Citation Nr: 21020733 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 18-11 250 DATE: April 8, 2021 ORDER New and material evidence having been received, readjudication of the claim for service connection for obstructive sleep apnea is warranted. Service connection for obstructive sleep apnea is denied. Service connection for type II diabetes mellitus (diabetes), claimed as a result of herbicide agent exposure, is denied. Service connection for peripheral neuropathy of the bilateral upper extremities, claimed as a result of herbicide agent exposure or as secondary to diabetes, is denied. Service connection for peripheral neuropathy of the bilateral lower extremities, claimed as a result of herbicide agent exposure or as secondary to diabetes, is denied. Service connection for congestive heart failure, claimed as a result of herbicide agent exposure or as secondary to diabetes, is denied. Service connection for hypertension, claimed as a result of herbicide agent exposure or as secondary to diabetes, is denied. Service connection for peripheral vascular disease of the bilateral upper extremities, claimed as a result of herbicide agent exposure or as secondary to diabetes, is denied. Service connection for peripheral vascular disease of the bilateral lower extremities, claimed as a result of herbicide agent exposure or as secondary to diabetes, is denied. Service connection for chronic obstructive pulmonary disease (COPD), claimed as a result of herbicide agent exposure, is denied. Service connection for renal failure, to include as secondary to diabetes, is denied. Service connection for diabetic retinopathy, to include as secondary to diabetes, is denied. Service connection for gastroesophageal reflux disease is denied. REMANDED Entitlement to service connection for bilateral glaucoma is remanded. Entitlement to service connection for erectile dysfunction is remanded. FINDINGS OF FACT 1. The Veteran initiated an appeal of the December 2014 rating decision but submitted an untimely substantive appeal (VA Form 9) to the September 2016 statement of the case (SOC); therefore, the December 2014 rating decision became final. 2. Evidence has been received after the December 2014 rating decision that is neither cumulative nor redundant of evidence already of record and raises a reasonable possibility of substantiating the claims for entitlement to service connection for obstructive sleep apnea. 3. The Veteran’s obstructive sleep apnea did not have its onset in service and the disability is not otherwise etiologically related to his service. 4. The evidence of record does not show that the Veteran served under conditions or circumstances that would have resulted in his exposure to herbicide agents; there is no evidence that the Veteran’s diabetes had its onset during service, within one year of the end of his service, or that it is caused by an in-service event, injury, or disease. 5. The evidence of record does not show that the Veteran served under conditions or circumstances that would have resulted in his exposure to herbicide agents; there is no evidence that the Veteran’s peripheral neuropathy of the bilateral upper extremities had its onset during service, within one year of the end of his service, or that it is caused by an in-service event, injury, or disease. 6. The evidence of record does not show that the Veteran served under conditions or circumstances that would have resulted in his exposure to herbicide agents; there is no evidence that the Veteran’s peripheral neuropathy of the bilateral lower extremities had its onset during service, within one year of the end of his service, or that it is caused by an in-service event, injury, or disease. 7. The evidence of record does not show that the Veteran served under conditions or circumstances that would have resulted in his exposure to herbicide agents; there is no evidence that the Veteran’s congestive heart failure. 8. There is no evidence that the Veteran’s hypertension had its onset during service, within one year of the end of his service, or that it was either caused by an in-service event, injury or disease 9. The evidence of record does not show that the Veteran served under conditions or circumstances that would have resulted in his exposure to herbicide agents; there is no evidence that the Veteran’s peripheral vascular disease of the bilateral upper extremities had its onset during service, within one year of the end of his service, or that it was either caused by an in-service event, injury or disease, or caused or aggravated by a service-connected condition. 10. The evidence of record does not show that the Veteran served under conditions or circumstances that would have resulted in his exposure to herbicide agents; there is no evidence that the Veteran’s peripheral vascular disease of the bilateral lower extremities had its onset during service, within one year of the end of his service, or that it was either caused by an in-service event, injury or disease, or caused or aggravated by a service-connected condition. 