Citation Nr: 21022169 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 13-35 185 DATE: April 14, 2021 ORDER Entitlement to service connection for arteriovenous malformation (AVM) with repair is denied. Entitlement to service connection for a bilateral eye disability is denied. Entitlement to service connection for a gastrointestinal disability (claimed as stomach problems) is denied. FINDINGS OF FACT 1. The preponderance of the evidence shows that AVM and a bilateral eye disability diagnosed as myopia are congenital disorders, neither were subject to a superimposed disease or injury that caused additional disability while on active duty, and a bilateral eye disability diagnosed as myopia was not caused or aggravated by an already service-connected disability. 2. The preponderance of the evidence shows that bilateral eye disabilities other than myopia and a gastrointestinal disability were not present during service or until many years thereafter and they are not caused or aggravated by a service-connected disability. CONCLUSION OF LAW The criteria for service connection for AVM with repair, a bilateral eye disability, and a gastrointestinal disability have not been met. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310, 4.9. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty with the United States Army from September 1979 to March 1985 with three years of earlier active duty service and four months of earlier inactive service. In June 2014, the Veteran testified at a hearing before a Veterans Law Judge (VLJ) and a copy of the transcript of the hearing is of record. Since that time, that VLJ has retired and in February 2021 the Veteran was notified of this fact and offered another hearing. In March 2021, the Veteran notified the Board of Veterans’ Appeal (Board) that she did not want another hearing. The undersigned has reviewed the prior hearing transcript. In June 2015 and October 2017, the Board remanded the claims of service connection for AVM, an eye disability, cephalgia, and a gastrointestinal disability. In November 2018 a VLJ other than the undersigned issued a decision that denied service connection for AVM, an eye disability, and cephalgia as well as Remanded the claim of service connection for a gastrointestinal disability. As to the claims of service connection for AVM, an eye disability, and cephalgia, the Veteran appealed the Board’s denial to the United States Court of Appeals for Veterans Claims (Court). In a March 2020 order, which incorporated the parties Joint Motion for Partial Remand (JMPR), the Court vacated and remanded the November 2018 Board decision that denied service connection for AVM, an eye disability, and cephalgia. In July 2020, the Board remanded the claims of service connection for AVM, an eye disability, and cephalgia to address the concerns raised by the JMPR. In September 2020, the Board remanded the claim of service connection for a gastrointestinal disability. As to the claim of service connection for cephalgia, while this issue was in remand status the regional office (RO) granted the claim. Therefore, the Board finds that this issue is no longer in appellate status. See Grantham v. Brown, 114 F.3d 1156, 1159 (Fed. Cir. 1997) (holding that the RO's award of service connection for a particular disability constitutes a full award of benefits on the appeal initiated by the veteran's notice of disagreement on such issue). The Board apologies for the delays in the full adjudication of this case. The Concerns Raised by the JMPR and the post-Remand Development As to the post-Remand development, the Board finds that it substantially complied with the Remands and the concerns raised by the JMPR. See 38 U.S.C. § 5103; Barr v. Nicholson, 21 Vet. App. 303 (2007); Stegall v. West, 11 Vet. App. 268 (1998); D’Aries v. Peake, 22 Vet. App. 97 (2008) (holding that only substantial, and not strict compliance with the terms of a remand request, is required); Dyment v. West, 13 Vet. App. 141, 146-47 (holding that there was no Stegall violation when the examiner made the ultimate determination required by the Board’s remand, because such determination more than substantially complied with the Board’s remand order). The Board has reached this conclusion because while the appeal was in remand status the RO obtained and associated with the record all available and identified VA and private treatment records to include the treatment notes from neurosurgeons Dr. Powell G. Neil and Dr. Charles L. Wolf, the May 2015 magnetic resonance imaging evaluation (MRI), and the Veteran contemporaneous VA treatment records. In this regard, while the Remand directed the RO to obtain Dr. Garrett Powell’s January 2012 treatment notes, these records are not found in the claims file. Nonetheless, the Board finds that adjudication of the appeal can go forward without these records because the Veteran did not provide the RO with