Citation Nr: A25041290 Decision Date: 05/06/25 Archive Date: 05/06/25 DOCKET NO. 240311-423807 DATE: May 6, 2025 ORDER Entitlement to a compensable disability rating for residuals of a left eyelid laceration scar is denied. FINDINGS OF FACT 1. The Veteran does not experience any of the characteristics of disfigurement as a result of his service-connected residuals of a left eyelid laceration scar. 2. The Veteran's service-connected residuals of a left eyelid laceration scar do not result in any compensable disability due to his complaint of intermittent interference with his peripheral vision as a result of left eye ptosis (or drooping eyelid). CONCLUSION OF LAW The criteria for a compensable disability rating for residuals of a left eyelid laceration scar have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.75 4.79, 4.118, Diagnostic Codes (DCs) 6019 and 7800. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran had active U.S. Air Force service from October 1998 to January 1992, including in the Southwest Asia theater of operations during the Persian Gulf War. He also had active U.S. Army service from September 2008 to September 2009, including in combat in Iraq during Operation Iraqi Freedom. His medals include the Iraq Campaign Medal with Campaign Star and the Combat Infantryman Badge. In November 2023, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of a claim of entitlement to a compensable disability rating for residuals of a left eyelid laceration scar most recently addressed in an April 2023 rating decision. In March 2024, the Agency of Original Jurisdiction (AOJ) issued the supplemental claim decision on appeal which essentially found that new and relevant evidence had been received and denied the claim based on the evidence of record at the time of that decision. Later that same month, in the March 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board only may consider the evidence of record at the time of the March 2024 AOJ supplemental claim decision on appeal. 38 C.F.R. § 20.301. If evidence was submitted after the AOJ issued the supplemental claim decision on appeal, then the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, then he may file a Supplemental Claim (VA Form 20 0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. Neither the Veteran nor his representative has raised any other issues nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that Board not required to address issues unless specifically raised by claimant or reasonably raised by record evidence). The Veteran specifically contends that this disability results in intermittent interference with his peripheral vision due to a drooping left eyelid (or ptosis) by the end of the day. However, the record evidence shows instead that his service-connected residuals of a left eyelid laceration scar are not manifested by any of the characteristics of disfigurement as a result of his service-connected residuals of a left eyelid laceration scar. These findings support the zero percent rating currently assigned for this disability under DC 7800. See 38 C.F.R. § 4.118, DC 7800. The record evidence also shows instead that he does not experience any compensable disability due to his complaint of intermittent interference with his peripheral vision due to left eye ptosis (or drooping eyelid) which he attributes to his service-connected residuals of a left eyelid laceration scar. In other words, although the record evidence indicates that he experiences intermittent interference with his peripheral vision when his left eyelid droops down over his left eye by the end of the day, the Veteran also is not entitled to a separate compensable rating for his complaint of visual impairment which he attributes to the service-connected residuals of a left eyelid laceration scar even under the applicable DC for visual impairment due to ptosis. See also 38 C.F.R. §§ 4.75 4.79, DC 6019. On VA ophthalmology outpatient treatment visit in January 2023, the Veteran complained of "a constant feeling like there is something in the eyes" with the left eye worse than the right eye and "a drooping of the lids" with the left eye worse than the right eye. "He states that he sustained facial trauma while deployed and had surgical repair of facial lacerations in Italy. He feels that [his] lid droops more as the day progresses." Physical examination showed full and smooth bilateral eye motility, full visual fields to confrontation bilaterally, pupils equal, round, and reactive to light and accommodation, and no afferent pupillary defect. Slit lamp examination of the eyes showed normal bilateral eyelids, lid ptosis in the left eye greater than the right eye "with mild hooding noted" in the left eye, no corneal tears bilaterally, clear corneas and conjunctiva bilaterally, a follicular reaction with conjunctival concretions bilaterally, deep and quiet anterior chambers bilaterally, and flat irises bilaterally. Visual field testing was normal bilaterally. The assessment included brow ptosis with secondary lid ptosis, left eye greater than right eye. On VA scars Disability Benefits Questionnaire (DBQ) in March 2023, the Veteran's complaints included feeling that the left eyelid was "dropping down over [the] eye." The VA examiner reviewed the Veteran's electronic claims file, including service treatment records and post-service VA treatment records. The Veteran denied receiving any treatment for his complaints. He stated that he noticed "something partially covering [his] eye by [the] end of [the] day." Physical examination