Citation Nr: 21074222 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 17-05 860A DATE: December 14, 2021 ORDER Entitlement to service connection for anterior cortical cataract, right eye, to include as secondary to service-connected disabilities, is denied. FINDING OF FACT The competent and credible evidence does not demonstrate that the Veteran's anterior cortical cataract, right eye, had its onset during active duty service, or was not proximately due to, the result of, or aggravated by, a service-connected disability. CONCLUSION OF LAW The criteria for entitlement to service connection for anterior cortical cataract, right eye, to include as secondary to service-connected disabilities, have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310 REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Marine Corps from February 1966 to February 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). Most recently, in February 2021, the Board granted service connection for diabetic retinopathy and remanded the issue on appeal for additional development. As the actions specified in the remand have been substantially completed, the matter has been properly returned to the Board for appellate consideration. See Stegall v. West, 11 Vet. App. 268 (1998); D'Aries v. Peake, 22 Vet. App. 97, 105 (2008). In an October 2021 rating decision, the RO, in pertinent part, granted service connection for service connection for right eye diabetic retinopathy, left eye diabetic retinopathy, and right eye central retinal artery occlusion; granted a higher level of special monthly compensation (SMC) from July 8, 2021; and granted SMC based on blindness of one eye from June 30, 2015. Duties to Notify and Assist Pursuant to the Veterans Claims Assistance Act (VCAA), VA has duties to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C. §§ 5102, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.156(a), 3.159. Neither the Veteran nor his representative has raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board . . . to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Service Connection 1. Entitlement to service connection for anterior cortical cataract, right eye, to include as secondary to service-connected disabilities The Veteran generally asserts that his anterior cortical cataract of the right eye was caused by a service-connected disability. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, service connection requires: (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. See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In addition, service connection may be established on a secondary basis for a disability which is shown to be proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310. Establishing service connection on a secondary basis requires evidence sufficient to show that a current disability exists and that the current disability was either caused by or aggravated by a service-connected disability. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995). The question before the Board is whether the Veteran's anterior cortical cataract, right eye, is etiologically related to service or a service-connected disability. Based on a careful review of all the subjective and clinical evidence, the preponderance of the evidence weighs against finding service connection for anterior cortical cataract, right eye, to include as secondary to service-connected disabilities, is warranted. The evidence demonstrates that the Veteran has a current diagnosis for anterior cortical cataract of the right eye. See October 2015 VA examination. The Veteran's service treatment records do not document any findings related to any complaints, treatment, or diagnosis for any eye problems. At a January 1968 separation examination, the Veteran had distant vision at 20/20 bilaterally and normal clinical evaluation of both eyes. VA treatment records from 2012 to 2020 document the Veteran's treatment for multiple eye problems. The Veteran was first diagnosed with cataract of the right eye in May 2015. A November 2020 VA treatment record reflects that the Veteran had complications of diabetes, to include his retinopathy and central retinal artery occlusion of the right eye with optic atrophy. The evidence does not show, and the Veteran does not contend, that his cataract of the right eye was related to his active duty service. Therefore, the Board finds that service connection for cataract of the right eye on a direct basis is not warranted. However, the Board must address whether the Veteran's anterior cortical cataract of the right eye was caused or aggravated by a service-connected disability. The record contains multiple VA etiological opinions addressing secondary service connection. In a February 2016 VA opinion, the VA examiner opined that the Veteran's cataract of the right eye was less likely than not proximately due to or the result of his service-connected diabetes mellitus, type II. In providing a rationale, the February 2016 VA examiner found that the Veteran's cataract of the right eye was due to his 30-year history of smoking two packs of cigarettes per day, having hypertension, and high cholesterol. The February 2016 VA examiner explained that these factors are self-selected, have no service relationship, and was a lifestyle choice only. In April 2016, the February 2016 VA examiner responded to the RO's request for a clarifying addendum opinion. The February 2016 VA examiner explained that the "diagnosis of the right eye is a non-service related and not diabetic related to the diagnosis to macular degeneration brought on cigarette smoking according to the medical literature." In an October 2020 VA opinion, the VA examiner opined that the Veteran's anterior cortical cataract of the right eye was less likely than not proximately due to or the result of his service-connected diabetes mellitus, type II, and/or hypertension. In providing a rationale, the October 2020 VA examiner explained that cataract formation is due to a variety of causes, including age, lifestyle, underlying systemic diseases, and trauma. Noting that the medical literature does not support a causal relationship between hypertension, the October 2020 VA examiner concluded that the Veteran's cataract of the right eye was less likely than not due to his hypertension. Furthermore, the October 2020 VA examiner discussed how uncontrolled diabetes can cause cataracts. Because of the Veteran's age and lifestyle, the October 2020 VA examiner stated that those factors could not be ruled out in contributing to the development of his cataracts. Given the "likelihood of cortical cataracts increases with age and the Veteran was released from active duty in 1968, and references to diabetic retinopathy are not noted in the records till 2015, it is less likely than not that the Veteran's cataracts are proximate due to the Veteran's service connected condition." In a July 2021 VA opinion, the VA examiner opined that the Veteran's cataract of the right eye was less likely than not proximately due to, the result of, or aggravated by a service-connected disability. Based on an objective evaluation and a review of the Veteran's relevant medical records, the July 2021 VA examiner found that the Veteran's cataract of the right eye was age-related. The Board finds that collectively, the October 2020 and July 2021 VA opinions provide the most probative evidence regarding the etiology of the Veteran's cataract of the right eye. After conducting an objective evaluation, reviewing the Veteran's relevant medical records, and discussing medical literature, the Board notes that the October 2020 and July 2021 VA examiners agreed that the Veteran's cataract of the right eye was less likely than not caused or aggravated by a service-connected disability. Rather, the determination was that the Veteran's cataract of the right eye was age-related. Based on the above, the Board concludes that service connection on a secondary basis for the Veteran's cataract of the right eye is not warranted. The only evidence in support of the Veteran's contention that his cataract of the right eye was caused or aggravated by a service-connected disability are his own lay assertions. Lay evidence may be competent to establish medical etiology or nexus. However, given that the Veteran has not demonstrated that he has specialized knowledge or training, the Board must find that he is not competent to provide a medical opinion as to the etiology of his cataract of the right eye. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Thus, his lay assertions have little probative value. In summary, the preponderance of the evidence weighs against finding in favor of the Veteran's service connection claim for anterior cortical cataract, right eye, to include as secondary to service-connected disabilities. Therefore, the benefit-of-the-doubt rule does not apply, and the service connection 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). LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Journet Shaw, 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.