11. The evidence of record does not show that the Veteran served under conditions or circumstances that would have resulted in his exposure to herbicide agents; there is no evidence that the Veteran’s COPD had its onset during service or that it is caused by an in-service event, injury, or disease. 12. The evidence of record does not show that the Veteran served under conditions or circumstances that would have resulted in his exposure to herbicide agents; there is no evidence that the Veteran’s renal failure had its onset during service, within one year of the end of his service, or that it was either caused by an in-service event, injury or disease, or caused or aggravated by a service-connected condition. 13. The evidence of record does not show that the Veteran served under conditions or circumstances that would have resulted in his exposure to herbicide agents; there is no evidence that the Veteran’s diabetic retinopathy had its onset during service, within one year of the end of his service, or that it was either caused by an in-service event, injury or disease, or caused or aggravated by a service-connected condition. 14. The Veteran’s GERD did not have its onset in service and the disability is not otherwise etiologically related to his service. CONCLUSIONS OF LAW 1. The December 2014 rating decision which denied service connection for obstructive sleep apnea is final. 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. 2. Evidence received since the December 2014 rating decision is new and material and serves to reopen the Veteran’s claim for service connection for obstructive sleep apnea. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 3. The criteria for service connection for obstructive sleep apnea have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for entitlement to service connection for diabetes have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309. 5. The criteria for service connection for bilateral peripheral neuropathy of the upper extremities have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 6. The criteria for service connection for bilateral peripheral neuropathy of the lower extremities have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 7. The criteria for service connection for congestive heart failure have not been met. 38 U.S.C. §§ 1110, 1112, 1116, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 8. The criteria for service connection for hypertension have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 9. The criteria for service connection for peripheral vascular disease of the bilateral upper extremities have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 10. The criteria for service connection for peripheral vascular disease of the bilateral lower extremities have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 11. The criteria for service connection for COPD have not been met. 38 U.S.C. §§ 1110, 1112, 1116, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309. 12. The criteria for service connection for renal failure have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 13. The criteria for service connection for diabetic retinopathy have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. § 3.102, 3.303, 3.307, 3.309, 3.310. 14. The criteria for service connection for gastroesophageal reflux disease have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1966 to June 1968. In December 2020, a videoconference hearing was held before the undersigned Veterans’ Law Judge. A transcript is of record. The Board notes that the Veteran has a separate appeal regarding service connection for generalized anxiety disorder and depression. This appeal is pending under the Appeals Modernization Act (AMA) review system and will therefore be addressed in a separate Board decision. As described further below, the Veteran’s claims for most of his conditions stem from a common group of facts and common theories. Consequently, the analysis is structured by theory rather than by each individual disability. New and Material Evidence New evidence means existing evidence not previously submitted to agency decision makers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156. To reopen a previously disallowed claim, new and material evidence must be presented or secured since the last final disallowance of the claim on any basis, including on the basis that there was no new and material evidence to reopen the claim since a prior final disallowance. Evans v. Brown, 9 Vet. App. 273, 285 (1996). For purposes of reopening a claim, the credibility of newly submitted evidence is generally presumed. Justus v. Principi, 3 Vet. App. 510, 513 (1992). The threshold for determining whether new and material evidence raises a reasonable possibility of substantiating a claim is low. Shade v. Shinseki, 24 Vet. App. 110, 117 (2010). In determining whether this low threshold is met, VA should not limit its consideration to whether the newly submitted evidence relates specifically to the reason why the claim was last denied, but instead should ask whether the evidence could reasonably substantiate the claim were the claim to be reopened, to include by triggering the Secretary’s duty to