Citation Nr: 21000836 Decision Date: 01/06/21 Archive Date: 01/06/21 DOCKET NO. 16-28 081 DATE: January 6, 2021 ORDER Service connection for a bilateral eye disability (claimed as blurry vision) to include as secondary to diabetes mellitus type II (DM II) is denied. FINDING OF FACT The Veteran's current eye disabilities did not develop during active service and are not otherwise shown to be related to active service, to include as secondary to his service-connected DM II. CONCLUSION OF LAW The criteria for service connection for an eye disability, to include on a secondary basis, have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty with the United States Navy from February 1964 to January 1968. This appeal comes before the Board of Veterans’ Appeals (Board) from a March 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) which denied service connection for blurry vision. The Veteran’s notice of disagreement (NOD) was received in October 2015. The RO issued the statement of the case (SOC) in May 2016, and the Veteran’s VA Form 9, substantive appeal was received in June 2016. In August 2017 and June 2019, the Board remanded the case to the RO for further development and adjudicative action. Service Connection 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). “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.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection for certain chronic diseases may also be established based upon a legal “presumption” by showing that the disease was manifested to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1112, 1137; 38 C.F.R. §§ 3.307, 3.309. Secondary service connection may be granted for a disability that is proximately due to, or aggravated by, a service-connected condition. 38 C.F.R. § 3.310. Entitlement to service connection for a bilateral eye disability (claimed as blurry vision) to include as secondary to DM II. The Veteran contends that his eye disability is secondary to his service-connected DM II. Service treatment records (STRs) show that in October 1966 the Veteran was diagnosed with traumatic conjunctivitis after being hit by a finger in his left eye. The following day, the Veteran reported that he was feeling better but that he still feels an ache behind his left eye. The Veteran visited the optometry clinic in November 1967 with complaints of experiencing headaches when welding but did not complain of any eye trouble or residuals from the traumatic conjunctivitis in October 1966. The Veteran’s eyesight was documented as 20/25 in the right eye and 20/15 in the left eye. On separation from service in January 1968, clinical evaluation of the eyes was normal. The Veteran was found to have 20/20 distant vision bilaterally. A VA optometry note dated in September 2019 noted diagnoses of pseudophakia, dry eyes, DM II without retinopathy, choroidal nevus right eye, chorioretinal scarring left eye, mild dry macular degeneration and refractive error. A VA optometry note dated in August 2014 noted additional diagnoses of bilateral ocular rosacea, age-related cataract left eye, and bilateral trichiasis. Additional VA treatment records dated in April 2011 indicate diagnoses of choroidal nevus right eye, chorioretinal scarring left eye, age-related cataracts and various refractive errors such as anisometropia, astigmatism and presbyopia. The Veteran underwent a VA examination for his claimed bilateral eye disability in October 2014. The examiner diagnosed the Veteran with nuclear sclerosis cataract OS and pseudophakia. The examiner simply stated that the Veteran’s “diagnosed eye conditions are not related to Diabetes Mellitus.” The examiner did not provide any rationale for this opinion. The Veteran underwent a VA examination for his DM II in October 2014. During this examination, the examiner found that the Veteran did not have diabetic retinopathy or any other eye conditions that are at least as likely as not related to his DM II. Funduscopic examinations of the Veteran’s eyes were within normal limits. VA ophthalmology notes dated March and April 2018 indicate that the Veteran underwent a right eye capsulotomy in March 2018 and a left eye capsulotomy in April 2018. The Veteran also underwent cataract surgery in May 2013. See May 2013 VA outpatient surgical note. The Veteran most recently underwent a VA examination for his claim in November 2017. The examiner stated that the small corneal scar present in the left central cornea is less likely than not proximately due to or the result of the Veteran's traumatic conjunctivitis experienced during his time of service. The examiner also stated that the conditions of dry eye and cataract/pseudophakia are less likely than not proximately due to or the result of the Veteran's traumatic conjunctivitis experienced during his time of service. The examiner explained that due to the traumatic nature of the injury (a finger poke to the eye) the small central scar in the left eye is less likely than not the result of the Veteran’s documented in-service eye injury. The examiner noted that review of the Veteran’s STRs, shows no documentation of the scar post injury. The examiner stated that the scarring is small and not resulting in perceived vision loss and noted that the Veteran underwent cataract surgery resulting in his pseudophakia OU. The examiner stated that there is no evidence linking the cataracts directly to his injury in service. The examiner also stated that the Veteran’s dry eye syndrome is more likely than not the cause of his bilateral blurred vision, but it is less likely than not that his dry eye condition was proximately due to the traumatic conjunctivitis the Veteran experienced during service. The November 2017 opinion is persuasive and of significant probative value as to the issue of direct service connection. It was rendered by a medical specialist, following a physical evaluation of the Veteran, and a complete review of the Veteran’s medical history, to include the in-service traumatic conjunctivitis. The opinion is based upon sound medical principles. There is no contradictory medical opinion of record. The Veteran's bilateral eye disabilities did not have their onset in service and did not manifest to a compensable degree within one year of discharge. While VA treatment records indicate that the Veteran has post-service treatment for several eye disabilities and STRs document traumatic conjunctivitis during service, there is no competent evidence of record linking the Veteran’s current eye disabilities to the traumatic conjunctivitis he experienced during service or to his service-connected DM II. The Veteran was first diagnosed with an eye disability in April 2011. See April 2011 VA ophthalmology note. VA treatment records consistently describe the Veteran’s cataracts as being age-related. See, e.g. May 2012 VA ophthalmology note. During the October 2014 VA examination, the Veteran reported the onset of his blurry vision as June 2013 and stated that it began after he had a lens replacement in his right eye. Notably, the injury documented in the Veteran’s STRs was to his left eye and no residuals of that injury were noted on the Veteran’s January 1968 separation examination which assessed the Veteran’s eyes as normal. Service connection on a secondary basis is also not warranted. The October 2014 DM II VA examination report indicates that the Veteran did not have diabetic retinopathy or any other eye conditions that are at least as likely as not related to his DM II. Additionally, VA treatment records consistently indicate that the Veteran does not have diabetic retinopathy and there is no competent evidence of record suggesting a relationship between the Veteran’s service-connected DM II and any of his current eye disabilities. Despite the Veteran’s sincere belief that his eye disabilities are related to his service and secondary to his DM II, he is not competent to make that determination. Lay evidence may be competent on a variety of matters concerning the nature and cause of disability. Jandreau v. Shinseki, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Colantonio v. Shinseki, 606 F.3d 1378, 1382 (Fed. Cir. 2010) (recognizing that in some cases lay testimony “falls short” in proving an issue that requires expert medical knowledge). In the present case, the Veteran is a lay person without appropriate medical training and expertise, and thus, is not competent to make an etiological conclusion regarding the cause of his present eye disabilities, especially in light of the fact that the onset of the current symptoms occurred many years after service discharge. In sum, the most probative evidence of record shows that the Veteran’s present eye disabilities did not have onset during active service, and are not otherwise related to active service, to include as secondary to his service-connected DM II. As such, the claim of service connection must be denied. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, because the preponderance of the evidence is against the claim, that doctrine does not apply. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet App. 49 (1990); 38 C.F.R. § 3.102. L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board V. Modesto 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.