an authorization to request these records and/or provide them herself despite being asked to do so by the RO in a July 2020 letter. See Wood v. Derwinski, 1 Vet. App. 190, 192 (1991) (holding 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.”). We cannot delay the adjudication of this case further. As to the claims of service connection for AVM and a bilateral eye disability, the Board notes that in accordance with the JMPR the Board remanded the appeal to obtain a medical opinion to reconcile the November 2017 VA medical opinion with VA’s definition of “disease” and “defect” provided in VAOPGCPREC 82-90 (July 18, 1990) (cited at 55 Fed. Reg. 45,711) (Oct. 30, 1990) (GC Opinion 82-90). Moreover, the Board finds that the subsequent medical opinion provided by the September 2020 VA examiner substantially complied with the Remand and the concerns raised by the JMPR because it provided a clear and certain opinion as to the whether the Veteran’s AVM is a congenital disorders as well as whether it is a “disease” or “defect” as defined by GC Opinion 82-90; provided opinions as to whether AVM was subject to a superimposed disease or injury as well as whether it was aggravated beyond its natural progression by her active military service; and provided opinions as to the etiology of the bilateral eye disability. The Board has also reached this conclusion because the September 2020 VA opinions are supported by a detailed citation to the Veteran’s medical records, the September 2011 opinion from Dr. Powell, the appellant’s competent and credible lay claims regarding observable symptomatology, and because they are supported by medical reasoning. See Guerrieri v. Brown, 4 Vet. App. 467, 473 (1993) (“the probative value of medical opinion evidence is based on the medical expert’s personal examination of the patient, the physician’s knowledge and skill in analyzing the data, and the medical conclusion the physician reaches.... As is true with any piece of evidence, the credibility and weight to be attached to these opinions [are] within the province of the [Board as] adjudicators...”); Wray v. Brown, 7 Vet. App. 488, 493 (1995) (holding that the adoption of an expert medical opinion may satisfy the Board’s statutory requirement of an adequate statement of reasons and bases if the expert fairly considered the material evidence seemingly supporting the veteran’s position). Similarly, as to the claim of service connection for a gastrointestinal disability, the Board finds that the post-Remand VA examination dated in November 2020 substantially complied with the Remand because it provided a clear opinion as to the origins of the Veteran’s gastrointestinal disability which opinion is supported by a detailed citation to the Veteran’s medical records, the appellant’s competent and credible lay claims regarding observable symptomatology, and because it is supported by medical reasoning. Id. The Service connection Claims The Veteran asserts, in substance, that service connection is warranted for AVM, a bilateral eye disability, and a gastrointestinal disability because they were caused and/or aggravated by service. As to the bilateral eye disability and the gastrointestinal disability, the Veteran also claims she is entitled to service connection because they are related to her AVM including its repair. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection if the disability is one that is listed in 38 C.F.R. § 3.309. 38 C.F.R. § 3.303(b); see also Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). In addition, service connection may also be granted on the basis of a post-service initial diagnosis of a disease, where the physician relates the current condition to the period of service. 38 C.F.R. § 3.303(d). Other specifically enumerated disorders will be presumed to have been incurred in service if they manifested to a compensable degree within the first year following separation from active duty. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. In this regard, in order to establish service connection for the claimed disorders, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999). For purposes of entitlement to VA benefits, the law provides that congenital or developmental defects like refractive error of the eyes are congenital or developmental defects and not a disease or injury within the meaning of applicable legislation. 38 C.F.R. §§ 3.303(c), 4.9. In the absence of superimposed disease or injury, service connection may not be allowed for congenital or developmental defects like refractive error of the eyes even if visual acuity decreased in service, as this is not a disease or injury within the meaning of applicable legislation relating to service connection. 