BVA9507367 DOCKET NO. 91-20 405 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Washington, DC THE ISSUES Entitlement to service connection for a back disorder, for headaches, and for a bilateral eye disorder, to include a disorder of the eyelids. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD D. B. Weiss, Associate Counsel INTRODUCTION The veteran had active military service from July 1973 to July 1975. The Board of Veterans' Appeals (Board) notes that the substantive appeal raises issues of service connection for insomnia and an increased rating for a tongue disability. These issues are not developed for appellate review. The matters are not inextricably intertwined with the issues on appeal, and are referred to the regional office for adjudication. For the sake of brevity, the Board will refer hereinafter to the claimed bilateral eye disorder with a disorder of the eyelids as simply an eye disorder. CONTENTIONS OF APPELLANT ON APPEAL In March 1989, the veteran contended that he had eye problems including blurred vision and spots in his visual field, and back pain as a result of his experiences as a boxer in service. In April 1991, the representative argued that the veteran received blows to his head and body and was near an explosion in service, which resulted in headaches, defective vision, and a back disorder. At his personal hearing, the veteran additionally claimed that he was treated in service for eyelid problems. In March 1995, the representative requested that an independent medical expert's opinion be sought in the case, as no medical opinion of record links the claimed disorders to service. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the veteran has not presented well grounded claims for service connection. FINDINGS OF FACT 1. A back disorder, headache, or an eye disorder were not shown in service; the veteran has not submitted competent evidence to link any of the relevant post-service disorders, which were first shown many years after service, to service. 2. Refractive error is not a disease or injury under the law. CONCLUSION OF LAW The claims for service connection for a back disorder, a headache disorder, and an eye disorder are not well grounded. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSION Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131 (West 1991). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (1994). Congenital or developmental defects such as refractive error are not diseases or injuries within the meaning of the applicable legislation. 38 C.F.R. § 3.303(c) (1994). The threshold question to be addressed regarding the service connection claims is whether the veteran has presented well grounded claims. If he has not presented well grounded claims for service connection, then the appeal must fail and there is no duty to assist him further in the development of the claims. 38 U.S.C.A. § 5107(a); Murphy v. Derwinski, 1 Vet.App. 78 (1992). Case law provides that although a claim need not be conclusive to be well grounded, it must be accompanied by evidence. A claimant must submit supporting evidence that justifies a belief by a fair and impartial individual that the claim is plausible. Tirpak v. Derwinski, 2 Vet.App. 609, 611 (1992); Dixon v. Derwinski, 3 Vet.App. 261, 262 (1992). The quality and quantity of the evidence required to meet this statutory burden of necessity will depend upon the issue presented by the claim. Where the issue is factual in nature, e.g., whether an incident or injury occurred in service, competent lay testimony, including a veteran's solitary testimony, may constitute sufficient evidence to establish a well-grounded claim under [38 U.S.C.A. §] 5107(a). See Cartright v. Derwinski, 2 Vet.App. 24 (1991). However, where the determinative issue involves medical causation or a medical diagnosis, competent medical evidence to the effect that the claim is "plausible" or "possible" is required. See Murphy v. Derwinski, 1 Vet.App. 78, 81 (1990). A claimant would not meet this burden imposed by section 5107(a) merely by presenting lay testimony because lay persons are not competent to offer medical opinions. Espiritu v. Derwinski, 2 Vet.App. 492 (1992). Consequently, lay assertions of medical causation cannot constitute evidence to render a claim well grounded under section 5107(a); if no cognizable evidence is submitted to support a claim, the claim cannot be well grounded. Tirpak, 2 Vet.App. at 611. If the claim is not well grounded, the claimant cannot invoke the VA's duty to assist in the development of the claim. See 38 U.S.C.A. § 5107(a) (West 1991); Rabideau v. Derwinski, 2 Vet.App. 141, 144 (1992). Grottveit v. Brown, 5 Vet.App. 91, 92-93 (1993). Service medical records reveal that at enlistment examination in July 1973, the veteran had no pertinent abnormality, except that his distant right and left eye vision was 20/100, and 20/70, respectively. The veteran advised that he wore glasses but did not have them with him. He gave a history of having had swollen or painful joints and bone, joint, or other deformity. He denied a history of frequent or severe headaches, or recurrent back pain. It appears that he initially indicated that he had had eye trouble but then erased this response and indicated no history of eye trouble. Service records of July and November 1973 indicate that prescriptions for glasses were written for him. In March 1974, he was cleared for boxing by a boxing physical. In August 1974, a hand fracture was suspected due to a boxing