Citation Nr: 21066972 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 20-20 919 DATE: November 3, 2021 ORDER Service connection for cerebellar degeneration is granted. Service connection for a bilateral eye condition, secondary to cerebellar degeneration, is granted. FINDINGS OF FACT 1. Resolving all doubt in the Veteran's favor, her cerebellar degeneration is etiologically related to service. 2. The Veteran's bilateral eye condition is secondary to cerebellar degeneration. CONCLUSIONS OF LAW 1. The criteria for service connection for cerebellar degeneration have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307, 3.309. 2. The criteria for service connection for a bilateral eye condition have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The appellant is a Veteran who served on active duty from October 1977 to March 1979. This matter is before the Board of Veterans' Appeals (Board) on appeal from a rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In October 2021 Travel Board hearing was held before the undersigned. Service Connection 1. Entitlement to service connection for cerebellar degeneration. 2. Entitlement to service connection for bilateral eye condition. The Veteran has asserted her cerebellar degeneration, with resultant bilateral eye condition, is related to her time in service. She has relayed that the in-service treatment for her right knee condition was a result of unexplained falls. She stated the falls were the onset of her primary cerebellar degeneration. She further asserts her bilateral eye condition is secondary to her cerebellar degeneration. 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. Service treatment records (STRs) show the Veteran was diagnosed with musculoskeletal injury due to military exercise trainings, military maneuvers, and gym workouts. Records link the right knee pain with chondromalacia patella to physical activity with an explained etiology of strenuous military training. STRs are silent for complaints of imbalance or lack of coordination. There is a report of a fall while on active duty. STRs show a November 1977 report of right knee pain. In February 1978, the Veteran had a right knee injury, and was seen for right knee chondromalacia secondary to subluxation. The Veteran had a dislocated right patella, that was the result of a fall. In July 1978, she was treated for right knee pain due to a twisting injury. In June 1979, she was treated for a right knee dislocation, and in August 1979 she was treated for chronic knee subluxing patella. In April 1980, she was treated for chondromalacia patella of the right knee. In 1986, she had a stroke. A June 2017 private DBQ notes the Veteran was diagnosed primary cerebellar degeneration, paraplegia, abnormal eye movements, and cerebellar dysarthria. The Veteran presented with difficulty walking, slurred speech, falls, and abnormal eye movements. The clinician noted cerebellar degeneration is a progressive neurodegenerative disorder with no known treatment. In a November 2017 DBQ, the Veteran was diagnosed with alternating esotropia, saccadic eye movements, and dry eyes, and the etiology was determined as spine-cerebellar degeneration, lupus, and fibromyalgia. A medical opinion was submitted from Dr. K S, from October 2019. The Veteran was diagnosed with primary cerebellar degeneration with the bilateral eye conditions of nystagmus and saccadic dysmetria with oscillopsia. Dr. S. noted the Veteran first fell during basic training in 1977. The falls continued but most needed no medical treatment. In May 2014, the fall resulted in a fracture of the astragalus. The clinician further noted that primary cerebellar degeneration is rare and difficult to diagnose. It is a progressive disease that usually begins with poor balance and falls. It often takes a long time for symptoms to develop and diagnose. There is no known cure or treatment for this disease. Dr. S. said her disease progressed to the point that she is now a paraplegic and full-time wheelchair user. After review of the records, the examiner concluded it is at least as likely as not that her condition began with her first fall in service. Rationale provided was that falling is the first symptom of this disease, and there were no falls prior to that time. After this time, the falls continued until she was diagnosed in December 2011. This diagnosis was confirmed by Dr. N. S., from the Bascomb Palmer Eye institute in Miami. Her eyes were examined, and Dr. S. and Dr. B. concluded she has primary cerebellar degeneration. In a January 2020 statement, the Veteran reported falling on occasion during service. She reported most of the falls resulted in no other injury other scrapes and bruises, and as a result she did not seek medical treatment. She reported a fall that resulted in a fracture of her pelvis in 2003, that resulted in the use of a walker. In May 2004 she fell and fractured her ankle. At the January 2020 DRO hearing, she reported a history of cerebellar degeneration, and a diagnosis of three eye conditions, alternating esotropia, saccadic eye movements, and saccadic syndrome with keratoconjunctivitis, which are symptoms of her primary cerebellar degeneration. In a May 2020 statement, she asserted the original fall during service was not a result of chondromalacia patella, as that condition causes softening of the kneecap lining, and does not lead to falls. She asserted the falls during service and shortly thereafter, were a result of poor balance caused by the early stages of cerebellar degeneration. She reported her symptoms were present well before her stroke in 1986. At the October 2021 hearing, the Veteran testified to experiencing falls during service, that were the precursor to cerebellar degeneration. She provided further testimony echoing her prior statements to VA. The Veteran has consistently reported suffering from a cerebellar degeneration that originated during her time in service. She has maintained that her first symptoms were evident by the in-service falls, some of which are documented in the STRs. The Board finds the Veteran's reports of in-service falls are credible and consistent. A veteran is also competent to testify regarding facts or circumstances that can be observed and described by a layperson. 38 C.F.R. § 3.159(a)(2). Dr. K. S. rendered a positive medical opinion linking her cerebellar degeneration to service, and provided a lengthy rationale explaining the early-onset manifestations during service. Further, the Veteran's eye disability has been linked to her cerebellar degeneration. The Veteran had repeated in-service falls, and a diagnosis cerebellar degeneration with an accompanied eye disability. There are consistent, competent, and credible complaints of falls during and ever since service, and a positive medical opinion linking cerebellar degeneration to service. Her eye disability has been associated with her cerebellar degeneration. As such, all reasonable doubt is resolved in the Veteran's favor, and service connection for a cerebellar degeneration and an eye disability on a secondary basis is granted. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Skiouris, 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.