Citation Nr: 21006422 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 14-15 163 DATE: February 4, 2021 ORDER Entitlement to service connection for a disability manifested by visual impairment, other than conversion disorder, is denied. FINDING OF FACT The preponderance of the evidence is against finding that visual impairment, other than conversion disorder, was incurred in or caused by service. CONCLUSION OF LAW The criteria for service connection for visual impairment, other than conversion disorder, have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1978 to April 1980. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In September 2017, the Veteran testified at a Board video conference hearing before the undersigned Veterans Law Judge. A transcript of this hearing is of record. This matter was last before the Board in April 2020, when it was remanded for further development. The requested development was completed, and the case has been returned to the Board for further appellate action. Entitlement to service connection for a disability manifested by visual impairment, other than conversion disorder During the September 2017 Board hearing, the Veteran’s attorney indicated that the Veteran is seeking service connection for visual impairment attributable to a conversion reaction caused by her anxiety and PTSD, as well as visual impairment caused by a corneal condition. An April 2020 Board decision granted entitlement to service connection for impairment attributable to a conversion reaction caused by her anxiety and PTSD. In a written statement accompanying her April 2014 application for service connection, the Veteran indicated that she was seeking service connection for visual impairment caused by cornea difficulties. Service connection may be established for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. Establishing service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). 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 any event, injury, or disease during service. Service treatment records show vision of 20/20 in both eyes on the Veteran’s entrance examination, but on the accompanying report of medical history, the physician noted defective vision corrected with glasses. In July 1979, the Veteran reported having eye trouble on her separation report of medical history. Post-service treatment records show that the Veteran reported being diagnosed with glaucoma and Chandler’s Syndrome in 1995. VA treatment records show that the Veteran reported symptoms of facial tics, severe photophobia, and loss of vision in both eyes beginning around 2007. A May 2009 VA neurology treatment record noted that the Veteran was recently seen by an ophthalmologist and a neuro-ophthalmologist, and neither treatment provider found an organic reason for the Veteran’s loss of vision. The neurologist indicated that the Veteran’s presentation was consistent with a diagnosis of conversion disorder and recommended that the Veteran follow up with her mental health treatment provider, as her symptoms could improve with adequate management of psychiatric disability. A subsequent VA neuro-ophthalmology treatment record likewise indicates that no physiologic basis was found for the Veteran’s claimed loss of sight, and the diagnosis was non-medically explained decreased vision. In July 2020, a VA examiner diagnosed the Veteran with chandler's syndrome, right eye, to include corneal decompensation, ocular hypertension and glaucoma, as well as elevated intraocular pressure cataract, both eyes, status post posterior chamber intraocular lenses in the right eye and left cataract with slow progression. After examination of the Veteran and claims file review, the examiner opined that other than conversion disorder, it is less likely than not a current disability manifested by vision impairment was incurred in or caused by in-service injury, event or illness. The examiner stated that underlying cause of Chandler's syndrome is unknown. Some researchers suspect that inflammation or chronic viral infection may play a role in the development of this condition. The examiner noted that there was no diagnosis or evidence of Chandler's disease or viral infection while in service, that the condition was diagnosed in 1995, and that a nexus is not established. Additionally, the July 2020 examiner noted that bilateral cataracts, status post posterior chamber intraocular lens, are not contributing to visual impairment. There is no competent and probative medical opinion to the contrary, and neither the Veteran nor her attorney have challenged the adequacy of the examination or opinion. Finally, to the extent that the Veteran believes that her current disability is related to service, as a lay person, the Veteran has not shown that she has specialized training sufficient to render such an opinion. In this regard, the diagnosis and etiology of vision disorders are matters that require medical training and expertise to determine. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). Thus, the Board finds the opinion of the 2020 VA examiner to be significantly more probative than the Veteran’s lay assertions. Accordingly, the Board finds that the preponderance of the evidence is against the claim for service connection for a disability manifested by visual impairment, other than conversion disorder, and the claim for service connection must be denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. § 5107; 38 C.F.R. § 3.102. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Asare, Associate 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.