assist or consideration of a new theory of entitlement. Id. at 117-18. The Veteran’s claim for service connection for obstructive sleep apnea was initially denied in a December 2014 rating decision on the basis that the Veteran did not have a diagnosis of sleep apnea. The Veteran initiated an appeal of this decision; however, he did not file a timely substantive appeal to the September 2016 SOC that was subsequently issued. See December 2016 VA Form 9. In December 2016, the Veteran was advised that VA could not accept the December 2016 formal appeal as timely. Therefore, the December 2014 rating decision is final. See 38 U.S.C. § 7105(c); 38 C.F.R. §§ 3.156(b), 20.1103. Since the December 2014 rating decision, the Veteran has provided treatment records, which include a diagnosis of sleep apnea, and testimony at a December 2020 Board hearing. The Board finds that this evidence was not of record at the time of the prior rating decision, relates to an unestablished fact necessary to substantiate the underlying claim, and raises a reasonable possibility of substantiating the Veteran’s claim. Accordingly, new and material evidence has been received and the claim for service connection for obstructive sleep apnea is reopened. Service Connection Service connection may be established for a disease or injury incurred in or aggravated during service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To prevail on the issue of service connection, there must be (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Hickson v. West, 12 Vet. App. 247 (1999). Certain chronic diseases, which are listed in 38 C.F.R. § 3.309(a) may be presumed to have been incurred during service if manifested to a compensable degree within one year of separation from active service. 38 U.S.C. §§ 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. With chronic disease shown as such in service (or within the presumptive period under § 3.307) so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service-connected, unless clearly attributable to intercurrent causes. 38 C.F.R. § 3.303(b). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time. Id. However, if chronicity in service is not established or where the diagnosis of chronicity may be legitimately questioned, a showing of continuity of symptoms after discharge is required to support the claim. 38 C.F.R. § 3.303(b). A claimant “can benefit from continuity of symptomatology to establish service connection in the ultimate sense, but only if [the] chronic disease is one listed in § 3.309(a).” Walker, 708 F.3d at 1337. Service connection may nonetheless be granted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). The law provides that, if a veteran was exposed to certain herbicide agents during service, certain listed diseases shall be service-connected if the requirements of 38 U.S.C. § 1116; 38 C.F.R. § 3.307(a)(6)(iii) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 U.S.C. § 1113; 38 C.F.R. § 3.307(d) are also satisfied. A veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the Vietnam era, shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. The last date on which such a veteran shall be presumed to have been exposed to an herbicide agent shall be the last date on which he served in the Republic of Vietnam during the Vietnam era. VA regulations presume that veterans who served in the Republic of Vietnam between January 9, 1962, and May 7, 1975, were exposed to those herbicide agents. 38 C.F.R. § 3.307(a)(6)(iii). Pursuant to VA regulations, if a veteran served in a unit that, as determined by the Department of Defense (DoD), operated in or near the Korean demilitarized zone (DMZ) in an area in which herbicide agents are known to have been applied between April 1, 1968 and August 31, 1971, the presumption will apply and exposure to an herbicide agent will be conceded. 38 C.F.R. § 3.307(a)(6)(iv). The Veteran has also claimed several conditions as secondary to his diabetes or COPD. Secondary service connection is warranted where a disability is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). Briefly, the threshold legal requirements for a successful secondary service connection claim are: (1) Evidence of a current disability for which secondary service connection is sought; (2) a disability for which service connection has been established; and (3) competent evidence of a nexus between the two. After considering all information including the lay and medical evidence of record in a case with respect to benefits under laws administered by the Secretary, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt will be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 1. Claims Based on Exposure to Certain Herbicide Agents The Veteran seeks service connection for diabetes, peripheral neuropathy of the bilateral upper and lower extremities, congestive heart failure, hypertension, peripheral vascular disease of the bilateral upper and lower extremities, and COPD as a result of claimed exposure to herbicide agents while serving in Vietnam and near the Korean DMZ. However, the evidence of record fails to demonstrate that