Citation Nr: 21062758 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 16-52 339 DATE: October 12, 2021 ORDER Service connection for right upper extremity neuropathy is granted. Service connection for left upper extremity neuropathy is granted. Service connection for right lower extremity neuropathy is granted. Service connection for left lower extremity neuropathy is granted. Service connection for right eye glaucoma is denied. FINDING OF FACT 1. The evidence is in equipoise regarding whether the Veteran's bilateral upper and lower extremity neuropathy is related to his exposure to herbicides while in-service. 2. The preponderance of the evidence is against finding that the Veteran's right eye glaucoma is linked to his active duty service. CONCLUSION OF LAW 1. The criteria for service connection for bilateral upper and lower extremity neuropathy are met. 38 U.S.C. §§ 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.3.09. 2. The criteria for service connection for right eye glaucoma are not met. 38 U.S.C. §§ 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.3.09. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1966 to July 1968. He is the recipient of the Vietnam Service Medal and the Republic of Vietnam Campaign Medal. Service Connection Service connection requires competent evidence showing: (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); see also Caluza v. Brown, 7 Vet. App. 498 (1995). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303(a). The term "herbicide agent" means a chemical in an herbicide used in support of the United States and allied military operations in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975 (the Vietnam Era), specifically: 2,4-D; 2,4,5-T and its contaminant TCDD; cacodylic acid; and picloram. 38 C.F.R. § 3.307(a)(6). Regulations create a presumption of service connection for certain diseases found to be associated with exposure to a herbicide agent such as that used in Agent Orange. See 38 U.S.C. §§ 1113, 1116; 38 C.F.R. §§ 3.307(d), 3.309(e). Absent affirmative evidence to the contrary, such diseases will be service connected even if there is no evidence of the disease during service, provided that herbicide exposure is established. In deciding the Veteran's claim, VA is responsible for determining 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. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant. Bilateral Upper and Lower Extremity Neuropathy The Veteran contends his bilateral upper and lower extremity neuropathy is due to exposure to herbicide agents in service. The record shows the Veteran served in the Republic of Vietnam during the period when herbicide agents were used; he is presumed to have been exposed to herbicide agents. 38 C.F.R. § 3.307(a)(6). Peripheral neuropathy may only be presumed associated with herbicide exposure if the onset is within a year of said exposure. 38 C.F.R.§§ 3.307(a)(6), 3.309(e). The evidence does not show the Veteran's peripheral neuropathy had an onset within a year of his exposure to herbicide agents. As such, presumptive service connection for his neuropathy cannot be granted on a presumptive basis. The Veteran may still establish service connection to herbicide agent exposure with medical evidence. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). In September 2019, the Veteran submitted a private medical examination and report regarding the etiology of his bilateral upper and lower extremity neuropathy. The examiner noted that she had reviewed the Veteran's service treatment records (STRs) and his civilian medical records along with conducting an in-person examination. She noted the Veteran's bilateral upper and lower extremity neuropathy had been diagnosed in 1990 and had progressively worsened over time. The examiner noted there has been medical studies which linked the delayed development of neuropathy to exposure to herbicides while in-service, referencing a VA case which had granted benefits for such delayed onset. The examiner opined that the Veteran's bilateral upper and lower extremity neuropathy was more likely than not related to his exposure to herbicides while in-service. A November 2019 VA medical opinion stated that it was less likely than not that the Veteran's bilateral upper and lower extremity neuropathy was linked to the Veteran's service, to include his exposure to herbicides in service. However, examiner did not address any literature regarding delayed onset or address the findings in the September 2019 private examination submitted by the Veteran. The Board finds that the evidence as to the etiology of the Veteran's bilateral upper and lower extremity neuropathy is in equipoise and in such instances, the benefit of the doubt is afforded to the Veteran. Although a remand for further medical opinion could be accomplished, the Board will not remand for negative evidence. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003). To the extent that there is any reasonable doubt, that doubt will be resolved in the Veteran's favor. 38 C.F.R. § 4.3. Thus, service connection for bilateral upper and lower extremity neuropathy is granted. Right Eye Glaucoma After review of the record, the Board is unable to find that the preponderance of the evidence supports a link between the Veteran's service and his right eye glaucoma. The Board acknowledges that the Veteran's STRs show that he had a right corneal abrasion while in-service. See November 1967 STR. However, the Veteran's 1968 separation examination did not note or diagnose a right eye disability and the Veteran was not diagnosed with or treated for glaucoma while in-service or within close proximity to service. A December 2019 VA examination specifically addressed in-service abrasion and found that there was no connection between the in-service corneal abrasion and the Veteran's development of glaucoma in his right eye. The examiner noted the Veteran's abrasion had been determined to have resolved without incident or scarring. As such, the examiner found it less likely than not that the Veteran's right eye glaucoma was related to his active duty service. The Board notes that there is no medical evidence of record to contradict or call into question the findings of the December 2019 examiner. The Veteran and his representative have not identified any evidence or introduced any evidence which supports a connection between the Veteran's right eye glaucoma and his active duty service, to include his in-service corneal abrasion. The Board has considered the Veteran's lay statements. While the Veteran is competent to report his medical history and his symptoms, he has not been shown to possess the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. King v. Shinseki, 700 F.3d 1339, 1345 (Fed.Cir.2012). The Board has concluded that the medical evidence, prepared by skilled professionals, is more probative regarding the Veteran's degree of disability. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish, 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.