BVA9505046 
DOCKET NO.  93-05 880     )       DATE
          )
          )

On appeal from the decision of the
Department of Veterans Affairs Regional Office in St. Petersburg,
Florida

THE ISSUE

Entitlement to service connection for a right knee and thigh
disorder; residuals of a left eye injury, including a
subconjunctival hemorrhage; bilateral astigmatism; a left lung
disorder; and a colon disorder.

REPRESENTATION

Appellant represented by: Florida Department of Veterans
Affairs

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

R. T. Jones, Counsel
INTRODUCTION

The veteran served on active duty from September 1982 to March
1989.

This matter comes to the Board of Veterans' Appeals (Board) from
rating decisions of the Department of Veterans Affairs (VA)
Regional Office (RO) in St. Petersburg, Florida, which denied
service connection for a right knee disorder (also claimed as a
right thigh disorder), residuals of left eye injury (including a
subconjunctival hemorrhage), astigmatism of both eyes, a left
lung disorder, and a colon disorder.

The veteran's appeal also initially included an issue of
entitlement to an increased (compensable) rating for a service-
connected left knee disability.  The RO has since assigned a
10 percent rating for that disability, and the file indicates
that the veteran is no longer appealing for a higher rating for
that disability.

A December 1992 decision by an RO hearing officer granted service
connection for a scar above the left eye, and a subsequent
December 1992 RO rating decision assigned a zero percent rating
for this condition.  A February 1993 VA Form 1-9 from the
veteran, and a March 1993 VA Form 1-646 from his representative,
indicate that the veteran is disagreeing with the zero percent
rating.  The issue of entitlement to an increased (compensable)
rating for the scar above the left eye is not properly before the
Board at this time.  The RO should issue the veteran a statement
of the case on the matter, in accordance with 38 U.S.C.A.
§ 7105(a) (West 1991), to give him an opportunity to appeal by
filing a timely substantive appeal.

CONTENTIONS OF APPELLANT ON APPEAL

The veteran contends he was treated for his right knee and thigh
condition beginning in November 1982, during service, and this
condition remains symptomatic and has required treatment since
that time.  He asserts that, following a left eye injury with a
subconjunctival hemorrhage during service, he had residual
disability including defective vision of the left eye and
subsequent problems with his right eye as well.  The veteran
argues that astigmatism of both eyes is related to service.  He
states he was seen for colonic pain and blood in his stool during
service and continues to have these problems.  He asserts that a
spot on his left lung was discovered during a chest X-ray in
service, and he has a left lung disorder which started during
service.

DECISION OF THE BOARD

The Board, in accordance with 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 preponderance
of the evidence is against the claims for service connection for
a right knee and thigh disorder; residuals of a left eye injury,
including a subconjunctival hemorrhage; astigmatism of both eyes;
a left lung disorder; and a colon disorder.

FINDINGS OF FACT

1.  A chronic disability of the right knee and thigh was not
present during service of for more than a year later, and it was
not caused by any incident in service.

2.  The veteran had an acute and transitory left eye
subconjunctival hemorrhage during service, as the result of an
injury, which resolved without residual disability; he currently
has no residuals of a left eye injury.

3.  The veteran has astigmatism of both eyes, which is a
refractive error and not a disability for VA compensation
purposes.

4.  Chronic left lung and colon disabilities were not present
during service, and the veteran does not currently have chronic
left lung or colon disabilities.

CONCLUSIONS OF LAW

1.  A disability of the right knee and thigh was not incurred in
or aggravated by active service.  38 U.S.C.A. § 1131 (West 1991);
38 C.F.R. § 3.303 (1994).

2.  Residuals of a left eye injury (including a subconjunctival
hemorrhage) and bilateral astigmatism were not incurred in or
aggravated by active service.  38 U.S.C.A. § 1131; 38 C.F.R.
§ 3.303.

3.  Chronic left lung and colon disorders were not incurred in or
aggravated by active service.  38 U.S.C.A. § 1131; 38 C.F.R.
§ 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

I.  Factual Background

The veteran served on active duty from September 1982 to March
1989.

On a January 1982 pre-enlistment examination, the veteran's
distant vision was 20/20, bilaterally.  At the recruiting center
in September 1982, his vision was 20/25 in the right eye and
20/20 in the left eye.  No other pertinent defects were noted.

