidence of record, the Board concludes that, while the Veteran has a diagnosis of blocked tear ducts, to include dry eyes, the preponderance of the evidence is against finding that it began during active service, or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). The Veteran’s service treatment records do not reflect complaints of, treatment for, or a diagnosis of blocked tear ducts. In fact, in a report of medical history dated October 1985, the Veteran indicated she was in good health and marked “no” in response to having eye trouble. The post-service evidence reveals an examination dated December 11, 2009 for complaints of persistent right epiphora for the past four months. The treating physician diagnosed the Veteran with chronic epiphora on the right-side and noted a denial of left side problems. However, this diagnosis is approximately 24 years after she left active duty service. Therefore, a continuity of symptoms is not shown based on the clinical evidence. As part of this claim, the Board recognizes the Veteran’s statements regarding her history of symptoms. In this regard, while the Veteran is not competent to diagnose her eye condition, as it may not be diagnosed by its unique and readily identifiable features, and thus requires a determination that is “medical in nature,” she is nonetheless competent to testify about the presence of observable symptomatology, which may provide sufficient support for a claim of service connection, if credible, regardless of the lack of contemporaneous medical evidence. Jandreau v. Nicholson, 492 F.3d 1372, 1376 (Fed. Cir. 2007). See Barr v. Nicholson, 21 Vet. App. 303, 307 (2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). However, the Board is unable to conclude that service connection is warranted based solely on her statements. Specifically, as was discussed above, the Veteran’s post-service records do not reflect treatment for or complaints of eye problems until an examination in December 2009 when she was diagnosed with epiphora. Moreover, she did not mention tear duct problems when she left service. Additionally, during her June 2015 VA examination, the Veteran reported her date of symptom onset as 2009, which would directly contradict an assertion of continuous symptoms. Therefore, continuity has not been shown based on the clinical evidence or based on her statements. Next, service connection may also be granted when the evidence establishes a medical nexus between her eye condition and her military service. In this case, the Board finds that the weight of the competent evidence does not attribute the Veteran’s blocked tear ducts to active duty, despite her contentions to the contrary. The June 2015 VA examiner opined that the Veteran’s eye condition is less likely than not due to or a result of the Veteran’s maxillary sinusitis. In support of his opinion, the examiner noted that the Veteran’s medical records showed sinusitis and epiphora as the necessity for surgery, however the Dacryocystorhinostomy procedure (DCR) is not a treatment for sinusitis and is for tearing only unrelated to sinus condition. The Board finds that the examination was adequate for evaluation purposes. Specifically, the examiner reviewed the claims file, interviewed the Veteran, and conducted a physical examination. There is no indication that the VA examiner was not fully aware of the Veteran’s past medical history or that he misstated any relevant fact. In adjudicating this claim, the Board has specifically considered the statements made by the Veteran relating her claimed disorder to service. Specifically, that her sinuses have blocked off her tear ducts due to her oral maxillofacial surgery that occurred while in service. The Federal Circuit has held that “[l]ay 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.” Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009) (quoting Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007)). Although the Veteran is competent to testify that she suffers from an eye condition, the Veterans statements, by themselves, are insufficient to establish a link between symptomatology during service and blocked tear ducts. Such a medical nexus does not involve a simple identification that a layperson is competent to make. See Jandreau, 492 F.3d at 1377, n.4. Therefore, the Board finds that the weight of the competent evidence does not attribute the Veteran’s eye condition, claimed as blocked tear ducts, to include dry eyes to military service despite her contentions to the contrary. In reaching the above conclusion, the Board also considered the doctrine of reasonable doubt. 38 U.S.C. § 5107(b). However, as the most probative evidence is against the claim, the doctrine is not applicable in this case. See also, e.g., Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Vample, Associate Counsel