Citation Nr: 21012519 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 17-32 956 DATE: March 4, 2021 ORDER Entitlement to service connection for glaucoma (claimed as reduced eyesight) is denied. FINDING OF FACT The Veteran’s glaucoma is not shown to be causally related to an in-service injury or disease, or to have manifested to a compensable degree within one year of separation. CONCLUSION OF LAW The criteria for service connection for glaucoma have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from June 1976 to September 1976. The Veteran also served as a member of the National Guard. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a December 2016 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In January 2020 the Veteran testified before the undersigned Veterans Law Judge at a videoconference hearing. A transcript of the hearing is of record. The Board remanded the issue on appeal for additional development in March 2020. 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). Duties to Notify and Assist The Veteran has not provided any reason or explanation for not responding to the RO’s March 2020 attempt to get the Veteran’s authorization to obtain private and VA treatment records pursuant to the Board’s prior remand. Because the Veteran failed to respond, the Board will adjudicate the claim from the evidence of record. 38 C.F.R. § 3.655(b). It is noted that the duty to assist "is not always a one-way street. If a Veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence." Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). Therefore, the Board finds that VA has satisfied its duty to assist. See 38 U.S.C. §§ 5100, 5102, 5103, 5103A; 38 C.F.R. § 3.159. Neither the Veteran nor his representative have advanced any procedural arguments in relation to VA's duty to notify and assist; therefore, the Board will proceed with appellate review. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015). Service Connection 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). 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). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the claimant prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the claimant. Gilbert, 1 Vet. App. at 53. VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154(a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Lay evidence cannot be determined to be not credible merely because it is unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 133637 (Fed. Cir. 2006). Entitlement to service connection for glaucoma is denied. The Veteran contends that his currently-diagnosed glaucoma is directly related to his military service. However, the preponderance of the evidence is against a finding of a nexus between the Veteran’s current disability and his active service. VA treatment records as recent as February 2020 reflect the Veteran’s diagnosis of glaucoma, so the current disability element of service connection is met. Concerning an in-service injury or disease, the Veteran has stated that he began having eye problems in service. Service treatment records (STRs) show that the Veteran’s eyes were normal at his May 1976 entrance examination and during a May 1980 periodic Reserve examination. Thus, a comparison of the enlistment and separation eye examination shows no objective reduction in visual acuity. However, during his two-week ACDUTRA reserve training in June 13 to 22, 1981, the Veteran was seen for increased ocular pressure. A June 17, 1981 STR noted that the Veteran’s ocular pressure has been up before but was never high enough to place the Veteran on eye drops, until two weeks ago. It was also noted that the Veteran needed to get his eye pressure checked out. A June 18, 1981 STR noted that the Veteran was having problems with glaucoma and feeling pressure. STRs also show that the Veteran had an ocular pressure of 36 and reduced visual acuity. Also on June 18, 1981, the Veteran completed VA Form 10-10 Application for Medical Benefits, seeking reimbursement for his treatment related expenses. On the form, in response to question 20A which asks whether injury was caused in military service, the Veteran checked “no.” In his January 2017 Notice of Disagreement, and June 2017 VA Form 9, the Veteran stated that when he was in “summer camp” at Camp Gruber in 1980, he had a glaucoma attack. He stated that he was transported to the VA hospital in Muskogee. The earliest available VA treatment records are from 2017 and generally reflect ongoing treatment for glaucoma from then to present. At his January 2020 Board hearing, the Veteran testified that he first had serious problems with his eyes “in summer camp” when he was taken to a VA hospital in Muskogee. He eventually had surgery. He saw a specialist at the Eye Institute, which was contracted by VA. The Veteran stated that he has glaucoma in both of his eyes, but he lost eyesight in his left eye during summer camp. The Veteran testified that summer camp was considered a period of active duty. There are no private treatment records. As discussed above, in March 2020 the RO attempted to get authorization from the Veteran to obtain VA and private treatment records from the 1980’s per the Veteran’s testimony that he sought VA and private treatment for his eyes during this timeframe. However, the Veteran did not respond. After reviewing the Veteran's claims folder, the Board finds that the preponderance of the evidence is against finding that the Veteran’s glaucoma was incurred in or caused by his active service. While the Veteran's STRs contain treatment for problems with glaucoma and reduced eye pressure during a June 13 to June 22, 1981 period of ACDUTRA, the Veteran indicated on a June 18, 1981 reimbursement form that his injury was not caused by his military service. The evidentiary record does not contain any medical evidence showing the Veteran manifested any eye disability within his first post-service year. In fact, post-active duty service treatment records do not show any treatment for eye symptoms until more than four years after active duty, while on a period of ACDUTRA for an isolated period of time. There are no additional records of complaints or treatment for the eyes until October 2017, at which time he was diagnosed with glaucoma, more than 30 years after the Veteran's discharge from active service. The Board acknowledges that no VA examinations or medical opinions have been obtained as to the Veteran's eye disability. However, given the isolated treatment for any eye related disability occurring only on June 17 and June 18, 1981, and the latency of a glaucoma diagnosis decades post any period of service, the low threshold for obtaining a VA examination and medical opinion have not been met in this case. See 38 U.S.C. § 5103A (d) (2012); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). While the Veteran has testified that his eye injury first took place during a summer camp in 1980, the Veteran has not provided any statements or evidence that link his currently-diagnosed glaucoma to that injury, nor any other in-service injury or event. Notably, mere conclusory or generalized lay statements that a service event or illness caused a current disability are insufficient to require a VA examination. Waters v. Shinseki, 601 F.3d 1274, 1278 (2010). Although the Veteran sincerely believes that his glaucoma is related to his service, he is a layperson and lacks the training/expertise to opine competently on medical questions such as the one presented in this case. Lay statements are not competent evidence regarding diagnosis or etiology, as to do so requires medical knowledge and training outside the realm of knowledge of a lay person. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007), Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Accordingly, the Board finds that a preponderance of the evidence weighs against the Veteran's claim for service connection for glaucoma. Because the evidence fails to establish a nexus between the Veteran’s current diagnosis of glaucoma and his in-service treatment for problems with glaucoma and reduced eye pressure, the claim does not satisfy the criteria for service connection. Therefore, the benefit-of-the-doubt rule does not apply, and the claim must be denied. 38 U.S.C. § 5107; 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 C. Gates 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.