Citation Nr: 21039782 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 16-57 734 DATE: July 1, 2021 ORDER Entitlement to service connection for glaucoma is denied. FINDING OF FACT The preponderance of the evidence is against a finding that the Veteran's glaucoma was incurred in or caused by service. CONCLUSION OF LAW The criteria for entitlement to service connection for glaucoma have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1984 to November 2004. This matter comes before the Board of Veterans' Appeals (Board) from a March 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The case was last before the Board in November 2018 and has returned to the Board for further appellate review. 1. Entitlement to service connection for glaucoma The Veteran seeks service connection for glaucoma, which he asserts began during service and has continued since. Upon review of the record, the Board finds that the most probative evidence of record is against a finding that the Veteran's glaucoma began during service or is otherwise related to service. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Generally, to prove service connection there must be: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Where a veteran served continuously for 90 days or more during active service and certain chronic diseases, including glaucoma, become manifest to a degree of 10 percent within one year from date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. Service treatment records show that the Veteran was referred for visual field tests after glaucoma was suspected in October 1992. Thereafter, June 1993 and November 1995 glaucoma tests revealed findings within normal limits. The Veteran reported that he possibly had glaucoma in a December 1997 and a July 2004 report of medical history. However, tests administered in July 2002 and November 2003 were negative for glaucoma. Post-service VA treatment records reveal that the Veteran was suspected as having glaucoma in February 2008. Thereafter, a November 2014 treatment record shows the Veteran was diagnosed with early primary open-angle glaucoma in the right eye and moderate glaucoma suspect in the left eye. A February 2017 letter from a private treatment provider indicates that the Veteran has a diagnosis of open angle glaucoma in the right eye greater than the left eye. The physician noted the Veteran's previous records showed that he had normal visual field many years ago, but then developed a superior visual field defect in the right eye. The physician explained that glaucoma develops slowly over time, so it is likely that the Veteran has had glaucoma for many years and gradually developed a visual field defect. However, the physician did not actually opine that the Veteran's glaucoma arose during service. Thus, the statement is afforded no probative weight as to a relationship between the Veteran's current glaucoma and service. The Veteran underwent a VA eye conditions examination in March 2019, during which the examiner indicated the Veteran had a diagnosis of right eye open angle glaucoma. The examiner also noted that some abnormalities were found for the Veteran's left eye; however, they were not significant enough to support a current diagnosis for glaucoma. The examiner explained that the Veteran's self-reports of possible glaucoma during service are not substantiated as subsequent diagnostic testing showed that he did not have a diagnosis of glaucoma. Moreover, the examiner explained that examinations conducted towards the end of the Veteran's service were negative for glaucoma and he was not diagnosed with glaucoma until 2014, 10 years after his separation from service. As such, the examiner opined that it is less likely than not the Veteran's glaucoma was incurred in service. This opinion is provided high probative value as it was provided following claims file review and provided a rationale for the conclusions reached that is consistent with the record. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (holding that it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion). While the Veteran believes that his glaucoma that began during service, as a layperson, he has not shown that he has the 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 to determine. Thus, the Board finds the medical evidence, to include the service treatment records and the VA examiner's opinion, to be more probative than the Veteran's lay assertions. In sum, the preponderance of evidence is against the claim for service connection for glaucoma, and the appeal is denied. In reaching this conclusion, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the claim, the doctrine does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990). K. A. BANFIELD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Lance, Associate 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.