In November 1982, during service, the veteran was seen for a cut
of the left upper eyelid after hitting a door.  He had a 1-inch
cut along the left forehead with slight blood noted.  Stitches
were applied.  He returned to the emergency room of the base
hospital the next day with bleeding from his sutured laceration.
The wound was cleaned, and pressure to the wound area was
applied.  The laceration appeared to be healing well, and all
sutures were intact.  The diagnosis was minor bleeding from the
sutured laceration.  He was instructed to keep the laceration dry
and clean.  He reported to the medical clinic on multiple
occasions in November 1982, and it was noted the wound was
healing well, and the stitches were removed.  Later that month,
about two weeks after the injury, he was seen at the clinic,
complaining of seeing objects in his left eye.  The assessment
was a healed laceration near the left eyebrow and a
subconjunctival hemorrhage of the left eye.  He was referred to
the optometry clinic where a persistent subconjunctival
hemorrhage was noted.  One week later at the optometry clinic, in
November 1982, there was a notation of a healing subconjunctival
hemorrhage.  Uncorrected distant visual acuity was 20/30 in both
eyes; the impression was simple myopic astigmatism.  He was to
return to the clinic if the hemorrhage did not clear in 2 to
3 weeks.

At an optometry clinic in July 1983, the veteran complained of
blurred vision and reported he had been struck on the head in
November 1982.  Uncorrected distant visual acuity was 20/30 in
the right eye and 20/40 in the left eye, and new eyeglasses were
prescribed.  Other eye examinations in service showed his vision
was correctable to 20/20, bilaterally, and numerous prescriptions
for eyeglasses are of record.

At the optometry clinic in October 1983, he reported his vision
had been getting steadily worse since he was hit on his head.
Examination of the eyes was normal.  The diagnosis was compound
myopic astigmatism.  A prescription was given for eyeglasses.

The veteran was seen at a clinic in November 1983, complaining of
left frontal and temporal headaches.  The eyes were normal on
physical examination, except for some diminished visual acuity
without glasses, and the veteran denied visual problems.  The
assessment was migraine or tension headaches.  In June 1984, the
veteran reported that his eyes seemed to be getting worse and he
had to be closer to objects in order to see them.  His eyes were
examined, myopic astigmatism was noted, and he was given a new
prescription for eyeglasses.

The veteran was seen at the hospital emergency room in April 1985
after he sustained multiple puncture wounds to the legs from a
cactus.  Cactus thorns were removed from both legs, and the
records indicate the more serious wounds were on the left leg.
In August 1986, he was seen for complaints of periodic epigastric
abdominal cramping and bloating for the past 3 to 4 weeks.  He
had initially noted these symptoms after drinking alcohol, but
the symptoms had persisted even after he stopped drinking alcohol
for the past two weeks.  It was recommended that he discontinue
alcohol, avoid caffeine, nicotine, chocolate, gastric irritating
foods and drinks.  He was to return to the clinic if his systems
persisted or became worse, and at that time consideration would
be given to additional diagnostic testing.  The assessment was
mild gastritis (versus peptic ulcer disease versus
gastroenteritis).  In October 1987, the veteran complained he was
having trouble with his left eye following an earlier injury.  It
was reported that floaters seemed to be changing.  The assessment
was refractive error, bilaterally; it was noted that the eyes
were healed.

A report of December 1988 chest X-rays indicates the right
costophrenic angle was cut off the film, but the study was
otherwise normal.  An azygous lobe was incidentally noted.

In December 1988 and January 1989 the veteran was seen at a
clinic for evaluation of complaints of bright red blood from his
rectum on two recent occasions.  A barium enema showed an
unremarkable colon.  There was a question of a 7-millimeter small
filling defect in the sigmoid.  An anoscope showed a Grade I/II
hemorrhoid.  A proctoscope to 22 centimeters was within normal
limits, and a flexible sigmoidoscope to 70 centimeters was within
normal limits.  The assessment was normal examination with a mild
internal hemorrhoid.

In the report of the February 1989 service discharge examination,
it was noted that the veteran had decreased visual acuity which
was corrected to 20/20, bilaterally.  The previously reported
barium enema and colon and rectal evaluation were noted.  Later
in February 1989, the veteran had his eyes examined for decreased
visual acuity.  The eye examination was normal and it was noted
that he had defective visual acuity which was correctable to
20/20, bilaterally.  There was an assessment of myopic
astigmatism.

