Citation Nr: 19104403 Decision Date: 01/17/19 Archive Date: 01/17/19 DOCKET NO. 16-50 870 DATE: January 17, 2019 ORDER Entitlement to service connection for left eye disability is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, the Veteran’s left eye disability is due to the traumatic injury he suffered in service. CONCLUSION OF LAW The criteria for entitlement to service connection for left eye disability have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the Navy from February 1980 to February 1992 and was a veteran of the Gulf War Era. This matter is before the Board of Veteran Appeals (Board) through an appeal of the May 2014 rating decision. The Veteran previously appeared for a Board hearing in July 2017 and a transcript has been provided from that hearing. 1. Entitlement to service connection for left eye disability The Veteran contends that his left eye disability is the result of an attack he suffered while in service. See Correspondence dated December 2015. The Veteran states that in September 1980, while walking back to his ship during Fleet Week, he was attacked by six males who were attempting to rob him. He suffered a broken left cheek bone and damage to his left eye, was hospitalized for one month following the incident, and had to undergo surgery to his left side orbital area. See Correspondence dated December 2015. The Veteran contends that he has been told by physicians that his declining eyesight and left eye disabilities are due, at least in part, to that blunt force trauma he suffered in service. See Correspondence dated December 2015; Hearing Transcript dated July 2017. A veteran is entitled to VA disability compensation if there is a disability resulting from a personal injury suffered or diseased contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. To establish a right to compensation for a present disability, a Veteran 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” – the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The record reflects a current diagnosis for RPE atrophy and retinoschisis in the left eye. See VA Examination dated April 2014. As to in-service incurrence, the Board finds that the Veteran’s September 1980 assault while in service constitutes an in-service event or injury for the purposes of 38 C.F.R. § 3.303(a). The Board finds that the Veteran’s service treatment records corroborate the Veteran’s lay statements regarding the attack and the treatment he received while hospitalized. See Service Treatment Records dated September 1980. Furthermore, buddy statements in the record are consistent with the Veteran’s statements. See Buddy Statement from J.A. dated December 2015; Buddy Statement from C.E. dated December 2015. The Board finds that the buddy statements hold significant probative weight because they are consistent with the medical record and the Veteran’s lay statements regarding the September 1980 incident. As it pertains to nexus, the VA conducted an examination in April 2014. The VA examiner found that the Veteran had RPE atrophy in both eyes and retinoschisis in his left eye. The examiner noted that the Veteran suffered a left zygomaticus and orbital fracture in September 1980, but opined that the Veteran’s left eye vision loss was not related to this incident. The examiner’s rationale was that the RPE degenerative process is occurring in both eyes and appears genetic in nature. He pointed out that neither left eye disability was diagnosed in service, and he opined that the trauma suffered was not contributory to this process. The examiner further opined that he could not find a further evaluation or diagnosis of eye pain following trauma, and that the findings were indicative of a degenerative condition, not of a traumatic etiology. See VA Examination dated April 2014. Similarly, the examiner noted that the Veteran’s service treatment records noted the Veteran had punctate keratopathy and hordeolum while in service. See VA Examination dated April 2014. The examiner opined that the Veteran’s left eye disability was also not related to either of these conditions because the infections were not contributory to the condition. See VA Examination dated April 2014. The Veteran submitted an opinion from a private physician, Dr. J.W., who opined that the Veteran’s poor vision and acuity are at least as likely as not caused by or a result of the trauma the Veteran experienced. See Letter from Dr. J.W. dated July 2017. The given rationale was that the left eye appeared to have choroidal rupture, macular pigment changes secondary to trauma, and a choroidal nevus, all of which are changes in his retina secondary to trauma. See Letter from Dr. J.W. dated July 2017. He also opined that the changes in the Veteran’s left eye were greater than those in his right. The Board finds that both the VA examination and the private opinion hold some probative weight. The April 2014 VA examiner’s rationale did not adequately address whether the Veteran’s in-service ocular trauma could have been a cause for his left eye disability, but rather offered a conclusory opinion that the disability was genetic and not due to trauma. The private physician’s opinion was based on an examination of retinal photos taken in July 2008, and the physician did not indicate whether he had considered any of the other evidence of record. The Veteran’s medical records indicate that the Veteran experienced eye trauma in 1980, while in service, and again in 2001, which caused a blowout fracture and macular scarring. See Non-Governmental Medical Treatment Records dated June 2015 and September 2008. The Veteran also submitted online medical articles in support of his claim. The first article from patient.info discusses zygomatic arch and orbital fractures, like the one the Veteran incurred in service. According to the article, visual acuity and other visual symptoms are associated with these types of injuries. See Zygomatic Arch and Orbital Fractures, https://patient.info/doctor/zygomatic-arch-and-orbital-fractures. The second article is from Medscape which outlines how choroidal ruptures are breaks in the choroid that result from blunt ocular trauma. See Choroidal Rupture, Medscape, http://emedicine.medscape.conVarticle/1190735-overview. The third article also discusses choroidal ruptures and it focuses on how choroidal ruptures can lead to visual loss. See Browning, D., What You Should Know About Choroidal Rupture. These articles hold some probative weight because they provide information regarding the connection between ocular trauma and vision loss. In looking at the evidence of record, there is probative evidence that the ocular trauma suffered in service caused the Veteran’s left eye disability. A disability does not need to be solely caused by service to warrant service connection. The medical articles in conjunction with the medical evidence indicates a connection between the trauma suffered in service and the Veteran’s current left eye disability. Furthermore, a claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. When the evidence supports the claim or is in relative equipoise, the claim will be granted. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). Therefore, the Board finds that resolving reasonable doubt in favor of the Veteran, service connection for the Veteran’s left eye disability is warranted. See 38 C.F.R. § 3.310(a). L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Bognar, Associate Counsel