Citation Nr: 21073173 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 20-13 300 DATE: December 7, 2021 ORDER Service connection for loss of peripheral vision is denied. FINDINGS OF FACT 1. The Veteran is currently diagnosed with bilateral left sided homonymous hemianopia (a visual field defect involving either the two right or the two left halves of the visual fields of both eyes), which results in a loss of peripheral vision. 2. The Veteran's eyes were not injured during service, and there were no diseases of the eyes during service. CONCLUSION OF LAW The criteria for service connection for loss of peripheral vision have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.326(a). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran, who is the appellant, had active service from October 1960 to June 1964. This matter came before the Board of Veterans' Appeals (Board) on appeal from an October 2018 Department of Veterans Affairs (VA) Regional Office (RO) rating decision denying service connection for peripheral vision loss. The Veteran testified at an April 2021 Board videoconference hearing before the undersigned Veterans Law Judge. The hearing transcript has been associated with the record. The Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5102, 5103, 5103A, 5107, 5126; 38 C.F.R. §§ 3.102, 3.159, 3.326(a). Concerning the duty to notify, the record reflects that the Veteran received adequate VCAA notice during the course of this appeal. Regarding the duty to assist, the record reflects that VA obtained all relevant documentation to the extent possible. While the Veteran has not received a VA eye examination during the course of this appeal, remand to obtain such an examination and opinion is unnecessary as, for the reasons discussed below, the Board finds that the Veteran did not sustain an eye injury during service. See McLendon v. Nicholson, 20 Vet. App. 79, 81-82 (2006); see also Bardwell v. Shinseki, 24 Vet. App. 36, 40 (2010) (holding that for VCAA, where the weight of the evidence has failed to establish an in-service injury, disease, or event, VA is not obligated to provide a medical examination or nexus opinion). For these reasons, the Board finds that the duties to notify and assist the Veteran in this case have been fulfilled. Service Connection for Loss of Peripheral Vision is Denied Service connection may be granted for disability arising from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. The currently diagnosed homonymous hemianopia (a visual field defect involving either the two right or the two left halves of the visual fields of both eyes) is not a chronic disease under 38 C.F.R. § 3.309(a). As such, the presumptive service connection provisions under 38 C.F.R. § 3.303(b) for service connection based on "chronic" symptoms in service and "continuous" symptoms since service are not applicable to the issue on appeal. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). When all the evidence is assembled, 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 a claim, in which case, the claim is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). At the outset, the evidence shows a bilateral eye disability that manifests as loss of peripheral vision, specifically, homonymous hemianopia. Per a January 2020 private treatment letter, the Veteran's physician reported a diagnosis of bilateral left sided homonymous hemianopia. The Veteran seeks service connection for a loss of peripheral vision, which the Veteran attributes to an in-service accident and being thrown from a jeep. The Veteran does not attribute the loss of peripheral vision to any other purported in-service injury or disease, and review of the service treatment records does not show treatment for any in-service injury or disease of the eyes. Having reviewed all the evidence of record, lay and medical, the Board finds that, while the Veteran did hit the back of the head after falling from a jeep during service, the accident did not result in an injury to either eye. Service treatment records reflect that the Veteran sought treatment in October 1963 for symptoms relating to an in-service accident after being thrown from a jeep. It was reported that the Veteran struck the back of the head and was rendered unconscious, with reports of pain and dizziness when the head was turned a certain way. The in-service physician did not report injury to either eye or any eye disability symptoms. Per the report from the June 1964 service separation examination, the Veteran had normal vision at service separation, with no eye disability noted. The separation examiner did discuss the in-service head injury, but noted that the Veteran merely experienced transient amnesia that resolved without residual. In the corresponding June 1964 Report of Medical History, the Veteran denied any history of eye trouble. An April 2005 VA treatment record reflects that the Veteran sustained a non service connected post service brain aneurism in March 2000. Per the VA treatment record, the Veteran reported having peripheral vision difficulty on the left side since the brain aneurysm. The report from a June 2018 private treatment record noted that the Veteran had a history of amnesia due to falling from a jeep during service. Per the treatment record, the date of injury was incorrectly reported as occurring in the 1980s. Further, the private physician noted that the Veteran had a brain aneurism in March 2000. A subsequent July 2018 private treatment record stated that the Veteran had been diagnosed with left sided homonymous hemianopia following the brain aneurism in March 2000. In August 2018, VA received a Statement in Support of Claim from the Veteran. Per the Statement, the Veteran conveyed being thrown from a jeep and striking the back of the head during service, with the blow to the back of the head resulting in unconsciousness and amnesia. The Veteran did not state that the blow resulted in a loss of peripheral vision (or any other eye injury/disability). Following separation from service, the Veteran had a brain aneurysm, which left no peripheral vision on the left side. The Veteran contends that the loss of peripheral vision was related to the in-service jeep accident. The Veteran submitted a notice of disagreement (NOD) in November 2018. At that time, the Veteran wrote that the peripheral vision loss began immediately after the in service jeep accident, and then grew progressively worse over the years. Along with the Veteran's lay statement, the NOD also contains a handwritten note from the Veteran's private physician, Dr. KL. Per the note, the private physician wrote that the Veteran has a "left-sided homonymous hemianopia related to history of an accident." Dr. KL subsequently submitted a private treatment/opinion letter in January 2020. Per the opinion letter, Dr. KL stated that the Veteran's bilateral left sided homonymous hemianopia was caused by the in-service jeep accident in 1963, and was later exacerbated by the March 2000 brain aneurysm. Finally, the Veteran