The veteran was discharged from service in March 1989.

In April 1989 the veteran was referred to the pulmonary clinic at
the National Naval Medical Center in Bethesda, Maryland, because
he had been told that he had an abnormal chest X-ray with a spot
on his left lung.  It was reported that chest X-rays showed the
right costophrenic angle was cut off but were otherwise within
normal limits.  The examiner interpreted the X-rays as being
normal and reassured the veteran.

In May 1990 the veteran applied for service connection for
residuals of injuries to the head, eyes, and right knee which he
stated occurred in November 1982.  He listed no treatment for any
of these claimed conditions following service.

On a June 1990 VA examination, the eyes and head were normal.
There was tenderness to the medial aspect of the right knee and
lower third of the right thigh with some numbness in this area.
On examination of the digestive system, including evaluation for
hemorrhoids, no abnormalities were reported.  Examination of the
respiratory system showed no cough or expectoration, and lung
expansion was good and equal.  The lungs were resonant
throughout, and breath sounds were normal with no rales.  X-rays
of the right knee were normal.  The examiner diagnosed residuals
of knee, head and eye injuries.

On a June 1990 VA ophthalmological examination, the veteran
reported he was having difficulty reading street signs and had
had a decrease of visual acuity for the past year.  He reported
an eye injury in 1982, and stated that he had had no vision after
the injury for days.  He stated that, following the injury, his
vision was blurred and he then had trouble with near vision in
his left eye.  Examination showed his visual acuity was 20/200,
bilaterally, without correction.  With correction, his vision
improved to 20/20, bilaterally.  The visual fields, all eye
structures, and dilated fundus examination were normal as to both
eyes.  The impression was myopic astigmatism.

VA outpatient treatment records in May and June 1991 relate
primarily to left knee complaints.  In May 1991 the veteran
reported that he had pain in his right hip, laterally down to his
right knee.  In June 1991 he was seen for a neurological
evaluation for right lower extremity complaints.  He gave a
history of experiencing numbness and burning pain in the lateral
portion of the right thigh since 1982 when he was in Navy boot
camp.  There was hyperesthesia in the lateral aspect of the right
thigh and the distribution of the lateral femoral cutaneous
nerve.  The impression was meralgia paresthetica.  He was advised
to lose weight and avoid tight pants.  It was reported that, if
he desired, he could be given nerve blocks to the lateral femoral
cutaneous nerve in the inguinal region.

The veteran testified at a hearing at the RO in June 1992.  He
said he had a small area of decreased sensation and tingling on
the side of his right knee during service which had expanded and
moved up his thigh in the last two or three years.  He said he
first noticed the problem when training in boot camp during
service.  The veteran said he was given Ben Gay and Tylenol for
the problem during boot camp, but did not receive any further
treatment during service.  He stated he reported the problem at
the time of his separation from service.  He related he had a
left eye injury during service and stated that he had a decrease
in vision following that injury and, because of the strain on the
left eye where he had a hemorrhage, additional strain caused
visual problems in his right eye as well.  The veteran noted he
had worn eyeglasses since the incident, with frequent
prescription changes due to worsening vision.  He reported
abdominal pain and discomfort for the past two years which he
related to previous bleeding from his rectum.  He stated he still
had occasional bleeding from his rectum.  He said he had
discomfort in the left lung and that a spot on the lung was found
by X-ray during service.

On an August 1992 VA compensation examination, it was noted the
veteran had paresthesia in the lateral aspect of the right leg
from the middle of the thigh to the knee.  Other findings related
to the left knee.  On the special intestinal examination, the
veteran reported he had had painless rectal bleeding since 1987,
but the cause of the bleeding had never been diagnosed.  He
reported he did not have diarrhea, constipation, or bowel or
abdominal disturbances.  The diagnosis was rectal bleeding of
unknown etiology with the examiner awaiting the results of a
barium enema, sigmoidoscopy, and blood count.  On the rectum and
digestive examination, he reported he currently had bleeding once
every week or two without soiling, incontinence, diarrhea,
tenesmus, dehydration, malnutrition, or fecal leakage.  The
diagnosis was rectal bleeding of unknown etiology, pending the
results of laboratory tests.  The file contains a notation that
the veteran did not show up for a scheduled barium enema and
sigmoidoscopy.

