Citation Nr: 23049167 Decision Date: 09/07/23 Archive Date: 09/07/23 DOCKET NO. 16-17 953 DATE: September 7, 2023 ORDER Service connection for residuals of eye injury, identified as diagnosed cystoid macular edema (CME), is denied. FINDING OF FACT The evidence persuasively weighs against finding that the Veteran's currently diagnosed CME was incurred in or is the result of any incident, disease, or injury in service. CONCLUSION OF LAW The criteria for service connection for CME have not been met. 38 U.S.C. § 1110, 5107 (2012); 38 C.F.R. § 3.102, 3.303 (2022). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1978 to October 1982. This matter is on appeal of a March 2015 rating decision. In May 2018, a hearing was held before the undersigned. A transcript of the hearing is of record. The Board remanded the appeal for further development in September 2018, September 2020, August 2021, August 2022, December 2022, and April 2023. As the Veteran's claims for service connection for glaucoma, cataracts, corneal edema, diabetic retinopathy, diabetic macular edema, and blepharitis were denied in the April 2023 Board decision, his claim for service connection for CME is the only eye disability that remains on appeal. Service Connection The Veteran and his attorney contend that his currently diagnosed CME either had its onset during service and/or is the result of an in-service injury. The Veteran asserts that he injured his right eye in service on the firing range when his weapon blew up in his face. Service connection may be granted for disability resulting from disease or injury incurred or aggravated during active military service. 38 U.S.C. § 1110. Generally, service connection requires (1) the existence of a present disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). The claims file reflects that the Veteran has been diagnosed with CME as early as May 2016. The first requirement for service connection, a current disability, has been met. Initially, the Veteran's service treatment records (STR) show no relevant complaints, findings, treatment, or diagnoses. However, post-service private treatment records indicate the Veteran reported welding accidents at work that resulted in his being diagnosed with a metal foreign body in the right eye in April 1990, a superficial foreign body in the left eye in June 1991, and with metal in the left eye in October 1998. Post service periodic reports of medical history for the Army Reserve and/or Massachusetts National Guard, dated in February 1993 and October 2003 show the Veteran denied any eye disorders or trouble. A February 1993 Army Reserve periodic medical examination report indicates that a general clinical evaluation of the Veteran's eyes was normal. During his May 2018 hearing, the Veteran testified that he injured his eyes when his weapon blew up in his face on the firing range at Fort Stewart, Georgia in 1980. He was treated onsite by a medic who told him he was lucky not to lose his right eye. The Veteran testified that this is the only trauma he remembers to his eyes. A May 2023 VA examiner, after reviewing the Veteran's claims file in conjunction with the examination, opined that it was less likely than not that his diagnosed CME was incurred in or caused by any in-service injury, event or illness. The examiner opined that the timing of the Veteran's newly diagnosed CME of the left eye was more consistent with his recent cataract surgery and diabetic retinopathy. Citing to medical articles, the clinician noted that macular edema can occur months after cataract surgery. The examiner also noted that the risk of CME increases with longer duration of diabetes mellitus. Because more recent eye records of cataract extraction and CME management were not of record, it was uncertain whether the Veteran's CME of the left eye was a complication of cataract surgery alone or due to a combination of his cataract surgery and diabetic retinopathy. The Board finds the May 2023 VA examiner's opinion and rationale most persuasive. The examiner's opinion is probative because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting rationale. As such, the Board gives much probative weight to the VA examiner's opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008). Moreover, there is no medical evidence of record in support of the Veteran's claim. Likewise, the Board acknowledges the Veteran's reported history in VA treatment records, as well as his testimony during the May 2018 hearing that he injured his eyes in an accident on the firing range during his service and that he did not recall any eye injuries since then. While the Veteran is competent to describe observable symptoms and injuries, he is not competent to address whether any current eye disability, particularly his diagnosed CME, is the result of any alleged eye injuries in service as the issue is medically complex and requires specialized medical education and knowledge. See Layno v. Brown, 6 Vet. App. 465, 469 (1994); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (explaining in footnote 4 that a veteran is competent to provide a diagnosis of a simple condition such as a broken leg, but not competent to provide evidence as to more complex medical questions); cf. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011). As such, the Board finds that the weight of the evidence is persuasively against the Veteran's claim for service connection for residuals of an eye injury identified as diagnosed CME. The Board has considered the benefit-of-the-doubt rule; however, since the weight of the evidence is persuasively against the Veteran's claim, the benefit-of-the-doubt rule is not for application. 38 U.S.C. § 5107(b); see Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Wells-Green, Lori 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.