38 C.F.R. §§ 3.303(c), 4.9. Therefore, VA regulations specifically prohibit service connection for congenital or developmental defects like refractive errors of the eyes unless such defect was subjected to a superimposed disease or injury which created additional disability. See VAOPGCPREC 82-90 (July 18, 1990) (cited at 55 Fed. Reg. 45,711) (Oct. 30, 1990) (service connection may not be granted for defects of congenital, developmental, or familial origin, unless the defect was subject to a superimposed disease or injury). Myopia and presbyopia are refractive disorders. See Dorland’s Illustrated Medical Dictionary (28th Ed. 1994) at 1094. Service connection may also be established on a secondary basis for a disability proximately due to or aggravated by a service-connected disease or injury. See 38 C.F.R. § 3.310; see also Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). To establish secondary service connection, a Veteran must show: (1) the existence of a present disability; (2) the existence of a service-connected disability; and (3) a causal relationship between the present disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998); see also Ward v. Wilkie, 31 Vet. App. 233 (2019). The requirement of a current disability is “satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim.” See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). In evaluating the evidence, the Board has been charged with the duty to assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Indeed, the Court has declared that in adjudicating a claim, the Board has the responsibility to do so. Bryan v. West, 13 Vet. App. 482, 488-89 (2000). In doing so, the Board is free to favor one medical opinion over another, provided it offers an adequate basis for doing so. Owens v. Brown, 7 Vet. App. 429, 433 (1995). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under the laws administered by VA. VA shall consider all information and medical and lay evidence of record. Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). I. AVM and a Bilateral Eye Disability diagnosed as Myopia. Initially, the Board notes that the record shows the Veteran wears glasses for myopia and has a diagnosis of AVM. See, e.g. April 1976 service examination history (Veteran reported a history of wearing glasses or contact lenses); September 1976 service eye examination (diagnosing hyperopia (farsightedness) and issued glasses); undated service eyewear prescription; May 2007, June 2011, and May 2015 treatment records (diagnosing refractive error); and September 2011 letter from Dr. Powell (noting a diagnosis of AVM). As to a claim of service connection for AVM, while as noted in the JMPR the November 2017 VA examiner’s opinion was not adequate because it was not certain enough to allow VA to reconcile whether the Veteran’s AVM is a congenital defect with VA’s definition of “disease” and “defect” found at GC Opinion 82-90, the Board finds that no such uncertainty is found in the post-Remand VA examiner’s September 2020 opinion. See Owens, supra; Guerrieri, supra. In this regard, the September 2020 VA examiner after a review of the record on appeal and an examination of the Veteran clearly and in no uncertain terms opined that AVM is a congenital disorder and this opinion is supported by a detailed citation to the Veteran’s medical records, the September 2011 opinion from Dr. Powell, and the appellant’s competent and credible lay claims regarding observable symptomatology as well as supported by medical reasoning and controlling medical literature and not directly contradicted by any other medical evidence of record. See Owen, supra; Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991) (VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions). Therefore, the Board finds that the September 2020 VA examiner’s opinion that AVM is a congenital disorder is the most probative evidence of record even when considering VA’s definition of “disease” and “defect” found at GC Opinion 82-90. Id. Accordingly, the Board finds that the claim of service connection for AVM on a direct basis is denied because it is not a disability for which service connection may be granted because it is a congenital disorder. See 38 C.F.R. §§ 3.303(c), 4.9. As to a claim of service connection for a bilateral eye disability diagnosed as myopia, the Board finds that it is also must be denied on a direct basis because it is not a disability for which service connection may be granted because it is also a congenital disorder. See 38 C.F.R. §§ 3.303(c), 4.9. As to any claim that service connection for AVM and a bilateral eye disability diagnosed as myopia are warranted because they were subject to a superimposed disease or injury while on active duty that caused additional disability, the Board notes that service treatment records, including a July 1984 and February 1985 examinations, are negative for any injury, disease, complaint, diagnoses, or treatment for the Veteran’s brain/veins/arteries and eyes. In fact, at her February 1985 separation examination the Veteran specifically denied a