showed a 1 x 0.2 centimeter (cm) left eyelid scar which was not painful, unstable, due to burns, or elevated, depressed, or adherent to underlying tissue or missing underlying soft tissue, no abnormal pigmentation, no tenderness to palpation, no gross distortion or asymmetry of facial features or visible or palpable tissue loss, and no limitation of function (to include limitation of motion). The VA examiner stated that the Veteran's scar did not impact his ability to work. The diagnosis was left upper eyelid scar. On VA scars DBQ in January 2024, the Veteran stated that he incurred a left eyelid laceration at the time of an in-service motor vehicle accident. "The laceration itself does not hurt, however, Veteran states that as a result his eyelid droops down which blocks some of his vision." The VA examiner reviewed the Veteran's electronic claims file, including service treatment records and post-service VA treatment records. Physical examination showed a 1 x 0.3 cm left upper eyelid scar which was not painful, unstable, due to burns, elevated, depressed, or adherent to underlying tissue or missing underlying soft tissue, no abnormal pigmentation, no tenderness to palpation, no gross distortion or asymmetry of facial features or visible or palpable tissue loss, and no limitation of function (to include limitation of motion). The VA examiner stated that the Veteran's scar impacted his ability to work. This examiner described the impact of the Veteran's scar on his ability to work as, "Drooping of eyelid at times blocks his peripheral vision which makes it more difficult to see during certain activities." This examiner also stated that the Veteran experienced "intermittent vision impairment as the eyelid droops down" due to his service-connected left eyelid scar. The diagnosis was left upper eyelid laceration. The Board does not doubt that the Veteran finds that the symptomatology attributable to his service-connected residuals of a left eyelid laceration scar may interfere intermittently with his peripheral vision as the eyelid droops down over his left eye by the end of the day. However, the record evidence shows that his service-connected residuals of a left eyelid laceration scar are not manifested by any of the characteristics of disfigurement as is required for a compensable disability rating under DC 7800. See 38 C.F.R. § 4.118, DC 7800. The Board acknowledges here that the January 2024 VA scars DBQ examiner found that the Veteran experienced intermittent interference with his peripheral vision when his left eyelid drooped down as a result of his service-connected residuals of a left eyelid laceration scar. Nevertheless, the record evidence (VA ophthalmology outpatient treatment visit in January 2023) also shows that he does not experience any compensable disability due to his complaint of visual impairment as a result of left eye ptosis (or drooping eyelid). In other words, despite his complaints of a drooping left eyelid intermittently interfering with his peripheral vision by the end of the day, he is not entitled to a separate compensable rating for service-connected residuals of a left eyelid laceration scar even under the applicable DC for visual impairment due to ptosis. See also 38 C.F.R. § 4.79, DC 6019. The Board notes in this regard that ptosis is evaluated under DC 6019 based either on visual impairment or, in the absence of visual impairment, disfigurement (under DC 7800). Id. The Board also notes in this regard that, generally, a Veteran's visual impairment is evaluated based on impairment of central visual acuity and visual field defect. Here, the VA ophthalmologist found no impairment of the Veteran's central visual acuity or visual field defect when examining his vision on outpatient treatment in January 2023. In other words, the Veteran does not experience either visual impairment (as defined in the Rating Schedule) or disfigurement as a result of his service-connected residuals of a left eyelid laceration scar such that a compensable disability rating is warranted under either DC 6019 or DC 7800. The Board next acknowledges that the January 2024 VA scars DBQ examiner concluded that the Veteran's service-connected residuals of a left eyelid laceration scar impacted his ability to work because he experienced "intermittent vision impairment as the eyelid droops down." This examiner also found that the Veteran had no limitation of function, to include limitation of motion, as a result of this disability. The Veteran does not contend - and the evidence does not show - that he was precluded from working as a result of his service-connected residuals of a left eyelid laceration scar. More importantly, the Veteran denied experiencing any pain or undergoing any treatment for this disability. Taken together, the evidence persuasively suggests that the Veteran does not experience any compensable disability due to his service-connected residuals of a left eyelid laceration scar such that he is entitled to a compensable disability rating under either the rating criteria for evaluating scars or visual impairment. The evidence persuasively weighs against the claim. Therefore, the benefit of the doubt rule does not apply. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). In summary, the Board finds that the criteria for a compensable disability rating for residuals of a left eyelid laceration scar have not been met. The appeal is denied. S. Sorathia Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael T. Osborne, 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.