Citation Nr: 21024555 Decision Date: 04/23/21 Archive Date: 04/23/21 DOCKET NO. 17-27 450 DATE: April 23, 2021 ORDER Entitlement to service connection for glaucoma, claimed as secondary to service-connected diabetes mellitus, type II, is granted. FINDING OF FACT The competent and probative evidence of record is in equipoise as to whether the Veteran's glaucoma is caused or aggravated by his service-connected diabetes mellitus, type II. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for glaucoma have been met. 38 U.S.C. §§ 1110, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from December 1965 to September 1967. Although the Veteran’s DD Form 214 does not reflect foreign service, personnel records unambiguously show that he served in the Republic of Vietnam from June 4, 1966, to May 24, 1967. He also had subsequent service of an unverified nature in the Army Reserve. This matter comes to the Board of Veterans' Appeals (Board) from an October 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) of the Veterans Benefits Administration (VBA), which is the Agency of Original Jurisdiction (AOJ). The Veteran expressed timely disagreement with this determination, and the present appeal ensued. In February 2021, the Veteran presented oral testimony in support of his appeal at a Board hearing that was conducted by the undersigned Veterans Law Judge (VLJ) via videoconferencing equipment. A transcript of this hearing is of record. At the hearing, the VLJ agreed to hold the record open for 30 days for the submission of additional evidence; however, no such evidence was received within that period. 1. Entitlement to service connection for glaucoma, claimed as secondary to service-connected diabetes mellitus, type II, is granted. Service connection may also be granted for disability which is proximately due to or the result of service-connected disability. 38 C.F.R. § 3.310 (a) (2017). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). Analysis The Veteran has asserted his claim to establish service connection under the theories of direct, presumptive, and secondary service. However, the Board’s analysis will focus on the theory of secondary service connection, as the evidence supports the benefits sought by the Veteran under this theory only. Private treatment records reflect that glaucoma was initially diagnosed by the Veteran’s primary care provider in May 2009 in connection with glucose testing to confirm a diagnosis of diabetes mellitus, type II, and the AOJ established service connection for the latter disability in a June 2010 rating decision. As such, the crux of the Veteran’s appeal is whether the most probative evidence reflects that the Veteran’s glaucoma is caused or aggravated by his service-connected diabetes mellitus, type II. In support of his appeal, the Veteran submitted a December 2009 statement from his private doctor reflecting that glaucoma is a complication of diabetes mellitus, type II. While the private clinician did not provide a rationale for this opinion, the Veteran submitted various VA materials that make general allusions to possible relationships between diabetes mellitus, type II, and diabetes mellitus, type II. The Board notes that the AOJ did not acknowledge the December 2009 private opinion in the October 2015 rating decision or May 2017 Statement of the Case (SOC); instead, a September 2016 VA opinion was obtained. After a review of the record and examination of the Veteran, the September 2016 VA examiner opined that glaucoma, which was initially diagnosed in 2013, was less likely as not caused or aggravated by diabetes mellitus, type II. Following his Board hearing in February 2021, the Veteran provided another private opinion from Dr. T.S. who stated that he had been following the Veteran since February 2012 as a glaucoma suspect and opined that diabetes can increase the risk of glaucoma and that because it is not curable, the Veteran will need eye drops or surgical intervention to treat his glaucoma for the rest of his life. In sum, the record includes competing medical opinions regarding whether the Veteran’s glaucoma was caused or aggravated by his service-connected diabetes mellitus, type II. The Board notes all of the opinions are deficient in some respect, as the December 2009 private examiner did not provide an accompanying rationale, the June 2019 VA examiner appears to have relied an inaccurate factual premise, as private treatment records clearly reflect a glaucoma diagnosis four years prior to 2013 (Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (a medical opinion that contains only data and conclusions is accorded no weight); also see Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (medical opinion based upon an inaccurate factual premise has no probative value)), and the most recent private examiner expressed his opinion in a somewhat speculative manner. However, in sum, the Board finds that the evidence is, at least, in relative equipoise regarding the question of whether the Veteran's glaucoma is caused or aggravated by his service-connected diabetes mellitus, type II. In cases such as this, when 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. Therefore, resolving all reasonable doubt in favor of the Veteran, the Board finds that service connection for glaucoma is warranted. 38 U.S.C. § 1110, 1131, 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Scott W. Dale, 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.