Citation Nr: 19152016 Decision Date: 07/03/19 Archive Date: 07/03/19 DOCKET NO. 15-39 612 DATE: July 3, 2019 ORDER Entitlement to service connection for cataracts, claimed as a bilateral eye condition, is denied. FINDING OF FACT The Veteran’s cataracts are not related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for cataracts have not been met. 38 U.S.C. §§ 1101, 1110, 1137; 38 C.F.R. §§ 3.159, 4.9. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from June 1969 to December 1971. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Boise, Idaho. Automatic waiver of RO consideration of the evidence submitted by the Veteran in October 2015 and November 2017 is presumed given the date of filing of the substantive appeal. See 38 U.S.C. § 7105(e). Entitlement to service connection for cataracts The Veteran claims service connection for cataracts, claimed as a bilateral eye condition. The Veteran argues that his vision was normal upon enlistment but worsened during his time in the Army, and as such that he is entitled to service connection for his present cataracts. Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: (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, 1167 (Fed. Cir. 2004). A veteran will be considered to have been in sound condition when examined, accepted, and enrolled for service, except for defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto. Only such conditions as are recorded in examination reports are to be considered as noted. 38 U.S.C. § 1111; 38 C.F.R. § 3.304(b). Under the provisions of 38 C.F.R. § 3.303(c) and 38 C.F.R. § 4.9, refractive errors are considered congenital or developmental conditions and are not diseases or injuries within the meaning of applicable legislation. See Winn v. Brown, 8 Vet. App. 510, 516 (1996). However, congenital or developmental conditions, if subjected to a superimposed disease or injury (i.e., aggravation), may be service connected for the additional disability. See VAOPGCPREC 82-90. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. 3.102. When all the evidence is assembled, VA must determine 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 the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). With respect to the first element of the test for service connection the Board must consider is whether the Veteran has a current disability. The Veteran’s post-service treatment records indicate that he has a history of retinal detachment and cataracts, and that he underwent cataract extraction surgeries in 1995 and 2010. The Veteran reports suffering from double vision and blurred vision since undergoing his cataract surgeries. The Veteran’s post-service treatment records reflect a current diagnosis of secondary bilateral cataracts. More specifically, the Veteran’s November 2015 private treatment records reflect that the Veteran was diagnosed with posterior capsular opacification, also called “PCO” or “secondary cataracts.” With respect to the second element of the service connection test, however, the Veteran’s service treatment records are silent for any complaints, symptoms, diagnosis, or treatment of cataracts or other eye diseases or injuries. In fact, the Veteran’s post-service treatment records indicate that his cataracts were first treated in 1995, over 20 years after the Veteran separated from service. Such a lapse of time is a factor for consideration in deciding a service connection claim. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). Indeed, there is no probative evidence of any eye condition during the Veteran’s service except for refractive errors, which are noted in the Veteran’s service treatment records. The Board acknowledges the Veteran’s contention that his vision was normal upon enlistment. However, the Veteran’s service treatment records clearly note that the Veteran suffered from poor visual acuity prior to service. On the Veteran’s March 1969 pre-induction examination, it was clinically noted that the Veteran’s eyes had refractive errors. Specifically, the Veteran had poor visual acuity (20/100 vision in both his right and left eyes), which was corrected with glasses to 20/25 vision in both eyes. Service treatment records show that the Veteran was given a prescription for spectacles to correct his vision upon enlistment in June 1969, and that the Veteran was referred to an optometry clinic for glasses in March 1970. On the Veteran’s November 1971 separation examination, it was clinically noted that the Veteran had 20/25 corrected vision in both eyes. As discussed, ,refractive errors are considered congenital or developmental conditions and are not diseases subject to VA compensation benefits. The Board must thus address whether the Veteran’s congenital refractive errors were subjected to an additional disease or injury during service. While the service treatment records note the Veteran’s pre-existing congenital refractive errors, they do not reflect any superimposed eye injuries or diseases. Moreover, the Veteran has affirmatively denied suffering from any eye traumas. See VA 646, Statement of Accredited Representative. Thus, the Board finds that there is no probative evidence of record showing an additional injury or disease during service that was imposed on his refractive error condition. Setting aside the question of whether an injury or disease was incurred or aggravated during the Veteran’s service, the criteria for the third element of the service connection test are also not satisfied. The competent medical evidence of record suggests that no nexus exists between the Veteran’s service and his current cataracts. In a July 2009 VA post-service treatment record, for instance, the VA examiner noted that the Veteran’s decreased visual acuity was “directly attributable” to his cataracts. Additionally, in the Veteran’s November 2015 private treatment records, the private examiner noted that the Veteran’s PCO was affecting the Veteran’s visual function. Considering the significant lapse in time between the Veteran’s service and his treatment for cataracts, the Board gives significant weight to these medical opinions on the nature of the Veteran’s eye condition. The Board acknowledges the Veteran’s contentions regarding the connection between his cataracts and the pre-existing refractive errors that were noted during service. The Veteran is competent to report on symptoms that are within the realm of his personal experience, such as blurred or double vision. See C.F.R. § 3.159; Layno v. Brown, 6 Vet. App. 465, 469-71 (1994). Nonetheless, the etiology of eye disorders is a medically complex question. The Veteran has not shown that he is qualified through education, training, or experience to offer a nexus opinion on such a complex medical condition. Accordingly, he is not competent to offer an opinion as to its etiology and his opinion in this regard cannot be ascribed probative value. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). In addition, while he has an honest belief that he did not have refractive error prior to entering service, the service records demonstrate that his belief is unfounded. Based on the foregoing, the evidence shows that the Veteran does not have an eye disorder for which service connection may be granted. No competent evidence has been offered to link the Veteran’s cataracts to his service. Moreover, the medical opinions of record suggest that the Veteran’s blurred vision and other vision problems are a direct result of his cataracts, and not due to any in-service injury or disease. The Board recognizes that no VA examination was provided regarding the Veteran’s cataracts. VA must provide a medical examination and medical opinion when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain disease manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability is persistent or recurrent symptoms of a disability may be associated with the Veteran’s service or with another service-connected disability, but (4) there is no competent medical evidence on file for the VA to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79, 81-82 (2006). Although the Veteran has not been afforded a VA examination for his cataracts, the Board does not find that there is adequate evidence indicating that there may be any type of relationship between his present disease and his service. As such, no examination is warranted. See McLendon, 20 Vet. App. at 81. Accordingly, the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application, and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Matthew Tenner Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Rademacher, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.