Citation Nr: 21006618 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 12-00 870 DATE: February 4, 2021 ORDER Entitlement to service connection for left eye glaucoma and cataracts, to include as due to a service-connected disability, is denied. FINDING OF FACT The Veteran’s left eye glaucoma and cataracts are not related to active duty service or to a service-connected disability. CONCLUSION OF LAW The criteria for entitlement to service connection for left eye glaucoma and cataracts to include as secondary to a service-connected disability, are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303(b), 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1972 to July 1996. This appeal is before the Board of Veterans’ Appeals (Board) from a February 2010 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran’s claim was previously remanded by the Board in April 2017 and again in September 2019. The Board finds substantial compliance with the September 2019 remand directives. Stegall v. West, 11 Vet. App. 268 (1998). The Veteran seeks entitlement to service connection for left eye glaucoma and cataracts, which he alleges is the result of multiple in-service eye injuries. In the alternative, he also alleges his left eye glaucoma and cataracts are the result of his service-connected right eye 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, 1131; 38 C.F.R. § 3.303(a). 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. Shedden v. Principi, 381 F.3d 1163, 1167 (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 to the regulations cited above, service connection is warranted for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury. 38 C.F.R. § 3.310. Any additional impairment of earning capacity resulting from an already service-connected condition, regardless of whether or not the additional impairment is itself a separate disease or injury caused by the service-connected condition, should also be compensated. Allen v. Brown, 7 Vet. App. 439 (1995). When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. Id. In rendering a decision on appeal, the Board must analyze the credibility and probative value of all medical and lay evidence of record, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. 38 U.S.C. § 1154(a); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) (“although interest may affect the credibility of testimony, it does not affect competency to testify”). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Board must resolve reasonable doubt in favor of the Veteran. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. 49. To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518 (1996). Turning to the evidence of record, the STRs indicate in October 1974 he suffered a head injury as a result of a car accident. In March 1978 he suffered from a left eye abrasion. In August 1978 he experienced dizzy spells and fell unconscious. In October 1978 he suffered a head injury during a football game. In July 1989, he suffered a corneal abrasion to his right eye. In February 1990 he received treatment for “tritis/uveitis.” In June 1992, an optometry note indicates the Veteran’s right cylinder was “-.25” and his left cylinder was “-.50.” In October 1992 suffered a head injury as result of an elbow to the face during a basketball game. His June 1996 separation examination did not note any difficulties related to the Veteran’s left eye. His June 1996 separation report of medical history indicates the Veteran reported “eye trouble” and the comments sections states, “Corneal abrasion, 1989, caused permanent loss of vision, wears glasses to correct.” The Veteran was awarded service connection for his right eye disability and assigned a 10 percent disability rating. See August 2008 Rating Decision. A November 2003 VA treatment record indicates a probable diagnosis of glaucoma. A January 2005 VA treatment record indicates he was diagnosed with bilateral primary open-angle glaucoma. In November 2007, VA treatment records indicate he underwent Selective Laser Trabeculoplasty for his bilateral glaucoma. In June 2008, a VA medical opinion was entered into the claims file. The opinion stated the Veteran’s glaucoma was unrelated to his in-service “tree limb injury” since the glaucoma is bilateral, and the tree limb only affected his right eye. Attached to his April 2010 Form-9 was a statement alleging the previously mentioned June 1992 STR indicates a diagnosis of glaucoma in his left eye. Attached to his January 2012 Form-9 was a statement, alleging the previously mentioned October 1978 STR reflects in-service treatment for his left eye and the June 1992 STR once again reflects his in-service left eye issues. In April 2012, a VA addendum opinion was entered into the claims file. The addendum opinion determined his glaucoma and cataracts are “not related to his service-connected recurrent corneal erosions secondary to trauma sustained in service.” The opinion also cited to the length of time between diagnoses and his separation from service. In April 2017, the Board remanded the Veteran’s claim for further development to acquire an opinion that considered the Veteran’s 1978 in-service eye injury. In January 2019 a VA addendum opinion was entered into the claims file; however, the opinion did not consider the Veteran’s 1978 in-service eye injury. In March 2019, the Veteran submitted a statement to the Board detailing his