the Veteran was exposed to herbicide agents during his military service. The Veteran’s service personnel records show that he served in the Republic of Korea from November 1966 to December 1967 and the United States from January 1968 to June 1968. The personnel records demonstrate that the Veteran was sent on a temporary duty assignment (TDY) in Korea from May 1967 to June 1967 to attend the Advanced Combat Training Academy. In an August 2013 correspondence, the Veteran reported that he was in Vietnam from November 1966 to February 1967 and was assigned to the 4th Division Artillery. He reported that he was then transferred to Korea. The Veteran stated that he was exposed to herbicide agents in both Vietnam and Korea. In October 2013, the National Personnel Records Center (NPRC) conducted a search for records demonstrating the Veteran’s service in the Republic of Vietnam and in November 2013 issued a statement finding that there was no evidence in the Veteran’s file to substantiate any service in the Republic of Vietnam. In December 2017, a memorandum from the Joint Services Research Record Center (JSRRC) through the Defense Personnel Records Information Retrieval System (DPRIS) showed that research of the 1966 and 1967 unit histories submitted by the 6th Battalion, 37th Artillery document that the unit was located in Korea, but no elements of the unit were sent to Vietnam at any time during those two years. In January 2018, VA issued a formal finding of insufficient evidence to verify exposure to herbicide agents during service. The report stated that review of the Veteran’s personnel records indicated that the Veteran did not serve in the Republic of Vietnam and that the Veteran did not serve in the Republic of Korea at a time when herbicide agents were used. During the December 2020 Board hearing, the Veteran reported that he was sent to Vietnam from approximately October 1966 to January 1967 on a temporary duty assignment. The Veteran reported that he underwent an Agent Orange registry examination and contended that this should demonstrate that he was exposed to herbicide agents during military service. The Veteran further reported that he was stationed near the Korean DMZ. The Board acknowledges the Veteran’s contention that his participation in a VA Agent Orange Registry indicates that he was exposed to herbicide agents during military service. However, it is important to note that Agent Orange Registry examinations are provided “[b]ased on Veterans’ recollection of service, not on their military records,” and “[w]ill not confirm exposure to Agent Orange.” See https://www.publichealth.va.gov/exposures/agentorange/benefits/registry-exam.asp. Therefore, participation in this examination alone does not establish that the Veteran was exposed to an herbicide agent, including Agent Orange, in service. The Board further notes that there is no Agent Orange registry in the Veteran’s claims folder. As for the Veteran’s report that he was sent to the Republic of Vietnam prior to being stationed in the Republic of Korea, as outlined above, this is not supported by his service records. Although the Veteran previously reported being in Vietnam from November 1966 to February 1967, service personnel records show he was stationed in Korea during that period. Moreover, the history for his unit was obtained and it does not show that any individuals were sent to Vietnam during the Veteran’s period of service with his unit. Finally, the Veteran also reported he was sent to Vietnam in approximately October 1966; however, service personnel records show he was not in the USARPAC (United States Army Pacific) area until November 1966, when he arrived in and was stationed in Korea. For these reasons, exposure to herbicide agents as a result of service in the Republic of Vietnam is not established. As for the Veteran’s service in Korea, while this is not in dispute, it is not shown that he served at a time when the use of herbicide agents in Korea is presumed (April 1, 1968 to August 31, 1971). The Veteran’s personnel records show he served in Korea until December 1967. Moreover, the Veteran has not contended nor has he provided any evidence to show that he came into personal contact with Agent Orange while serving in Korea. As such, exposure to herbicide agents as a result of the Veteran’s service in Korea cannot be presumed or directly established. Furthermore, even if the Veteran had been exposed to herbicide agents during military service, congestive heart failure, hypertension, peripheral vascular disease, and COPD are not presumptive conditions associated with such exposure. See 38 C.F.R. § 3.309(e). Accordingly, the Board finds that the Veteran’s service records and the information from the JSRRC and the NPRC to be more probative and persuasive of the circumstances of the Veteran’s active service, as they are from official sources. Bardwell v. Shinseki, 24 Vet. App. 36 (2010). Therefore, the Board finds that service connection for diabetes and peripheral neuropathy of the bilateral upper and lower extremities cannot be established via exposure to herbicide agents because the evidence of record does not establish either actual or presumed exposure, and congestive heart failure, hypertension, peripheral vascular disease, and COPD are not presumptive conditions associated with exposure to herbicide agents. 