Citation Nr: 22016559 Decision Date: 03/22/22 Archive Date: 03/22/22 DOCKET NO. 18-15 814 DATE: March 22, 2022 ORDER Entitlement to service connection for right eye astigmatism is denied. REMANDED Entitlement to service connection for a left ankle disability is remanded. Entitlement to service connection for a right ankle disability is remanded. FINDING OF FACT The Veteran's right eye astigmatism is not a disease or injury within the meaning of applicable legislation relating to service connection; and he has experienced no superimposed disease or injury related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for right eye astigmatism have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1979 to August 1982. These matters come before the Board of Veterans' Appeals (Board) on appeal from September 2016 and January 2017 rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a Board hearing before the undersigned Veterans Law Judge (VLJ) in October 2021. The transcript is of record. 1. Entitlement to service connection for right eye astigmatism The Veteran is seeking service connection for his right eye astigmatism, asserting that his right eye astigmatism is the result of tracing bullets and getting gun powder into his eyes while in service. The Veteran testified that he had 20/20 vision when he went entered service but currently requires eyeglasses. In general, service connection requires: (1) evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of an in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). For purposes of entitlement to benefits, the law provides that refractive errors of the eyes are congenital or developmental defects and are not a disease or injury within the meaning of applicable legislation. 38 C.F.R. §§ 3.303(c), 4.9. Refractive errors are defined to include astigmatism, myopia (nearsighted), hyperopia, and presbyopia. In the absence of superimposed disease or injury, service connection may not be allowed for refractive error of the eyes, including myopia, presbyopia, and astigmatism, even if visual acuity decreased in service, as this is not a disease or injury within the meaning of applicable legislation relating to service connection. Id. Thus, VA regulations specifically prohibit service connection for refractive errors of the eyes unless such defect was subjected to a superimposed disease or injury which created additional disability. See VAOPGCPREC 82-90 (1990); 55 Fed. Reg. 45711 (1990). Here, the Veteran's VA treatment records show a diagnosis of myopic astigmatism with presbyopia. Service treatment records show that a vision screening performed upon the Veteran's entrance into active duty in July 1979 revealed uncorrected visual acuity of 20/30 in both eyes. Although the Veteran asserts that his current right eye astigmatism warrants service connection, his service treatment records do not show any diagnosis of, treatment for, or evidence of any superimposed disease or injury while in service. The Board has considered the Veteran's lay statements that his astigmatism is a result of tracing bullets and getting gun powder into his eyes, and the Board does not dispute any symptomology he may experience regarding his vision. Although the Veteran is competent to describe observable symptoms of his vision issues, he is not competent to opine as to the etiology of his symptomology, as he has not been shown to possess the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Finally, while the Veteran testified that he had 20/20 vision when he entered service, service treatment records show otherwise, as the Veteran's entrance examination revealed that he had 20/30 vision in both eyes. As such, absent any persuasive evidence that the Veteran's refractive error was subject to a superimposed disease or injury during service, it is not a disability for purposes of VA disability compensation as it is congenital in nature. See 38 C.F.R. § 3.303 (c); see also Winn v. Brown, 8 Vet. App. 510, 516 (1996); Beno v. Principi, 3 Vet. App. 439 (1992). For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether entitlement to service connection for right eye astigmatism is warranted. Rather, the evidence persuasively weighs against service connection. The benefit of the doubt doctrine, see 38 U.S.C. § 5107(b), is therefore not for application as to this claim. Lynch v. McDonough, No. 2020-2067, 2021 U.S. App. LEXIS 37307 (Fed. Cir. Dec. 17, 2021). REASONS FOR REMAND 1. Entitlement to service connection for a left ankle disability is remanded. 2. Entitlement to service connection for a right ankle disability is remanded. The Veteran contends that his bilateral ankle disability is the result of his duties in infantry and being assigned to an Airborne Division in which he made numerous jumps out of helicopters and airplanes. The Veteran testified to continuous bilateral ankle pain since service. A review of the Veteran's service treatment records shows that in February 1981, the Veteran was seen after twisting his left ankle. The Veteran noted left ankle pain for years. The Veteran was seen in June 1981 for complaints of a sore right ankle. The Veteran was afforded a VA examination in September 2018. The Veteran was diagnosed with bilateral osteoarthritis of the ankle. The examiner stated that there is no evidence of record of the Veteran sustaining an ankle injury during service. The examiner noted that the Veteran was seen on a couple of occasions for ankle pain with associated foot pain and documentation of a history of left foot, broken toes during a car accident as a child. The examiner expressed that the Veteran's service treatment records show that he was seen two times in service for left foot/ankle pain and one time for right ankle pain. The examiner noted that the Veteran was not given an ankle diagnosis in service and that each time he was seen and treated, there was no documentation of follow-up for recurrent symptoms that would indicate a chronic condition. The examiner expressed that the Veteran separated from service in 1982 with no documentation of complaints of, or being seen for ankle pain until 2016, approximately 34 years following service. The examiner stated that x-rays of the ankles in 2016 demonstrated minimal degenerative changes (small spurs), which would be considered normal age-related findings. The examiner noted that the Veteran has had a prior left foot injury and severe pes planus of both feet. Therefore, the examiner opined that the Veteran's ankle pain is not related to service and is more likely related to his pes planus and prior left foot injury history. After review, the Board finds that another VA examination is warranted in order to address the Veteran's contention that his bilateral ankle disability is a result of the numerous jumps out of helicopters and airplanes. The Board finds that the VA examiner did not discuss the Veteran's lay contentions regarding the nature of his bilateral ankle injury or his assertions of continuous ankle problems following service. Here, the VA examiner relied on the lack of documented treatment for his ankle problems until 2016 and did not address the Veteran's lay assertions regarding the onset and history of his bilateral ankle problems during and following service. Therefore, another remand is required. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Make appropriate attempts to verify the Veteran's Reserve service and obtain Reserve personnel and medical records. 3. Thereafter, schedule the Veteran for a VA examination in order to determine the nature and etiology of the Veteran's bilateral ankle disability. The examiner must review the claims file in its entirety, to include a copy of this REMAND, and that review must be noted in the report. The examiner is requested to provide an opinion as to whether the Veteran's bilateral ankle disabilities are causally or etiologically related to his military service, to include any injury or symptomatology therein. The examiner must discuss the Veteran's assertions that he has had bilateral ankle pain continuously since service and that his bilateral ankle disability is a result of the numerous jumps out of helicopters and airplanes. The examiner must provide a complete rationale for any opinions offered, citing to the examiner's own expertise, medical principals, and/or evidence in the Veteran's record, when necessary, to support the conclusion reached. If an opinion cannot be reached without resorting to speculation, the examiner must fully explain why that is so. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.D. 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.