Citation Nr: 21015901 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 16-13 798 DATE: March 18, 2021 ORDER Entitlement to service connection for an eye disorder, to include cataracts, dry eye syndrome, vitreous opacities, and squamous blepharitis is denied. FINDINGS OF FACT 1. During service refractive error was identified. 2. An acquired eye disorder, to include cataracts, dry eye syndrome, vitreous opacities, and squamous blepharitis, was not manifest during service. CONCLUSIONS OF LAW 1. Refractive error is not a disease or injury within the meaning of the law providing compensation benefits. 38 C.F.R. § 3.303. 2. An acquired eye disorder, to include cataracts, dry eye syndrome, vitreous opacities, and squamous blepharitis, was not incurred in or aggravated by service and an eye disorder may not be presumed to have been incurred therein. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1975 to September 1979. This issue was previously remanded by the Board in March 2020 for procedural and evidentiary development. 1. Entitlement to service connection for an eye disorder, to include cataracts, dry eye syndrome, vitreous opacities, and squamous blepharitis Veterans are entitled to compensation if they develop a disability “resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty.” 38 U.S.C. §§ 1110 (wartime service), 1131 (peacetime service). To establish entitlement to service-connected compensation benefits, a Veteran must show: “(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 -the so-called ‘nexus’ requirement.” See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). 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. See Baldwin v. West, 13 Vet. App. 1, 8 (1999). The Veteran has not been diagnosed with an eye disorder that is also a “chronic disease” as identified under 38 U.S.C. § 1101 and 38 C.F.R. § 3.309(a). The Veteran asserts that his eye disorders are related to service. The Veteran particularly cites exposure to gasoline in his eyes. The Veteran also states that he removed asbestos on the flight deck and engine rooms without any mask protection. In October 1975, there was an assessment of refractive error, which found cupping. The examiner noted that there was slight discrepancy in the C/D ratio, but it did not appear significant. A November 1976 service treatment record mentions that the Veteran’s right eye was swollen and later treated. The remaining service treatment records do not document any relevant symptoms, complaints, treatment, or diagnoses. The Veteran’s separation examination in September 1979, there was no mention of an eye disorder or trouble in a Report of Medical History. Visual acuity was 20/50 and 20/30, with a normal field of vision. The Veteran was afforded an examination in June 2020 with regards to his eye disorders. A VA examiner found eye disorders and analyzed each individually. The VA examiner noted that the Veteran stated that he “was on the fire team and got a lot of smoke, jet fuel and gas in his eyes while in the Navy.” The VA examiner found that the Veteran has mild nuclear age-related cataracts in both eyes. However, the VA examiner stated that “There were no evidence of cataracts in the veteran’s medical record during service. There were also no injuries documented in the veteran’s file that would cause this type of cataract. Cataracts are a normal age-related change in most cases, and it is more likely they were age related cataracts, given the veterans current age of 65 which is typical of having cataracts by that time regardless of military service or not.” The VA examiner concluded that the Veteran’s cataracts were most likely due to age than to his service in the military. The VA examiner also found that the Veteran has dry eye syndrome. The VA examiner, specifically to this issue, wrote: “There [is] no evidence of any cornea scars or damage to the eye from asbestos fibers or jet fuel. There [is] also no evidence in the medical record that supports that the veteran had dry eye syndrome during service. Based on the review of the medical records and the physical examination of the veteran, it is my opinion that the veteran’s dry eye syndrome was less likely than not due to his service in the military.”   The VA examiner found that the Veteran has virtuous opacities in both eyes. The examiner wrote “There was no documentation in the veteran’s medical record of this condition. This is a condition where age-related changes that occur in the vitreous inside your eye becomes more liquid and fibers clump together and cast shadows on the retina. Based on review of the medical records and the physical examination of the veteran, I find it less likely than not that the vitreous opacities incurred or caused by the veteran’s military service.” Finally, the VA examiner discussed the Veteran’s squamous blepharitis. The examiner wrote “On examination, I found the veteran to have squamous blepharitis (upper and lower eyelids) in both eyes…There was no evidence of any cornea scars or damage to the eye from asbestos fibers or jet fuel. There [is] also no evidence in the medical record that supports that the veteran had blepharitis during service. Based on the review of the medical records and the physical examination of the veteran, it is my opinion that the veteran’s squamous blepharitis was less likely than not due to his service in the military.” In adjudicating a claim, the Board is charged with the duty to assess the credibility and weight given to evidence. See Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997). Competency of evidence differs from weight and credibility. The former is a legal concept determining whether testimony may be heard and considered by the trier of fact, while the latter 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). The probative value of a medical opinion primarily comes from its reasoning; threshold considerations are whether a person opining is suitably qualified and sufficiently informed. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). In this case, the Board accepts the June 2020 VA medical opinions that the Veteran eye disorders are less likely than not are less likely than not related to service as highly probative medical evidence on this point. The Board notes that the examiner rendered these opinions after thoroughly reviewing the claims file and relevant medical records. The examiner noted the Veteran’s pertinent history and provided a reasoned analysis of the case. See Hernandez-Toyens v. West, 11 Vet. App. 379, 383 (1998); Gabrielson v. Brown, 7 Vet. App. 36, 40 (1994). The Board finds these medical opinions to be highly probative as they are adequately supported by additional rationale, including reasoned explanations of why the eye disorders are not linked to service. The Board specifically cites that the examiner discussed the Veteran’s claims of exposure to asbestos and jet fuel when necessary. The Board has considered the lay statements of the Veteran regarding his eye disorders. The Veteran is competent to provide evidence of what he experiences, including his symptomatology and medical history. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). The Veteran is competent to report what he experienced. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). However, the Board does not find his statements to be as probative as the VA examiner’s opinion, which was based on extensive review of the record, thorough examination, consideration of the lay statements, and the VA examiner’s medical expertise. Notably, the Veteran has not indicated that a medical professional provided him with a diagnosis of an eye disorder during active service, or within a year of separation. In sum, there is insufficient competent and probative evidence linking the post service pathology to service. The service treatment records do not document any relevant notations in regard to the post service diagnoses. The more probative evidence establishes that the Veteran did not have an acquired eye disorder during service, and that any of the eye disorders are not related to any event in service. The evidence establishes that the remote onset of the eye disorders is unrelated to service. To the extent that he had swelling of an eye during service, the record establishes that such was acute and that there are no residuals.   The record does establish that refractive error was noted during service. However, refractive error is not considered a disease or injury and may not service as the basis for an award of compensation. We also note that there was an assessment of a discrepancy in the C/D ratio during service. However, it was not considered to be significant and there is no evidence relating post service pathology to the in-service finding. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Jonah Nelson, 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.