history of eye trouble. See Colvin, supra. It is important for the Veteran to understand that at this point it is the Veteran herself that provides factual evidence against her own claim. Moreover, at the July 1984 and February 1985 examinations it was opined that her head, eyes, opthalmoscopic, pupils, ocular mobility, vascular system, abdomen, viscera, and G-U system were normal with 20/20 vision and field of vision, color vision, and/or night vision being normal. These medical opinions are not contradicted by any other medical evidence of record. Id. Similarly, and more importantly, while the post-service record documents the claimant’s AVM and a bilateral eye disability diagnosed as myopia, it is likewise negative for any competent and credible evidence that either was subject to a superimposed disease or injury while on active duty that caused additional disability. Id. In fact, as to AVM, the September 2020 VA examiner opined that it was not subject to a superimposed disease or injury while on active duty that caused additional disability and the Board finds this opinion the most probative evidence of record because it was supported by a detailed citation to the Veteran’s medical records, the September 2011 opinion from Dr. Powell, and the appellant’s competent and credible lay claims regarding observable symptomatology as well as because it is supported by medical reasoning and controlling medical literature and not directly contradicted by any other medical evidence of record. See Owen, supra; Colvin, supra. As to the bilateral eye disability diagnosed as myopia, given the above record which is negative for an injury and/or treatment for eye disease while on active duty, the Board finds that VA had no obligation to obtain a medical opinion as to this question. See Paralyzed Veterans of America, et. al., v. Secretary of Veterans Affairs, 345 F.3d 1334 (Fed. Cir. 2003) (holding that the criteria for obtaining an etiology opinion have not been met when the evidence of record does not establish that the veteran suffered an event, injury, or disease in service because no reasonable possibility exists that providing a medical examination or obtaining a medical opinion would substantiate the claim); Duenas v. Principi, 18 Vet. App. 512, 519 (2004) (VA is not obligated to provide an examination for a medical nexus opinion where, as here, the supporting evidence of record consists only of a lay statement). Furthermore, even if the Veteran reported she sustained an eye an injury while on active duty that caused additional disability, which she did not, the Board finds that she is not competent to provide the missing superimposed disease or injury opinions because she does not have the required medical expertise to provide answers to these complex medical questions (i.e., did she have a superimposed disease or injury while on active duty that caused additional AVM and myopia). See Davidson, supra. Given the above, the Board finds that the most probative evidence of record shows that the claimant did not sustain a superimposed disease or injury while on active duty that caused additional AVM or a bilateral eye disability diagnosed as myopia. See Owens, supra. Therefore, the Board finds that the preponderance of the evidence is against the claims of service connection for AVM and a bilateral eye disability diagnosed as myopia due to a superimposed disease or injury. 38 U.S.C. § 1131; 38 C.F.R. § 3.303, 4.9; VAOPGCPREC 82-90. Similarly, as to the Veteran’s claim that her bilateral eye disability diagnosed as myopia is secondary to her AVM, the Board notes that the appellant is not already service-connected for AVM and, as explained above, her appeal as to the denial of her claim for service connection for AVM is being denied. Therefore, the Board finds that the Veteran also does not meet the criteria for secondary service connection for a bilateral eye disability diagnosed as myopia. See 38 U.S.C. § 1131; 38 C.F.R. § 3.310; also see Allen, supra; Wallin, supra; Ward, supra. II. A Bilateral Eye Disability other than Myopia and the Gastrointestinal Disability As to current disabilities, the post-service record now shows the Veteran being diagnosed with cataracts, gastroesophageal reflux disease (GERD), clostridium difficile colitis, gastritis, duodenitis, and Barrett’s Esophagus. See, e.g., VA examinations dated in September 2020 and November 2020. As to the gastrointestinal disability claim, service treatment records document complaints and treatment for adverse symptomatology including abdominal pain, nausea, vomiting, diarrhea, constipation, upset stomach, and indigestion most often diagnosed as a viral syndrome but also as cramps and a sinus congestion. See, e.g., service treatment records dated in September 1978, November 1978, September 1979, December 1979, September 1982, October 1982, May 1983, June 1983, November 1984, January 1985, and