On an August 1992 VA peripheral nerve examination, it was
reported the veteran had peripheral neuritis that extended from
the right knee to the middle of the thigh, an area of about 8 by
2 inches.  The specific nerve could not be identified in the
right lower extremity.  The diagnosis was peripheral neuritis of
the lateral aspect of the right thigh.

On an August 1992 VA pulmonary examination, the veteran reported
that he had a chest X-ray in 1989 that showed a spot in his left
lung, and another X-ray later showed the spot was still there.
He said the etiology of the spot was not diagnosed.  Pulmonary
function testing showed no dyspnea or apparent pulmonary function
disorder.  The diagnosis was a spot of the left lung of unknown
etiology.  A subsequent chest X-ray in two views showed the lung
fields were clear.  There was an impression of a normal chest
with an incidental finding of an azygous lobe.

II.  Analysis

The claims for service connection are well grounded; that is,
they are not inherently implausible.  38 U.S.C.A. § 5107(a).
Facts relevant to the issues have been properly developed to the
extent possible, and the statutory obligation of the VA to assist
the veteran in development of the claims is satisfied.  Id.

In order to establish service connection for a claimed
disability, the facts, as shown by the evidence, must demonstrate
that a particular disease or injury resulting in current
disability was incurred in active service or, if preexisting
service, was aggravated therein.  38 U.S.C.A. § 1131.  If a
condition noted during service is not shown to be chronic, then
generally a showing of continuity of symptoms after service is
required for service connection.  38 C.F.R. § 3.303(b).

A.  Service Connection for a Right Knee and Thigh Disability

The veteran claims that he was treated for his right knee and
thigh condition in November 1982 and this condition was noted on
his service separation examination.  The service medical records
do not support the veteran's assertion, but rather show no right
knee or thigh problems, and the service discharge examination
makes reference only to the left knee condition.  The veteran did
not claim service connection for a right knee problem until more
than a year after he separated from service.  The veteran's
assertions notwithstanding, the lack of any notation of problems
with the right knee or thigh for over six years of service
following the alleged onset of the condition in boot camp, and
for more than a year following his discharge from service, shows
an absence of continuity of symptoms and is persuasive evidence
that the current nerve problem in the right knee and thigh area
began after service.  Mense v. Derwinski, 1 Vet.App. 354 (1991).

The veteran's currently diagnosed problem in the right thigh and
knee area is peripheral neuritis.  This condition was earlier
diagnosed as meralgia paresthetica, a disease marked by
paresthesia, pain and numbness in the outer surface of the thigh,
in the regions supplied by the lateral femoral cutaneous nerve,
due to entrapment of the nerve at the inguinal ligament.  See
Dorland's Illustrated Medical Dictionary, 1007 (27th ed. 1988).
This condition was first shown more than a year following the
veteran's separation from service, and there is no competent
medical evidence to link it to service.

The weight of the evidence establishes that the right knee and
thigh disorder was not incurred in or aggravated by service.  As
the preponderance of the evidence is against the claim, the
benefit-of-the-doubt doctrine does not apply, and service
connection for a right knee and thigh disability must be denied.
38 U.S.C.A. § 5107(b); Gilbert v. Derwinski, 1 Vet.App. 49
(1990).

B.  Service Connection for Residuals of a Left Eye Injury,
including a Subconjunctival Hemorrhage, and for Bilateral
Astigmatism

The veteran asserts he has a decrease in his visual acuity in his
eyes as a result of a blow to the left eye area during service.
The service medical records show that he did sustain an injury,
and service connection has been granted for a scar above the left
eye.  As a result of the injury, he had a subconjunctival
hemorrhage in the left eye in service, but the medical evidence
shows this cleared without any residual disability.  The veteran
has been seen on a number of occasions for complaints of
decreased visual acuity; however, on every occasion, his
decreased visual acuity has been shown to involve refractive
error of astigmatism.  The June 1990 VA ophthalmological
examination showed the veteran had myopic astigmatism with vision
correctable to normal with prescription eyeglasses.  Refractive
error of the eye is not a disease or injury within the meaning of
legislation provided for compensation benefits.  38 C.F.R.
§ 3.303(c).  The medical evidence, including the 1990 VA eye
examination, shows no structural damage or any residuals of
injury to either eye.  As to the veteran's assertion that
decrease in visual acuity is a result of the injury in service,
he is a layman and is incompetent to give a medical opinion on
diagnosis or etiology of a condition.  Espiritu v. Derwinski,
2 Vet.App. 492 (1992).

