DISEASES OF CONJUNCTIVA KERATITIS AND CORNEAL OPACITIES

WILLIAM H. DONNELLY · 2026 · Case ID: 26005089

DENIED

Summary

The veteran, who served in the U.S. Army from July 1973 to July 1976, appeals the denial of service connection for an eye disability, claimed as jaundice of the eyes, and a respiratory disability, claimed as COPD and bronchitis. The Board reviewed multiple VA examinations and treatment records. For the eye condition, the veteran reported blurry vision and jaundice around the time of an in-service kidney infection, but service records noted only conjunctival injection and hypotension, with a normal eye evaluation at separation. Post-service records noted dry eyes. A VA examiner in December 2025 opined that the veteran's cataracts and dry eye syndrome were age-related and not linked to service, noting jaundice is a side effect of systemic disease and not debilitating. The Board found this opinion probative and consistent with service records, denying service connection for the eye condition. For the respiratory condition, service records were silent for COPD or bronchitis, but noted chest pain and breathing difficulties diagnosed as muscle spasms and acid reflux. Multiple VA examinations provided negative nexus opinions, attributing the veteran's COPD and bronchitis to his significant smoking history, which began during service. The Board found the veteran's claims of in-service onset and diagnosis of small air passage disease not credible, as they were inconsistent with service records and post-service medical evidence. The Board also noted that service connection for tobacco-related conditions is precluded by law. Service connection for both the eye and respiratory conditions was denied.

Rationale

No diagnosis of jaundice during service or post-service.; Cataracts and dry eyes diagnosed nearly 40 years after service.; Examiner opined conditions were age-related and not linked to service.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

17-62 150

Full Decision Text

Citation Nr: 26005089
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 17-62 150
DATE: April 30, 2026

ORDER

Entitlement to service connection for an eye disability, claimed as jaundice of the eyes, is denied.

Entitlement to service connection for a respiratory disability, to include chronic obstructive pulmonary disease (COPD) and bronchitis is denied.

FINDINGS OF FACT

1. The Veteran's eye disability did not begin during active service, nor is it otherwise related to an in service injury, event, or disease.

2. The Veteran's respiratory disability did not begin during active service, nor is it otherwise related to an in service injury, event, or disease.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for an eye disability, claimed as jaundice of the eyes have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137,5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for entitlement to service connection for a respiratory disability, to include chronic obstructive pulmonary disease and bronchitis have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137,5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active duty service with the U.S. Army from July 1973 to July 1976. This case comes before the Board of Veterans' Appeals (Board) on appeal from a December 2012 rating decision of the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ).

The Veteran testified at an October 2021 hearing held before the undersigned via videoconference. A transcript of the hearing is associated with the claims file.

In January 2022, August 2022, January 2023, and September 2023, the Board remanded this matter for additional development.

In May 2024, the Board denied service connection for an eye disability and a respiratory disability. The Veteran filed an appeal to the Court of Appeals of Veterans Claims (the Court). In May 2025, on the basis of a Joint Motion for Remand (JMR), the Court vacated and remanded the Board's decision for further consideration. In October 2025, the Board remanded this matter for further action consistent with the terms of the joint motion. The matter is now before the Board again for further appellate review.

Following issuance of a December 2025 Supplemental Statement of the Case (SSOC), the Veteran filed a timely VA Form 20-0996, Request for Higher-Level Review in March 2026. The form failed to request review of a specific decision, and simply recited argument regarding the etiology and onset of respiratory symptoms. He also submitted additional VA treatment records. The Board finds this filing is inadequate to opt the appeal into the Appeal Modernization Act (AMA) system from the Legacy system. Although timely, the filing is too indefinite to determine the Veteran's intent; it fails to specify the desire to opt the SSOC to the AMA, and the submission of additional evidence is contrary to the election of higher level review, which would close the record at the time of the SSOC. 38 C.F.R. §§ 3.2400, 3.2500.

Service connection will be granted if it is shown that the veteran suffers from a disability resulting from personal injury suffered or disease contracted in the line of duty, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty, during active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Disorders diagnosed after discharge will still be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d); see also Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994).

For secondary service connection, it must be shown that the disability for which the claim is made is proximately due to or aggravated by a service-connected disability. See 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc).

Some chronic diseases
. § 3.303. Disorders diagnosed after discharge will still be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d); see also Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994).

Some chronic diseases may be presumed to have been incurred in service, if they become manifest to a degree of ten percent or more within the applicable presumptive period. 38 U.S.C. §§ 1101(3), 1112(a); 38 C.F.R. §§ 3.307(a), 3.309(a). For those listed chronic conditions, a showing of continuity of symptoms affords an alternative route to service connection. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F. 3d 1331 (Fed. Cir. 2013). The claimed condition is not among the listed chronic diseases.