February 1984. Additionally, the Board notes that the September 1978 records documenting the Veteran complaints and treatment for left and thereafter right sided abdominal pain and/or an upset stomach also noted that it was probably gastrointestinal in origin before diagnosing a viral syndrome. Moreover, an abdominal scan dated later in September 1978 noted a large amount of small bowel gas due to possible aerophagai but no other pathology. Furthermore, the Veteran at her April 1975 examination reported a history of stomach problems for 2 weeks in April 1975 and at her February 1985 examination reported a history of frequent indigestion. The Board also finds that the Veteran is competent to report on the visible manifestations of her disabilities, such as difficulty seeing and gastrointestinal symptomatology. See Davidson, supra. As to the gastrointestinal disability claim, the Board finds it significant that when examined in July 1984 and February 1985 it was opined that her abdomen, viscera, and G-U system were normal despite the history of stomach problems for 2 weeks in April 1975 reported in the July 1984 examination history, the history of frequent indigestion reported in the February 1985 examination history, and despite the above gastrointestinal problems seen in her service treatment records; these medical opinions are not contradicted by any other medical evidence of record. See Colvin, supra. The Board also finds it significant that in the February 1985 examination history the Veteran specifically denied a history of stomach trouble. The Board also finds the contemporaneous July 1984 and February 1985 service examinations more probative than the post-service lay claims from the Veteran because medical professionals have greater medical training. See Owens, supra; Black v. Brown, 10 Vet. App. 297, 284 (1997) (in evaluating the probative value of medical statements, the Board looks at factors such as the individual knowledge and skill in analyzing the medical data). The Board also finds the July 1984 and February 1985 service examinations provide particularly negative evidence against the claims for a chronic gastrointestinal disability, clearly indicating that at the time the Veteran separated from service even she did not think she had a chronic gastrointestinal disability. Therefore, as to the gastrointestinal disability, the Board finds as the July 1984 and February 1985 examiners must have found that any problems the Veteran had with gastrointestinal upset due to viral syndrome, cramps, and her sinus while on active duty were transient in nature and resolved by the time she separated from service. Id. As to the claim of service connection for a bilateral eye disability other than myopia service treatment records, including the July 1984 periodic and February 1985 separation examinations as well as the September 1976 and December 1978 eye examinations, are negative for an injury, history, complaints, diagnoses, or treatment for an eye disability other than myopia. In this regard, the Board finds it significant that when examined in February 1985 the Veteran specifically denied having a history of eye trouble. The Board also finds it significant that when examined in July 1984 and February 1985 it was opined that her eyes, opthalmoscopic, pupils, ocular mobility as well as her field of vision, color vision, and/or night vision examinations were normal. In this regard, the Board also finds it significant that service treatment records do not document the Veteran’s treatment for an eye injury or disease despite the records containing highly detailed reports of other problems. Therefore, the Board finds that the most probative evidence of record shows that the Veteran did not develop a bilateral eye disability other than myopia or a chronic gastrointestinal disability while on active duty despite her claims to the contrary and despite her treatment for adverse gastrointestinal symptoms while on active duty. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a); Colvin, supra; Hensley, supra. Similarly, the record does not show that the Veteran had a continued problem with a bilateral eye disability other than myopia or a gastrointestinal disability in and since service. In fact, as reported above, the July 1984 and February 1985 examiners opined that her eyes, opthalmoscopic, pupils, ocular mobility as well as her field of vision, color vision, night vision, abdomen, viscera, and G-U system examinations were normal and the Veteran specifically denied having a history of eye trouble when examined in February 1985 and, as to her gastrointestinal problems, reported in February 1985 that it was only related to her need for a special diet. Likewise, and perhaps more importantly, despite any claims from the Veteran to the contrary, the post-service record does not document her continued complaints, diagnoses, or treatment for a bilateral