Citation Nr: 21072915 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 15-41 619 DATE: December 6, 2021 ORDER 1. Service connection for a left eye disorder is denied. 2. Service connection for a right eye disorder is denied. FINDINGS OF FACT 1. The Veteran's left eye disorder did not have its onset during service and is not otherwise related to service. 2. The Veteran's right eye disorder did not have its onset during service and is not otherwise related to service. CONCLUSIONS OF LAW 1. The criteria for service connection for a left eye disorder have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 4.9. 2. The criteria for service connection for a right eye disorder have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 4.9. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from September 1976 to June 1978. This case is on appeal from a March 2015 rating decision. Most recently, in August 2021, the Board remanded the claims on appeal for additional development. The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). 1. Service connection for a left eye disorder. 2. Service connection for a right eye disorder. Legal Criteria 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." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). In addition, refractive errors of the eye are diseases or injuries for which service connection cannot be granted. See 38 C.F.R. §§ 3.303 (c), 4.9; see also O'Bryan v. McDonald, 771 F.3d 1376, 1380-81 (Fed. Cir. 2014) (refractive error of the eye is not a compensable disease because it is specifically excluded from the regulation even though refractive errors of the eye can progress) (citing Terry v. Principi, 340 F.3d 1378, 1383-84 (Fed. Cir. 2003)). Analysis The Veteran contends that he has left and right eye disorders that are related to service. In this regard, in an April 2015 Notice of Disagreement (NOD), the Veteran reported that he has vision loss from an in service accident in Germany involving lead based paint in his eyes. He reported that he flushed out the paint, but experienced vision loss ever since. Also, he reported that he had 20/20 vision when he enlisted and no longer had 20/20 vision when he was discharged from service. The Veteran's service personnel record (SPRs) show that he served in Germany as a Motor Transportation Operator in 1977. His service treatment records (STRs) show that in November 1977, the Veteran reported right eye pain and slight swelling. Also, he reported an eye problem due to chemical irritation during his separation exam in January 1978. It was unclear if it was one or both eyes. His separation examination show that he had normal uncorrected visual acuity for the right eye and reduced uncorrected visual acuity for the left eye. No results were found for bilateral corrected vision. The Veteran's post-service VA treatment records show that in 2019 he was treated for irritation and bleeding of the left eye and noted for early signs of cataracts. In a June 2019 hospital visit, the Veteran denied vision loss or changes. In December 2019, the Veteran was afforded a VA examination for this claim. The ophthalmologist reviewed the claim file. The ophthalmologist diagnosed the Veteran with bilateral cataracts with an onset date of 2019. The ophthalmologist found that the Veteran's eye disorders were less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The ophthalmologist reported that the Veteran's bilateral distance uncorrected and corrected and near corrected visual acuity were normal while the bilateral near uncorrected visual acuity was reduced. Also, the ophthalmologist reported that the Veteran did not present problems with astigmatism, differences in visual acuity for distance and near vision, pupillary defect, cornea irregularities, anatomical loss, double vision, visual field, defect, light perception, extremely poor vision or blindness, or functional impact. The ophthalmologist found that the Veteran's cataracts are not a congenital disease or defect. He also found that the cataracts are less likely than not incurred in or otherwise attributable to service. He explained that there was no history of an in-service injury that would cause cataracts. He also explained that the cataracts are at least as likely as not due to age. Pursuant to the October 2020 Board remand, a medical opinion for these claims was obtained. The same ophthalmologist reviewed the claims file. He found that the Veteran's eye disorders were less likely than not incurred in or cause by the claimed in-service injury, event, or illness. In addition, the ophthalmologist found that the Veteran did not have vision loss due to paint in the eyes. The ophthalmologist explained that, while the Veteran reported a history of chemical irritation on a questionnaire in June 1978, no eye injury was documented in the Veteran's STRs. Further, the ophthalmologist explained that there is no vision loss and no sign of residual from lead paint injury. The ophthalmologist noted that the Veteran's uncorrected reduced visual acuity results reflected in the separation examination for the left eye did not show corrected vision. The ophthalmologist concluded that the Veteran's vision trouble is due to a refraction error. Pursuant to the August 2021 Board remand, the Veteran was afforded another examination for these claims in September 2021. The same ophthalmologist reviewed the claims file. The ophthalmologist reported a 2019 diagnosis of cataracts. He also reported that the Veteran is experiencing cataracts and worsening visual acuity for distance and near vision. However, the ophthalmologist found that the Veteran's cataracts were less likely than not incurred in or caused by the claimed in-service injury, event, or illness. Furthermore, the ophthalmologist opined that it is less likely than not that the cataracts are caused by getting paint in the eye. The ophthalmologist explained that there is no known physiologic association between getting paint in the eye and cataracts. He also explained that getting paint in the eye does not cause vision loss. The Board finds that the September 2021 VA examination and medical opinion persuasive as it is based on the relevant information, including physical examinations of the Veteran, his statements, STRs, and post-service treatment records. Moreover, the ophthalmologist's explanations are logical and follow from the facts and information given. See Monzingo v. Shinseki, 26 Vet. App. 97, 105-06 (2012); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The ophthalmologist found that the Veteran has current eye disabilities of cataracts diagnosed in 2019 and reduced visual acuity. In reviewing the record, the ophthalmologist considered the Veteran's STRs showing reports of eye pain and swelling in November 1977 and chemical eye irritation during separation in January 1978 as well as the Veteran's report of getting lead based paint in his eye and reduced visual acuity following discharge from service. However, the ophthalmologist explained that there is no known physiologic association between getting paint in the eye and cataracts. Therefore, the ophthalmologist's conclusions that the Veteran's cataracts are not congenital conditions and were less likely than not incurred in or caused by the claimed in-service injury, event, or illness is highly persuasive and probative evidence. In addition, while the Veteran also experiences reduced bilateral vision acuity, refractive errors of the eye are conditions for which service connection cannot be granted. See 38 C.F.R. §§ 3.303 (c), 4.9; see also O'Bryan, 771 F.3d at 1380-81 (Fed. Cir. 2014). While the Veteran believes that he has right and left eye disorders incurred in or caused by service, this is a complex medical question outside the competence of a non-medical expert to determine whether such a cause-and-effect relationship exists in this particular case. Thus, this nexus question requires expert consideration and cannot be considered within the competence of a non-expert lay witness. The Veteran, as a lay person, has not established the competence needed to rebut expert medical opinion. See Fountain v. McDonald, 27 Vet. App. 258, 274-75 (2015); Monzingo, 26 Vet. App. at 106. As such, his opinion is not adequate to rebut the VA ophthalmologist's opinion, nor is it otherwise sufficiently probative to be considered competent evidence tending to increase the likelihood of a positive nexus between service and a right or left eye disorder. Accordingly, the preponderance of the evidence is against finding that the Veteran has a right eye or left eye disorder that was incurred in or caused by service. Therefore, the benefit-of-the-doubt doctrine is not applicable and service connection for an eye disability, including vision loss, is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. DAVID JIMERFIELD Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Nevarez-Myrick, Nancy 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.