testified at an April 2021 virtual Board hearing. At that time, the Veteran testified to having lightheadedness, dizziness, and periodic memory lapses (temporary amnesia) following the accident. The Veteran also testified to later developing headaches. The Veteran did not testify to having any vision problems following the in-service jeep accident. Rather, the Veteran specifically testified to having peripheral vision problems following the non service connected post-service March 2000 brain aneurysm. Having reviewed the evidence of record, lay and medical, the Board finds the weight of the credible evidence to be against a finding of an in-service injury, disease, or event as the cause of the currently diagnosed bilateral left sided homonymous hemianopia, which results in a loss of peripheral vision. Per the evidence of record, discussed above, the service treatment records do not support that the Veteran injured either eye following the in-service accident and being thrown from a jeep. Rather, the evidence reflects that the Veteran struck the back of the head after falling from the jeep, and the post injury symptoms manifested as pain, dizziness, and temporary amnesia. Further, various VA and private treatment records report that the Veteran first developed loss of peripheral vision following the non service connected post-service March 2000 brain aneurysm. The Board has considered the Veteran's November 2018 lay statement found within the NOD stating that the peripheral vision loss symptoms have been present since the in-service jeep accident/injury; however, the Board finds this lay statement not to be credible as it is inconsistent with, and outweighed by, other lay and medical evidence of record, especially the Veteran's own, more contemporaneous lay statements and statements made for treatment purposes. As discussed above, in a June 1964 Report of Medical History, the Veteran denied having any vision problems as service separation. See Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997) (upholding Board's finding that a veteran was not credible because recent lay evidence about a wound in service was internally inconsistent with the veteran's contemporaneous lay statements that he had not received any wounds in service). Further, per an April 2005 VA treatment record, the Veteran explicitly stated that the peripheral vision problems began following the non service connected post-service March 2000 brain aneurysm. This VA treatment record is supported by the Veteran's August 2018 Statement in Support of Claim and testimony at the April 2021 virtual Board hearing. See Harvey v. Brown, 6 Vet. App. 390, 394 (1994) (Board decision properly assigned more probative value to a private hospital record that included lay history that was made for treatment purposes than to subsequent statements made for compensation purposes). In sum, the Board finds the assertions made in the November 2018 lay statement to be inconsistent with and outweighed by more contemporaneous in service findings and history and post-service medical histories given by the Veteran for treatment purposes that indicate that vision problems did not manifest until after the non service connected post-service March 2000 brain aneurysm. See Curry v. Brown, 7 Vet. App. 59 (1994) (noting that contemporaneous evidence has greater probative value than history as reported by the veteran; affirming Board decision that cited from MCCORMICK ON EVIDENCE (3rd ed.1984) for the proposition that "memory hinges on recency" and that earlier statements are generally more trustworthy than later ones). The Board has also considered the November 2018 and January 2020 private opinions from Dr. KL purporting to link the currently diagnosed bilateral left sided homonymous hemianopia to the in-service jeep accident. First, the Board notes that these to opinions contain no rationale for the opinion provided, so are inadequate for VA rating purposes on that basis and lack probative value. See Jones v. Shinseki, 23 Vet. App. 382 (2010) (holding that an opinion without any rationale against which to evaluate the probative value of his determination is inadequate). Further, the Board notes that the first opinion was rendered in the same NOD containing the Veteran's one-and-only lay assertion that peripheral vision problems first manifested following the in-service jeep accident and have been present since service. For the reasons discussed above, the Board has found this lay statement to not be credible. As it appears that the November 2018 and subsequent January 2020 positive nexus opinions were based on the inaccurate factual history of peripheral vision problems first manifesting following the in-service jeep accident, which in this decision the Board has found to not be credible, the opinions are based upon an inaccurate factual premise and are, therefore, not probative for VA rating purposes. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that an opinion based upon an inaccurate factual premise has no probative value). (Continued on the next page) In sum, the Board finds the weight of the credible evidence to be against a finding of an in-service injury, disease, or event as the cause of the currently diagnosed bilateral left sided homonymous hemianopia, which results in a loss of peripheral vision. Service treatment records reflect that, while the Veteran did sustain a head injury during service after falling from a jeep, the Veteran did not manifest any eye/vision symptoms either immediately following the in-service injury or at any time prior to service separation. In fact, the Veteran explicitly denied having any vision problems at service separation. Further, when seeking treatment from VA in April 2005, following the March 2000 brain aneurism, the Veteran stated that peripheral vision difficulties manifested following the aneurism. To the extent a private physician has opined that the peripheral vision difficulties are related to the in service jeep accident, the Board notes that such opinion is based upon the Veteran's non-credible November 2018 lay statement indicating that loss of peripheral vision first manifested following the in-service jeep accident. As the opinion is based upon an inaccurate factual premise, it is of no probative value. As the weight of the evidence supports that the Veteran's eyes were not injured at the time of the in-service head injury after being thrown from a jeep, as neither the Veteran nor the evidence of record conveys any other eye injury or disease during service, and as the weight of the probative and credible medical and lay evidence supports that the bilateral left sided homonymous hemianopia, which results in a loss of peripheral vision, was caused by the non service connected post-service March 2000 brain aneurysm, the preponderance of the evidence is against service connection for loss of peripheral vision, and the appeal must be denied. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Blowers, 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.