eye disability other than myopia or a gastrointestinal disability since her 1985 separation from service because it does not show any treatment for a bilateral eye disability other than myopia until 2010 (see, e.g., treatment records dated in March 2010, June 2011, September 2013, and February 2014 (diagnosing cataracts)) and a gastrointestinal disability until 2003 (see, e.g., treatment records dated in February 2003 (diagnosing GERD); November 2006 (diagnosing resolved clostridium difficile colitis); October 2008 (diagnosing gastritis and duodenitis); and February 2015 (diagnosing Barrett’s Esophagus)); at least 18 years post-service. At this point, the service medical records and the post-service medical evidence each provide evidence against these claims. Therefore, the Board finds that the most probative evidence of record shows that the Veteran did not have a continued problem with a bilateral eye disability other than myopia or a gastrointestinal disability in and since service. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303(b). Furthermore, the record is negative for a competent and credible opinion that shows that her current bilateral eye disability other than myopia or a gastrointestinal disability are due to the Veteran’s military service. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303(d); also see Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992) (establishing service connection requires finding a relationship between a current disability and events in service or an injury or disease incurred therein). In fact, as to the gastrointestinal disorders, the November 2020 VA examiner opined that it is not due to her military service. Moreover, the Board finds this opinion the most probative evidence of record because it was provided after a review of the record on appeal and an examination of the Veteran as well as because it is supported by ciation to evidence found in the record and controlling medical literature as well as not contradicted by any other medical evidence of record. See Owens, supra; Guerrieri, supra; Colvin, supra. As to the bilateral eye disability other than myopia, the Board notes that VA did not obtain an opinion as to direct service connection. However, given the above record which is negative for the claimed disability while on active duty and for at least 25 years after service, the Board finds that VA had no obligation to obtain a medical opinion as to this question. See Paralyzed Veterans of America, et. al., supra; Duenas, supra. It is important for the Veteran to understand that at this point both the factual evidence and the medical evidence (treatment records and the best medical opinions) provides highly probative evidence against the claims that the Board cannot ignore. In addition, the Board finds that the Veteran is not competent to provide the missing nexus opinions because she does not have the required medical expertise to provide answers to these complex medical questions (i.e., what caused her current bilateral eye disability other than myopia and gastrointestinal disability). See Davidson, supra. In this regard, the Board finds that she simply does not have the medical qualifications to provide a nexus opinion given the negative service treatment records and the at least 18 year gap between active duty that ended in 1985 and the first complaints, diagnoses, or treatment for either of these disorders post-service. Therefore, the Board finds that the most probative evidence of record shows that the Veteran’s post-service bilateral eye disability other than myopia and gastrointestinal disability are not due to her military service. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303(d); also see Rabideau, supra. Similarly, as to the Veteran’s claims that her bilateral eye disability other than myopia and gastrointestinal disability are secondary to her AVM, the Board notes that the appellant is not service-connected for AVM. Therefore, the Board finds that the Veteran does not meet the criteria for secondary service connection for a bilateral eye disability other than myopia and a gastrointestinal disability. See 38 U.S.C. § 1131; 38 C.F.R. § 3.310; also see Allen, supra; Wallin, supra; Ward, supra. Accordingly, the Board finds that the preponderance of the evidence is also against the Veteran’s claims of service connection for a bilateral eye disability other than myopia and a gastrointestinal disability. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. Conclusion In reaching the above conclusions, the Board has also considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the probative evidence is against the claims, the Board finds that this doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert, 1 Vet. App. at 55-56. John J. Crowley Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N.T. Werner, 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.