2. Claims Subject to the Presumption for Chronic Diseases The Veteran seeks service connection for diabetes, peripheral neuropathy of the bilateral upper and lower extremities, congestive heart failure, hypertension, and peripheral vascular disease of the bilateral upper and lower extremities. These conditions are subject to compensation under the presumption for chronic diseases in the event that they manifested either during service or to a compensable degree within one year of service. 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307(a), 3.309(a). Here, there is no evidence that the Veteran’s claimed conditions either manifested in-service or to a compensable degree within a year after his service ended. His service treatment records (STRs) do not contain complaints, treatment, or diagnoses for any of these conditions. The first of these conditions to manifest and to be diagnosed was hypertension during the 1980’s, as an August 2006 VA treatment record documents that the Veteran had an approximate 20 year medical history of hypertension. The fact that many decades passed before any of these conditions manifested also prevents a finding of service-connection due to continuity of symptomatology. 38 C.F.R. § 3.303(b). Notably, the Veteran does not claim that any of these conditions either began in-service or within a year after his service ended. Consequently, the presumption for chronic diseases cannot be used to establish service connection for these conditions. 3. Claims Subject to Secondary Service Connection The Veteran seeks service connection for peripheral neuropathy of the bilateral upper and lower extremities, congestive heart failure, hypertension, peripheral vascular disease of the bilateral upper and lower extremities, renal failure, and diabetic retinopathy, each secondary to diabetes. The Veteran further contends that his obstructive sleep apnea is caused by COPD. However, because the Veteran is not service-connected for diabetes or COPD, service connection for the claimed conditions cannot be established secondary to diabetes. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). 4. Direct Service Connection The evidence of record does not support a conclusion that any of the Veteran’s claimed conditions were caused by an in-service event, injury, or disease. In this regard, the Board notes that the Veteran’s STRs are silent for complaints of or treatment for diabetes, peripheral neuropathy of the bilateral upper and lower extremities, congestive heart failure, hypertension, peripheral vascular disease of the bilateral upper and lower extremities, COPD, renal failure, diabetic retinopathy, obstructive sleep apnea, and GERD. On entrance examination in April 1966, the Veteran’s blood pressure was 120/68. The Veteran sought treatment in May 1968 for stomach pain. The Veteran reported on his June 1968 separation report of medical history that he did not experience shortness of breath, asthma, pain or pressure in the chest, heart problems, high or low blood pressure, frequent trouble sleeping, frequent indigestion, or stomach problems. The Veteran’s blood pressure was noted to be 122/70 on separation. The Veteran’s private treatment records show that he was diagnosed with hypertension during the 1980’s. The Veteran was diagnosed with congestive heart failure and underwent an angioplasty in 2002. He was treated for COPD, then diagnosed as shortness of breath, from approximately June 2011. In a February 2013 physician’s statement, the Veteran’s VA physician noted that the Veteran was diagnosed with in approximately 2003. In a corresponding disability benefits questionnaire (DBQ), the VA physician reported that the Veteran was diagnosed with coronary artery disease, congestive heart failure, and hypertension. The Veteran’s private treatment records was treated for GERD from approximately November 2014. He underwent a right upper arm arterio-venous graft in December 2014 and a right basilic vein transposition in February 2015. The Veteran was diagnosed with obstructive sleep apnea in February 2019. In the February 2020 VA Form 9, the Veteran contended that his GERD problems began during service due to having to eat quickly and because of poor water quality. During the December 2020 Board hearing, the Veteran reported that he was diagnosed with GERD in 2006. The Veteran reported that he was unable to remember when he was diagnosed with COPD, but that he had been diagnosed with it once he started to get older. The Veteran contended that the military medical personnel in the field during his military service were not able to diagnose all the conditions he experienced during service. The Veteran reported that he was told that he had high blood pressure during military service, but he was not treated for it until after service. Notably, however, the Veteran’s STRs show that his blood pressure remained consistent from 120/68 on entrance examination in April 1966 to 122/70 on separation examination in June 1968. The Veteran reported in June 1968 that he did not experience high or low blood pressure, and the Veteran was noted to have a normal vascular system on separation examination. There is no indication that the Veteran was diagnosed with hypertension during military service. The Board acknowledges the Veteran’s contentions relating his current health conditions with his active military service. However, these statements are not competent evidence, as he is a layperson, and lacks the training to opine regarding medical causation in this matter. