Citation Nr: 21073722 Decision Date: 12/10/21 Archive Date: 12/10/21 DOCKET NO. 17-43 446 DATE: December 10, 2021 ORDER Service connection for a bilateral eye disorder is denied. REMANDED Service connection for abnormalities to the left paracardiac area, to include paracardiac fibrosis and subsegmental atelectasis, is remanded. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has a bilateral eye disability which is attributable to his active duty service. CONCLUSION OF LAW The criteria for service connection for a bilateral eye disability are not met. 38 U.S.C. §§ 1101, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.3.09, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1978 to March 1982, from March 1991 to July 1991, from September 2006 to February 2008, from January 2012 to October 2012, and from July 2013 to April 2014. The Veteran is a Persian Gulf veteran as he had qualifying service in the Southwest Asia theater of operations during the Persian Gulf War. See 38 C.F.R. § 3.317(e). 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). Bilateral eye Specific to claims for service connection of eye disabilities, congenital or developmental defects, including refractive errors of the eyes, are not "diseases or injuries" for disability compensation purposes under VA law. See 38 C.F.R. §§ 3.303(c), 4.9; Palczewski v. Nicholson, 21 Vet. App. 174, 179 (2007). Refractive error of the eyes generally includes diagnoses of hyperopia, presbyopia, and astigmatism. See, e.g., Dorland's Illustrated Medical Dictionary 170, 904 (30th ed. 2003) (defining hyperopia and astigmatism as errors of refraction). Absent superimposed disease or injury, service connection may not be allowed for a congenital or developmental defect of the eyes, even if visual acuity decreased in service, as this is not a disease or injury within the meaning of applicable legislation relating to service connection. Parker v. Derwinski, 1 Vet. App. 522 (1991); McNeely v. Principi, 3 Vet. App. 357, 364 (1992). Thus, in the absence of some event or trauma, a refractive error is a constitutional or development abnormality for which compensation benefits may not be authorized. 38 C.F.R. §§ 3.303(c), 4.9 (congenital or developmental defects, refractive error of the eye, personality disorders, and mental deficiency as such are not diseases or injuries within the meaning of applicable legislation); see also VAOPGCPREC 82-90 (July 18, 1990). Pursuant to the Board's 2020 Remand, a VA examination of the Veteran's bilateral eyes was conducted in May 2021 by an ophthalmologist. In the examination the Veteran denied ocular trauma or using prescribed eyedrops. The Veteran's stated that he had no ocular complaints other than needing reading glasses. The examiner found, after review of the Veteran's medical records in file and examination of the Veteran, that the Veteran had a diagnosis of hyperopia, which pre-dated his active duty service, and presbyopia. Neither the Veteran's hyperopia nor his presbyopia was not found to have been aggravated or worsened beyond normal progression by his active duty service. The examiner noted the Veteran did not have any superimposed injury or disease in service which resulted in any additional disability, including during the time of the Veteran's service in Southwest Asia. The examiner also found that the Veteran did not have any evidence of glaucoma. Thus, the 2021 examination found no condition for which service connection could be granted. The Veteran and his representative have not identified any evidence which supports a claim for service connection or introduced or identified any evidence which conflicts with the 2021 VA examination. As such, the Board finds that the preponderance of evidence is against finding that the Veteran has an eye disability for which service connection can be granted. 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). REASONS FOR REMAND Left Paracardiac Area The Board's February 2021 Remand instructed that an examination occur regarding the Veteran's claimed disorder of the left paracardiac area. However, only a cardiology examination was undertaken. The Veteran's condition is not claimed to be a cardiac disability. Thus, the May 2021 examination is inadequate and a new examination is warranted. The matter is REMANDED for the following action: Schedule the Veteran for a VA examination by an appropriate clinician to determine the nature and etiology of any abnormalities to the left paracardiac area. It should be noted that the Veteran's claim is not for a disability of his heart. The entire claims file, to include a copy of this REMAND, should be made available to and reviewed by the clinician. A complete medical history should be obtained. The examiner is asked to determine if the Veteran has or had a diagnosis of any abnormality of his paracardiac area, including left paracardiac fibrosis and/or subsegmental atelectasis at any time during the pendency of the claim or recent to the filing of the claim. If the Veteran has or had such a diagnosis, the examiner is asked to opine whether a. it is at least as likely as not (50 percent or greater probability) that any such condition was incurred in, or due to, the Veteran's service, to include the Veteran's service in Southwest Asia and his exposure to environmental hazards therein, OR b. is proximately due to or aggravated beyond its natural progression by any of the Veteran's service connected disability of his right biceps tendon tear. The examiner is asked to attempt to reconcile, or explain, medical evidence showing negative and positive findings for left paracardiac fibrosis and/or subsegmental atelectasis. The Veteran's lay statements regarding onset and continuity of symptomology should be recorded and considered. A rationale for all opinions must be provided. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish 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.