Citation Nr: 18147071 Decision Date: 11/05/18 Archive Date: 11/02/18 DOCKET NO. 16-41 534 DATE: November 5, 2018 ORDER Service connection for an eye disorder, claimed as hyperopia, is denied. REMANDED Entitlement to an initial rating in excess of 40 percent for overactive bladder is remanded. FINDINGS OF FACT 1. The Veteran’s preexisting refractive error was not aggravated by service, to include as a result of his photorefractive keratectomy (PRK) surgery. 2. The Veteran does not have a diagnosis of an eye disability for VA compensation purposes. CONCLUSION OF LAW The criteria for service connection for an eye disorder, claimed as hyperopia, are not met. 38 U.S.C. §§ 1101, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.306. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran has active duty service from January 2010 to January 2014, with prior inactive service. This case is before the Board of Veterans’ Appeals (Board) on appeal from a June 2014 rating decision of the Department of Veterans Affairs Regional Office (RO) in Waco, Texas. The Board notes that while the Veteran filed a timely notice of disagreement as to the RO’s denial of his claim of service connection for a neck disorder, he did not file a substantive appeal as to this issue. Therefore, this issue is not currently on appeal. Service Connection Entitlement to service connection for an eye disorder, claimed as hyperopia The Veteran contends that he received PRK surgery in service to correct his vision problems. However, he asserts that the surgery ultimately caused his vision to degrade. 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. 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), 3.304, 3.306. Upon review of the evidence of record, the Board finds that service connection is not warranted. As an initial matter, the post-service evidence does not reflect an eye disorder other than presbyopia. Therefore, while the Veteran has been diagnosed with presbyopia, congenital or developmental defects, such as refractive error of the eyes, are not considered “diseases or injuries within the meaning of applicable legislation” and, hence, do not constitute disability for VA compensation purposes. 38 C.F.R. §§ 3.303(c), 4.9; Beno v. Principi, 3 Vet. App. 439, 441 (1992). Next, the Board acknowledges the Veteran’s assertions that his preexisting presbyopia was aggravated by his in-service PRK surgery. However, to establish aggravation, the Veteran must demonstrate that the preexisting disorder has increased in severity as a result of active duty service. See 38 U.S.C. § 1153; Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004). Further, the Board notes that VA regulations provide that the usual effects of medical and surgical treatment in service, having the effect of ameliorating disease or other conditions incurred before enlistment, will not be considered service-connected unless the disease or injury is otherwise aggravated by service. 38 C.F.R. § 3.306(b)(1). In this case, while the Veteran had PRK surgery during service to ameliorate his vision problems, there is no evidence that his surgery aggravated his preexisting refractive error. Specifically, the February 2014 VA examiner stated that the Veteran had “excellent” results from his PRK surgery. Further, to the extent that the Veteran asserts that he developed severe presbyopia and blurry vision after service that was caused by his PRK surgery, the examiner (in a September 2016 addendum) opined that his presbyopia and blurry vision are related to the aging process and the natural progression of his preexisting refractive error. Moreover, the examiner determined that the Veteran’s disorder would have occurred “even if there had been no elective refractive surgery which was completely successful.” In any event, the examiner also noted that the Veteran was advised that he would have presbyopia after the surgery. As a result, the Board finds that the Veteran did not experience any unusual effects from PRK surgery, and that the surgery did not aggravate his preexisting eye disorder. Additionally, the Board notes that there is not sufficient evidence, nor has the Veteran asserted, that his presbyopia was otherwise aggravated by service. In arriving at this conclusion, the Board acknowledges the Veteran’s assertions and belief that his presbyopia was aggravated by his PRK surgery. Nevertheless, while is competent to report symptoms such as blurry vision, he is not competent to provide a diagnosis in this case or offer opinions regarding aggravation. The issue is medically complex and requires specialized medical education and knowledge, which he is not shown to possess. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). For the foregoing reasons, the preponderance of the evidence is against the claim for entitlement to service connection for an eye disorder. The benefit of the doubt doctrine is therefore not for application and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. REASONS FOR REMAND Entitlement to an initial rating in excess of 40 percent for overactive bladder is remanded. The evidence, including the Veteran’s statements, suggests that his service-connected bladder disability has worsened since his last VA examination in September 2016 – namely, the Veteran reports that he must change his absorbent materials more than 4 times a day. Therefore, the Veteran should be afforded a new examination in order to accurately assess the current level of impairment. See Snuffer v. Gober, 10 Vet. App. 400, 402-403 (1997); Caffrey v. Brown, 6 Vet. App. 377, 381 (1994); Cf. VAOPGCPREC 11-95 (April 7, 1995). The matter is REMANDED for the following action: 1. Obtain any pertinent outstanding treatment records from the VA Medical Center in El Paso, Texas, since September 2016, and any other VA facility from which the Veteran has received treatment. If the Veteran has received additional private treatment, he should be afforded an opportunity to identify the treatment so that VA may obtain the records pertaining thereto or submit the records himself. 2. Following completion of the above, schedule the Veteran for a VA examination to determine the current severity of his overactive bladder. The claims folder must be made available to and be reviewed by the examiner. All tests deemed necessary should be conducted and the results reported in detail. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, he or she should clearly explain why that is so. BARBARA B. COPELAND Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Meyer, Associate Counsel