Citation Nr: 21026938 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 13-20 507 DATE: May 4, 2021 ORDER Entitlement to service connection for a bilateral eye condition, to include bilateral eye glaucoma and conjunctivitis, is denied. FINDING OF FACT A bilateral eye disability, other than pinguecula, to include bilateral eye glaucoma and conjunctivitis, did not manifest in service or within one year of discharge and is not otherwise attributable to service. CONCLUSION OF LAW A bilateral eye condition, other than pinguecula, to include bilateral eye glaucoma and conjunctivitis, was not incurred in or aggravated by service. 38 U.S.C. §§ 1101, 1112, 1113, 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1980 to July 1982. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2013 rating decision by the Department of Veteran's Affairs (VA) Regional Office (RO). The Veteran provided testimony at a November 2017 videoconference hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing is associated with the claims file. The claim was remanded in April 2018 and June 2020 for further development. The Board notes that in a January 2021 rating decision, the Veteran was granted service connection for bilateral eye pinguecula. However, the RO continued the claim for the Veteran's bilateral eye glaucoma and conjunctivitis in a subsequent January 2021 supplemental statement of the case, as the Veteran was also separately diagnosed with these eye conditions. Therefore, the claims for entitlement to service connection for bilateral eye glaucoma and conjunctivitis are still on appeal and are again before the Board. Service Connection Veterans are entitled to compensation from VA 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 a right to compensation for a present disability, 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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). After the evidence is assembled, it is the Board's responsibility to evaluate the entire record. See 38 U.S.C. § 7104(a). When there is an approximate balance of evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each issue shall be given to the claimant. See 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3. In Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the United States Court of Appeals for Veterans Claims (Court) stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail." To deny a claim on its merits, the preponderance of the evidence must be against the claim. See Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. Bilateral eye condition The Veteran seeks service connection for a bilateral eye condition. The Veteran has testified that he was a welder in service, and that he experienced burning, redness and watering of the eyes in service. See Board Hearing transcript p. 11. The Veteran has been diagnosed with glaucoma of the eyes and conjunctivitis of the eyes. See April 2014 VA Examination. With regard to an in service injury, the Board notes the Veteran's March 1982 report of burning in both eyes, as well as report of mild infection of conjunctivitis. Subsequent to the June 2020 Board remand, the Veteran was issued a VA opinion for his bilateral eye disabilities in December 2020. In that opinion, the examiner found that the Veteran's claimed glaucoma and conjunctivitis were less likely than not related to his burning of the eyes in service. The examiner stated that the Veteran suffered from a burning sensation when he was a welder during service, and that such can cause dry eye and a corneal burn can leave a scar if exposure to heat was extreme. However, the examiner noted that on the last ocular examination dated from 2014, there was no corneal residuals such as dry eye or corneal scars. This indicates that the condition of burning in service was temporary and left no residuals. In another opinion, the examiner further explained that glaucoma is highly likely to be an inherited condition, highly unlikely to be related to a military event or condition, and conjunctivitis during service could have been related to heat and environmental conditions, but such would be related to the conditions at the time in service. The examiner explained that recurrent conjunctivitis after several decades of discharge would be highly unlikely to be related to an in service event. Post service conjunctivitis would be highly likely due to current environmental conditions unrelated to previous military service. See December 22, 2020 VA opinions both submitted in Caseflow 12/22/20. The Board affords this VA opinion probative value because the examiner based his findings on a review of the Veteran's STRs and post-service treatment records, and upon the April 2014 physical examination findings of the Veteran. Essentially, he concluded that due to the nature of the injury in service and the Veteran's disability, it was less likely than not that his current bilateral eye disability is related to his military service. This opinion is consistent with the Board's review of the evidence of record. Consideration has been given to the Veteran's testimony that his military duties led to his current eye disabilities. Although the Veteran is competent to report having burning of the eyes while in the military, he is not competent to state that his military duties caused his current disabilities. Where the determinative issue is one of medical causation, only those with specialized medical knowledge, training, or experience are competent to provide evidence on the issue. See Jones v. West, 12 Vet. App. 460, 465 (1999). In this regard, the question of causation of such a disorder involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. As such, the question of etiology in this case may not be competently addressed by lay evidence alone, and the Veteran's own opinion is nonprobative evidence. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007). (Continued on the next page) Accordingly, the Board finds that a preponderance of the evidence is against a finding that the Veteran's bilateral glaucoma and/or conjunctivitis are etiologically related to his period of active service. As the preponderance of the evidence is against the claim, the benefit of reasonable doubt doctrine is not applicable, and service connection for bilateral eye glaucoma/conjunctivitis must be denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). S. HENEKS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Nadia Kamal, 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.