experience. At separation examination in April 1975, the head and eyes were normal on examination, as was the spine. Distant visual acuity was 20/40 bilaterally. VA examination of the veteran in September 1975 revealed no pertinent history. The examination showed the head to be negative for abnormality, and showed no specific findings for the eyes and back, but the general medical examination was said to be within normal limits. On history forms for VA examination in August 1989 and in September 1990, the veteran complained of back pain, blurry vision, and headaches. At VA outpatient treatment in March 1988, the pertinent impression was muscle tension headaches with suspected psychogenic component. Degenerative joint disease of the cervical spine was diagnosed in October 1988. In March 1989, at the VA eye clinic, the assessment was refractive error with an otherwise normal examination. In July 1990, the veteran reported that he had diminished distant vision and gave a history of being a boxer in service. The impressions were myopia and astigmatism. The assessment in November 1990 was headaches. In February 1991, the assessment was back/neck pain with positive rheumatoid factor. The veteran complained of back and head pain of 3 days' duration in March 1991, and the diagnosis was ibuprofen induced gastritis. In July 1991, the veteran complained of pain in his back, and the impression was arthritis of unclear etiology. He gave a history of boxing for 2 years. At his hearing before a member of the Board in April 1992, the veteran testified that he fought 179 times as a member of the Bamberg Boxing Team in service. (transcript of hearing at page 4 or t. 4.) He testified that he received treatment for visual impairment in service from his team doctor, who was a military physician. This included treatment for swollen eyes, and at his last fight his doctor told him that his eyelids were so weak that he could lose his vision if he continued to fight. Therefore, he saw a military eye specialist. (t. 4-5, 14.) He did not receive any further eye or eyelid treatment in service. He had a VA eye examination in Washington, D.C., in 1975 after discharge from service, and glasses were prescribed. His next eye visit was in 1988. (t. 6.) At the 1988 visit, he received some rays (apparently a surgical procedure) in his eyes, which blinded him for a few hours. (t. 7.) He first noted headaches after boxing for 1-2 months in service. He used ice bags and aspirin for these, as was recommended to him. (t. 8.) He still has the headaches. (t. 9.) The cause of the headaches was being investigated by a VA neurologist. (t. 11.) He had problems in his upper back, neck, and lower back due to punches received in service. (t. 12.) He had received treatment for this in service, but it had not helped, and the pain continues. (t. 13- 14.) In May 1993, VA outpatient treatment records reflect, that the veteran sustained a laceration to his left eyebrow, for which he was treated with sutures. The veteran's service personnel records were received as part of the development of this appeal. They do not reflect a military occupational specialty of boxing. They show that the veteran's occupational speciality in service was as a combat engineer. After review of the evidence, the Board finds that although it is undisputed that the veteran boxed in service, there is no objective evidence of any back disorder, headache, or eye disorder in service, nor of any evidence of same for years after service. The currently shown disorder of the eyes, refractive error, is not a disease or injury under the law in any case. 38 C.F.R. § 3.303(c). In this appeal, the question is whether the claimed disorders began in service. See 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303(d). The answer to this question requires medical findings because the problems complained of first became manifest years after service. That is, the traumatic boxing events alleged to have occurred so long ago may not simply be presumed to cause current medical difficulties today. See Murphy v. Derwinski, 1 Vet.App. 78, 81 (1990). The Board's decision makers "may consider only independent medical evidence to support their [medical] findings." Colvin v. Derwinski, 1 Vet.App. 171, 175 (1991). The veteran, as a medically untrained person, is not qualified to render an opinion of evidentiary weight as to the etiology of his current medical problems. See Espiritu v. Derwinski, 2 Vet.App. 492, 494 (1992). Consequently, his hearing testimony is credible insofar as it tends to establish that he sustained trauma boxing in service. However, insofar as it relates any current disability to boxing injuries in service, the veteran's testimony is not competent evidence. The medical treatment records and the VA examinations are silent for any etiological link between the claimed post- service health problems and service or any events therein. Under the circumstances of this appeal, competent evidence of an etiological relationship between the veteran's current back, head, and eye condition and service must be presented in order for the claims to be well grounded. Such evidence is not of record. Accordingly, the claims are not well grounded, and no further duty to assist in the development of the claims arises. Rabideau v. Derwinski, 2 Vet.App. 141 (1992). ORDER The claims for service connection for a back disorder, headaches, and a bilateral eye disorder are dismissed. GEORGE R. SENYK Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.