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The Board further acknowledges that the Veteran has not been scheduled for a VA examination to determine whether the Veteran’s conditions were caused by or incurred during active military service. However, there is no competent medical evidence of record showing that his current conditions, to include diabetes, peripheral neuropathy of the bilateral upper and lower extremities, congestive heart failure, hypertension, peripheral vascular disease of the bilateral upper and lower extremities, COPD, renal failure, diabetic retinopathy, obstructive sleep apnea, and GERD are related to military service. As noted above, the Veteran was not diagnosed with any of these conditions until several decades after military service. The Veteran specifically reported that he did not experience shortness of breath, asthma, pain or pressure in the chest, heart problems, high or low blood pressure, frequent trouble sleeping, frequent indigestion, or stomach problems on his June 1968 separation report of medical history. At the December 2020 Board hearing, the Veteran generally contended that his claims for service connection were based on the fact that he did not have these disabilities prior to service. However, as was also explained to the Veteran at the hearing, it is not enough to generally assert that a disability is related to service because it did not exist prior to military service. Instead, there must be a causal connection between the claimed disability and military service. As there is nothing in the record to indicate that there may be an association between the claimed disabilities and the Veteran’s military service, a VA examination is neither necessary nor warranted. Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010) (rejecting the theory that medical examinations are to be routinely and virtually automatically provided to all veterans in disability cases involving nexus issues). As previously described, none of the Veteran’s conditions manifested during his active service, and none of the medical evidence of record suggests a connection between the Veteran’s service and any in-service event, injury, or disease. The Veteran’s statements relating his current conditions to active military service are not competent evidence. Consequently, the Board finds that service connection cannot be established for any of the conditions on a direct basis. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. REASONS FOR REMAND Entitlement to service connection for bilateral glaucoma. The Veteran seeks service connection for bilateral glaucoma, which he contends was caused by his military service. See December 2020 hearing transcript. The Veteran’s STRs indicate that the Veteran sought treatment for a nonpainful lesion under his left eyelid in March 1967 and August 1967. The Veteran was diagnosed with anisicoria, an eye condition where pupils are of different sizes, in September 1967. Accordingly, the Board finds that remand for a VA examination to determine the nature and etiology of the Veteran’s current bilateral glaucoma is warranted. Entitlement to service connection for erectile dysfunction. The Veteran seeks service connection for erectile dysfunction, which he contends was caused by his military service. See December 2020 hearing transcript. During the December 2020 hearing, the Veteran reported that he sought private treatment for erectile dysfunction in approximately 1968 or 1969. Accordingly, the Board finds that remand for those records is warranted prior to adjudication. The matters are REMANDED for the following action: 1. Write to the Veteran and request that he identify and authorize VA to obtain any private or non-VA records of treatment for erectile dysfunction, specifically to include any private treatment from 1968 or 1969, as reported during the December 2020 hearing. 2. Obtain a medical opinion by an appropriate clinician to determine the nature and etiology of the Veteran’s bilateral glaucoma. After reviewing the claims file, the examiner must opine as to whether the Veteran’s bilateral glaucoma is at least as likely as not related to an in-service injury, event, or disease, including the documented in-service lesion under the left eyelid and diagnosed anisicoria. If a physical examination is deemed necessary to provide the requested opinion, then such should be scheduled. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Griffin, 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.