Citation Nr: 21029307 Decision Date: 05/13/21 Archive Date: 05/13/21 DOCKET NO. 15-12 367 DATE: May 13, 2021 ORDER Service connection for a left eye disability is denied. FINDING OF FACT The preponderance of the evidence is against finding that any current left eye disability began during active service, is otherwise related to an in-service injury or disease, and is not secondary to any service-connected disability. CONCLUSION OF LAW The criteria for service connection for left eye disability have not been met. 38 U.S.C. §§ 1110, 1112, 1116, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1977 to February 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a March 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) which denied the reopening of the claim for service connection for a left eye disability. A June 2019 Board decision reopened the claim; accordingly the question at issue now involves entitlement to service connection. The Veteran testified at a Board hearing before a Veterans Law Judge in August 2018. A transcript of that proceeding is of record. This matter was previously before the Board in June 2019, April 2020, and August 2020 when it was remanded to obtain additional evidence and medical examinations. Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an 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. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). A disability that is proximately due to, the result of, or aggravated by a service-connected disease or injury shall be service connected. 38 C.F.R. § 3.310. Refractive error of the eye is not a disease or injury within the meaning of applicable legislation for service connection purposes. 38 C.F.R. § 3.303(c). The Veteran contends that he has a left eye condition resulting from his time in service. Specifically, during the August 2018 Board hearing, the Veteran testified that he believes his blurred vision and loss of vision is due to exposure to flames from loading artillery in service. He also reported experiencing vision loss and blurred vision in service, that continues today. The Veteran's separation papers, DD 214, confirm that the Veteran served 14 years in the Army with a primary military specialty as an artillery cannon crewmember. A single service treatment record dated February 1991 reveals that the Veteran was treated for left eye symptoms which were diagnosed as a left corneal abrasion secondary to a foreign body in the eye. The eye was irrigated. There is no evidence that the Veteran had any other eye injury, or symptoms during service. This corneal abrasion healed as his January 1992 separation examination report indicated that clinical evaluation of the eyes was "normal" with no abnormalities noted by the examining physician. His vision was also tested to be 20/20 in both eye on separation examination and on the accompanying separation examination medical history the Veteran check "no" to the question which asked if he had eye trouble. A February 2007 VA treatment record reveals that the Veteran had complaints of blurry vision dating from approximately July 2006. This record indicates a "system concern: hypertensive retinopathy" because the Veteran had a history of hypertension for over 15 years. A VA medical problem list dated in June 2008 indicates presbyopia, open angle glaucoma and retinal dystrophy as medical problems. In February 2010 a VA Compensation and Pension examination for hypertension was conducted. The diagnosis indicated that that the Veteran had "Adult Best's Vitelliform macular dystrophy of the eye, that is a genetic condition unrelated to his hypertension." In July 2011, another VA examination of the Veteran was conducted. Funduscopic examination of the left eye was limited secondary to miosis but did not reveal any cataract or retinopathy. On ophthalmology examination the Veteran reported being in the military between 1977 and 1992, and that he was on medication to treat hypertension. He did not report having the corneal abrasion during service, nor did he report or make assertions of having eye injury or difficulty seeing during service as the result of any flames or blast from his artillery duties. Eye examination revealed left eye uncorrected distance vision of 20/50, and uncorrected near vision of 20/100. Physical examination of the left eye was normal with no residual injury or defect of the cornea being present. The diagnosis was presbyopia. In September 2011 another VA examination of the Veteran was conducted with respect to his hypertension claim; he reported a decrease of visual acuity in both eyes and that he wore glasses. Eye examination was normal except for uncorrected vision of 20/40 in both eyes. A February 2015 VA ophthalmology progress note indicates that the Veteran was diagnosed with: primary open angle glaucoma, low tension glaucoma, vitelliform retinal dystrophy, and nuclear sclerotic cataracts in both eyes. Medication was prescribed to treat the Veteran's glaucoma. In August 2019 a VA eye examination of the Veteran was conducted. The examiner noted the Veteran's history of a left corneal abrasion during service in 1991. His recent history was being followed for low tension glaucoma, vitelliform macular lesion, and optic nerve atrophy both eyes at the VA eye clinic. He was prescribed eye drops to treat his glaucoma and his best corrected vision was 20/25 in both eyes. The examiner stated that the Veteran's left eye corneal abrasion during service was completely healed without any residual disability. The examiner further stated that it was less likely than not that any of the other diagnosed eye disorders, low tension glaucoma, vitelliform macular lesion, and optic nerve atrophy, were due to the left corneal abrasion during service. In April 2020, the examiner issued an additional medical opinion that none of the diagnosed eye disabilities were caused, or aggravated by, the Veteran's service-connected hypertension. Finally, in August 2020, the examiner expressed the opinion that it was less likely than not that any of the diagnosed eye disabilities were due to the reported exposure to flames from loading artillery during service. The examiner specifically indicated that the Veteran's cataracts were age related and his vitelliform macular dystrophy occurs in the general population and is genetic in nature. The Board finds these opinions highly probative as they were made by a medical professional with consideration of the specific facts in this case and after examination of the Veteran. The April 2020 examination addresses the Veteran's theory of service connection. The opinions are also supported by other evidence of record. There is no medical opinion or competent and credible evidence in significant conflict with the VA medical opinions. The Board has considered the Veteran's statements, to include his assertions that his eye symptoms began during service due to exposure from flames of from loading artillery cannons. As the Veteran is not shown to have medical education or experience, he is a lay person and is competent to report (1) symptoms that are observable to a layperson, e.g., such as blurred vision; (2) symptoms at the time supporting a later diagnosis by a medical professional; or (3) a contemporaneous medical diagnosis. See Davidson v. Shinseki, 581 F.3d 1313 (2009). The Veteran is not competent to independently render a medical diagnosis or opine as to the specific etiology of a condition as these are medically complex issues. Thus, his lay assertions do not constitute evidence upon which service connection can be granted. In any event, the Board ultimately assigns greater probative weight to the medical evidence of record, to include the opinion rendered by a trained medical professional based on appropriate diagnostic testing and reasonably drawn conclusions with supportive rationale. To the extent the Veteran asserts a continuity of symptomatology beginning during service, the Board finds these statements to lack credibility as they are in direct conflict with the Veteran's report of medical history at separation from service where he denied having eye trouble, and clinical evaluation of his eyes was normal. The Board finds the report of medical history at separation from service to be more reliable than more recent assertions as it was done contemporaneous to service and for the purpose of identifying disability at that time. For the above reasons, the preponderance of the evidence is against the claim and service connection is denied. MARJORIE A. AUER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Havelka, 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.