With regard to the claimed residuals of a left eye injury,
including a subconjunctival hemorrhage, the evidence shows that
no current residuals exist, and thus service connection is
precluded.  Rabideau v. Derwinski, 2 Vet.App. 141 (1992).  As to
bilateral astigmatism, this refractive error is not a disability
which may be service connected.  38 C.F.R. § 3.303(c).

As the preponderance of the evidence is against the claim for
service connection for residuals of a left eye injury, including
a subconjunctival hemorrhage, and bilateral astigmatism, the
benefit-of-the-doubt doctrine does not apply, and the claim must
be denied.  38 U.S.C.A. § 5107(b); Gilbert, supra.

C.  Entitlement to Service Connection for a Lung Disability

The service medical records show no chronic lung disability.  A
December 1988 chest X-ray in service showed normal lungs.  An
azygous lobe was incidentally noted, but this is merely a
congenital or developmental anomaly for which service connection
is precluded.  38 C.F.R. § 3.303(c).  The veteran asserts that he
had a spot on his left lung which was shown by X-ray near the
time he was discharged from service.  This assertion, or at least
the veteran's belief that a chest X-ray showed a spot on his
lung, is supported by the record of his visit to a Naval Medical
Center in April 1989 when he sought pulmonary consultation to
explain this purported finding.  The chest X-ray, however, was
interpreted by the examiner as being normal and the doctor
reassured the veteran.  An August 1992 VA pulmonary examination
noted no pulmonary disorder, and a chest X-ray was interpreted as
being normal, with an incidental finding of an azygous lobe.  No
spot on the lung or any pulmonary disorder was found.

The preponderance of the evidence establishes that the veteran
currently does not have a chronic lung disability, due to service
or otherwise.  As the preponderance of the evidence is against
the claim, the benefit-of-the-doubt doctrine does not apply, and
service connection must be denied.  38 U.S.C.A. § 5107(b);
Gilbert supra.

D.  Entitlement to Service Connection for a Colon Disorder

The evidence shows the veteran was treated once in service for
mild gastritis, apparently associated with drinking alcohol, but
no related chronic disability is shown.  He was later evaluated
for reported rectal bleeding prior to his discharge from service.
At that time, it was shown the veteran had a small internal
hemorrhoid, but after extensive studies no identifiable colon
disability was identified.  The problem was noted by history only
at the time of the 1989 discharge examination.  No colon disorder
was found at a 1990 VA examination.  VA examinations in 1992
listed a diagnosis of rectal bleeding of unknown etiology, but
this was based only on history, and no abnormal objective
findings were reported.  The veteran did not report for a
scheduled barium enema and sigmoidoscopy which had been order as
part of the examination to assist in diagnosis.  In this regard,
while the VA has a duty to assist the veteran in development of
facts pertinent to his claim, the veteran also has a duty to
assist in cooperating in developing evidence.  The duty to assist
is not a one-way street.  Wood v. Derwinski, 1 Vet.App. 190
(1991).  It is incumbent upon a veteran to submit to VA
examinations when applying for compensation.  38 C.F.R. §§ 3.326,
3.327, 3.655.  Here, the veteran, without just cause, failed to
cooperate by reporting for scheduled diagnostic studies.

The existing record does not substantiate the current existence
of a chronic colon disorder, let alone relate it to service.  The
preponderance of the evidence establishes that the claimed
condition was not incurred in or aggravated by service.  Thus,
the benefit-of-the-doubt doctrine is not applicable, and the
claim for service connection must be denied.  38 U.S.C.A.
§ 5107(a); Gilbert, supra.

ORDER

Service connection for a right knee and thigh disorder, residuals
of a left eye injury including a subconjunctival hemorrhage,
astigmatism of both eyes, a left lung disorder, and a colon
disorder is denied.

          L. W. TOBIN
          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.