alleged in-service injuries; specifically: (1) a car accident in October 1974; (2) an elbow to his eye causing a corneal abrasion in October 1978; (3) blunt trauma to the head from a football injury in October 1981. In September 2019 the Board once again remanded the Veteran’s claim for a new VA addendum opinion. In November 2019, a VA addendum opinion was entered into the claims file, which included a review of the September 2019 Board decision, the Veteran’s claims file, and the October 1978 STR. The opinion determined his glaucoma and cataracts are less likely than not incurred in or caused by the Veteran’s in-service left eye injuries. Specifically, that glaucoma and cataracts are age related disabilities and are “unrelated to any trauma” during service. Moreover, that the evidence does not “show any damage to the angle structures that would indicate the glaucoma is traumatic in origin.” As to aggravation, the opinion determined they were less likely than not proximately due to or aggravated by his service-connected right eye injury. Specifically, that glaucoma and cataracts were diagnosed many years after his right eye and that “Epithelial defects cannot cause cataracts or glaucoma.” After a review of the claims file in conjunction with the applicable laws and regulations, the Board finds the preponderance of the evidence is against finding the Veteran’s left eye glaucoma and cataracts are related to active duty service or to a service-connected disability. The Board recognizes that the Veteran currently is diagnosed with glaucoma and cataracts. Thus, the first element of service connection is established. See Shedden, 381 F.3d at 1167. However, the evidence of record does not support the second and third required elements; specifically, an in-service event or injury and a medical nexus between his current disabilities and his active duty service. Here, the Board acknowledges his in-service left eye injury and that he believes it caused his current left eye disabilities; however, the evidence of record and the June 2008, April 2012, and November 2019 VA medical opinions all determined his glaucoma and cataracts are not the result of any in-service injury. The November 2019 addendum opinion explicitly stated that the evidence did not “show any damage to the angle structures that would indicate the glaucoma is traumatic in origin;” indicating, his glaucoma and cataracts were not due to any trauma caused by his in-service injury. Moreover, the Board acknowledges his claim that the June 1992 STR reflects treatment for glaucoma; however, the record makes no mention of glaucoma and the evidence of record does not contain any indication he was diagnosed with glaucoma in 1992. Indeed, he was not diagnosed with cataracts until 2002 and with glaucoma until 2004; 6 and 8 years after active duty service. Furthermore, the evidence of record is devoid of any competent or credible medical evidence indicating his left eye disabilities are the result of active duty service. As to secondary service connection, the Veteran is service connected for a right eye epithelial defect and thus fulfills the first element of secondary service connection. See 38 C.F.R. § 3.310. However, the evidence of record does not support the finding that his left eye disabilities were aggravated by, proximately due to, or the result of his service-connected right eye disability. Here, the Board acknowledges the Veteran’s claim’s that his service-connected right eye injury caused or aggravated his left eye glaucoma and cataracts. However, the November 2019 VA medical opinion explicitly determined, “Epithelial defects cannot cause cataracts or glaucoma.” Moreover, the evidence of record is devoid of any competent or credible medical opinion indicating his right eye epithelial defect caused or aggravated his left eye glaucoma and cataracts. Indeed, the only evidence indicating his left eye glaucoma and cataracts are related to active duty service or to a service-connected disability are his own lay statements. Lay evidence may be competent to establish medical etiology or nexus (Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009)), but VA can give lay evidence whatever weight to which it concludes the evidence is entitled. Waters v. Shinseki, 601 F.3d 1274, 1278 (Fed. Cir. 2010). In this case, although he may believe his left eye disabilities are related to active duty service or to a service-connected disability, he is not competent to make such determinations, which are medical in nature. See Jandreau, 492 F.3d at 1372. Such opinions require specialized training and knowledge and are matters which are not capable of lay observation. As such, the Board finds his contentions are of little probative value. In conclusion, the preponderance of the evidence is against finding the Veteran’s left eye glaucoma and cataracts are related to active duty service or to a service-connected disability. Hence the benefit of the doubt rule does not apply. Gilbert, 1 Vet. App. 49; 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7. Accordingly, the Veteran's claim of entitlement to service connection for left eye glaucoma and cataracts, to include as secondary to a service-connected epithelial defect, is denied. [SIGNATURE ON NEXT PAGE] JONATHAN B. KRAMER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Law Clerk, Tyler R. Masters 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.