Citation Nr: 21027318 Decision Date: 05/05/21 Archive Date: 05/05/21 DOCKET NO. 14-26 010 DATE: May 5, 2021 ORDER Entitlement to service connection for glaucoma on both eyes is denied. FINDING OF FACT The Veteran's glaucoma did not originate in service and is not otherwise etiologically related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for glaucoma have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had honorable active service with the United States Marine Corps from June 1967 to August 1970. This matter is before the Board of Veterans' Appeals (Board) on appeal from a December 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a videoconference hearing before the undersigned Veteran Law Judge (VLJ) in May 2019. A transcript of the hearing is associated with the claims file. In September 2019, the Board remanded the claim for development including a new VA examination. In November 2020, the Veteran was afforded a new VA examination. The Board finds that there was substantial compliance with the September 2019 remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Specifically, the Veteran was afforded a new adequate opinion by a different VA examiner, whose opinion is discussed below in more detail. Thus, the Board will proceed to adjudicate the claim currently on appeal. Generally, service connection will be granted for a disability resulting from an injury or disease caused or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). A grant for service connection for a disability requires: (1) a present disability or persistent or recurrent symptoms of a disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship ("nexus") between the present disability and the in-service event, injury, or disease. 38 U.S.C. § 1110; 38 C.F.R. § 3.303; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including the evidence pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the Veteran. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Board determinations with respect to the weight and credibility of evidence are factual determinations going to the probative value of the evidence. Layno v. Brown, 6 Vet. App. 465, 469 (1994). Competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility 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); Layno, 6 Vet. App. at 465. Lay statements may serve to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. 38 C.F.R. § 3.159; see Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a Veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. In this case, the Board has reviewed all the evidence of record, with an emphasis on the evidence relevant to this appeal. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that VA must review the entire record but does not have to discuss each piece of evidence). Hence, the Board will summarize the relevant evidence where appropriate and the Board's analysis below will focus specifically on what the evidence shows, or fails to show, as to the claim on appeal. The Veteran contends that his bilateral glaucoma disability began during active service. Specifically, during the May 2019 hearing before the Board, he testified that while serving in Vietnam, a battery exploded, and acid got in his eyes and on his hands. He further asserted that he was put on profile for several days until his eyes and hands healed. See Hearing Transcript received May 2019. First, the Board considered whether service connection was warranted on a presumptive basis. In particular, the Board considered whether any evidence supported that the Veteran's bilateral glaucoma began in service. In December 1968, service treatment records documented that the Veteran was injured by an exploding battery, and that the Veteran reported blurred vision. Afterwards, the Veteran reported he was off duty for a couple days before returning to his duties. See STR-Medical received January 1975 and Hearing Transcript. At separation in August 1970, the clinical evaluation noted no eye related abnormalities. See STR-Medical received January 1975. The records from service do not support that the Veteran had glaucoma during service. Moreover, the Veteran was not diagnosed with glaucoma until decades later. For example, VA treatment records reported in the Veteran's history that he was diagnosed with glaucoma around the year 1995. See CAPRI received August 2020. The Veteran testified to the same during the hearing. The Board recognizes that the Veteran might sincerely believe that his glaucoma began in Vietnam. In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on his symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge); see also Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Although the Veteran is competent to report his symptoms, he does not possess the medical expertise required to provide a competent opinion concerning the etiology of the disability at issue. So, glaucoma in service is not shown by any competent evidence of record. Then the Board considered direct service-connection, but the evidence does not show a causal relationship ("nexus") between the Veteran's bilateral glaucoma and an in-service event, injury, or disease. For direct service connection, first you must have a present disability. The Veteran's treatment records reflect a present diagnosis of glaucoma with corresponding treatment. Specifically, the Veteran had private treatment for glaucoma and around June 2010 began treatment at the VA. See Medical Treatment Record Non-Government Facility received August 2010, Medical Treatment Records Government Facility received December 2010. Next, for direct service connection, you must also have an in-service event, injury, or disease. In December 1968, service treatment records documented that the Veteran was injured by an exploding battery, and that the Veteran reported blurred vision, as discussed above. These records supported the Veteran's testimony that he had an event or injury during service effecting his eye. Therefore, an in-service event is supported by the Veteran's testimony and service treatment records. Last, for direct service connection, there must be a causal relationship ("nexus") between the present disability and the in-service event. However, the evidence of record, including an opinion, does not support a link between the Veteran's present bilateral glaucoma and the described in service event. In November 2020, the Veteran had a VA examination. He was diagnosed with bilateral angle recessed glaucoma. The examiner reported that the Veteran had poorly controlled pressures in his eyes for over 15 years leading to severe vision loss in the right eye. See C&P Exam received November 2020. The Veteran had very high pressure in his right eye and more mild pressure in the left eye. VA treatment providers have prescribed the Veteran two different medications in the form of drops to help the Veteran control his eye pressure. Id. The November 2020 VA examiner opined that the Veteran's diagnosis of glaucoma is less likely than not incurred in or caused by the event reported during service. See Medical Opinions received November 2020. The examiner stated that traumatic angle recession glaucoma, which the Veteran had was typically caused by a blunt force trauma. The examiner considered the Veteran's reports of the incident. The examiner opined that battery acid in the eye was not a blunt force trauma and that battery acid in the eye would not result in glaucoma. Id. The Board acknowledges the Veteran's contentions that his glaucoma is related to his military service. While the Veteran believes that his bilateral glaucoma is related to service, as a lay person, the Veteran has not shown that he has specialized training sufficient to render such an opinion. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). In this regard, the diagnosis and etiology of glaucoma are matters not capable of lay observation and require medical expertise. Accordingly, his opinion as to the diagnosis or etiology of his bilateral glaucoma is not competent medical evidence. The Board finds the opinion of the VA examiner to be significantly more probative than the Veteran's lay assertions. Neither the Veteran nor his representative has raised any duty to notify or duty to assist issues regarding the Veteran's bilateral glaucoma claim denied herein. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board."); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). The Board finds that the preponderance of the evidence of record weighs against the establishment of a nexus between the Veteran's glaucoma and active duty service. Given the extensive time between active duty service and the diagnosis of bilateral glaucoma, as well as considering all of the evidence of record, the Board finds that the preponderance of the evidence of record weighs against service-connection for glaucoma. Since the preponderance of the evidence is against the claim, the provisions of 38 U.S.C. § 5107(b) regarding reasonable doubt are not applicable. The claim of entitlement to service connection for bilateral glaucoma must be denied. B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Associate Counsel, C. Parnell 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.