Congenital or developmental defects, such as refractive error of the eyes, are not diseases or injuries within the meaning of applicable legislation and, thus, are not disabilities for which service connection may be granted. 38 C.F.R. § 3.303(c); see also 38 C.F.R. § 4.9. Refractive errors are defined to include astigmatism, myopia, hyperopia, and presbyopia. As such, service connection is not available for vision problems attributable to refractive errors. Absent superimposed disease or injury, service connection may not be allowed for a congenital or developmental defect of the eyes, 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. Parker v. Derwinski, 1 Vet. App. 522 (1991); McNeely v. Principi, 3 Vet. App. 357, 364 (1992).

Determinations as to service connection will be based on review of the entire evidence of record, to include all pertinent medical and lay evidence, with due consideration to VA's policy to administer the law under a broad and liberal interpretation consistent with the facts in each individual case. 38 U.S.C. § 1154(a); 38 C.F.R. § 3.303(a).

Eye Disability

Service treatment records (STRs) document that the Veteran was seen for eye complaints. In June 1974, the Veteran complained of blurry vision, which had been coming and going "for a long time now." The doctor attributed the complaints to "hypertension." The Board notes, however, that recorded blood pressures are actually low, and in April 1974 he was diagnosed with hypotension. It appears therefore that the June notation is an error in word choice. In January 1976 the Veteran was referred for an eye examination. The Veteran reported that he was feeling down and had a yellow tint in his eye around his pupils. The Veteran was evaluated and was shown to have normal visual acuity in his eyes. The Veteran was assessed with rule out yellow jaundice hepatitis. The July 1976 separation examination had a normal eye evaluation.

Post service treatment records documented that the Veteran was seen and treated for an eye condition. A February 2014 VA treatment record noted that he had an impression of dry eyes.

Since the initiation of the claim in May 2012, the Veteran has undergone multiple VA examinations. All have been found inadequate for VA purposes with respect to the question of a nexus, and are therefore not discussed herein.

In October 2021, he testified that he had blurred vision for a long time. He stated that he had jaundice/blurry vision around the time he had a kidney infection.

In December 2023, the Veteran was afforded a VA examination. He was diagnosed with age related nuclear cataract and dry eye syndrome of bilateral lacrimal glands. The Veteran reported that his condition started with jaundice and blurred vision. The examiner opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner noted that the Veteran was seen during service for conjunctival injection (redness of eyes), which was a separate and unrelated to jaundice (yellowing of the eyes). The Veteran was only diagnosed with age-related cataracts (causing mildly reduced vision) and dry eyes. The examiner explained that both conditions were diagnosed nearly 40 years after service, and cataracts were caused by age, and dry eyes were multifactorial in nature and a combination of systemic and environmental factors. The examiner concluded that there was no evidence to suggest any correlation or link between service and his current diagnoses, and no diagnosis of jaundice.

In October 2025, the Board remanded this matter to obtain a VA examination and opinion. The Board found that a remand was warranted for a new examination and opinion to comply with the September 2023 Remand Order. The Board found that the December 2023 examiner did not address the Veteran's reports of blurry vision and the June 1974 STR.

During the December 2025 VA examination, the Veteran reported that he had jaundice in 1974. The Veteran complained of cloudy vision at that time. The Veteran was currently diagnosed with cataracts. The examiner provided a negative nexus opinion. The examiner explained that jaundice was the yellowing of the sclera of the eyes or skin. The examiner noted that the Veteran did not have a diagnosis of jaundice during the present examination. The examiner remarked that jaundice was a side effect of a systemic disease and was not debilitating. The examiner indicated that jaundice did not cause eye or vision abnormalities described as blurry vision, loss of vision, pain, loss of field vision, or blindness. The examiner indicated that the Veteran' cataracts was most likely from his age or age related circumstances. The examiner explained that cataracts were the hardening of the natural lens in the eye. The examiner concluded that the Veteran's disability was not related to service, to include eye problems in June 1974.

The examiner also provided a negative toxic exposure risk activity (TERA) opinion. The examiner indicated that there was no evidence that a TERA caused the Veteran's eye condition. There was no medical or scientific evidence available that provided any indication of a relationship between the development of the Veteran's eye disability and the TERA.

Although laypersons are sometimes competent to provide opinions on certain medical questions, the specific issue in this case falls outside the realm of common knowledge of a lay person as it involves making a definitive clinical determination of the nature and etiology of the Veteran's eye disability. See Kahuna v. Shinseki, 24 Vet. App. 428, 435 (2011). While the Veteran can describe that he experiences an eye disability, he is not able to provide competent evidence as to the etiology of his disability based on logic and reasoning, as opposed to direct observation.

The Veteran's refractive error is a congenital defect, which is not a disease warranting compensation, absent some superimposed disease or injury. While STRs show the Veteran had in-service eye complaints, the medical evidence does not demonstrate that these showed a superimposed condition that aggravated or otherwise caused him to develop his current eye conditions.

The Board finds the December 2025 opinion probative as it addressed the Veteran's contentions, reviewed the Veteran's file, and reviewed the Veteran's treatment as to his eye disability. The examiner concluded that the Veteran's disability was not related to service, to include the history of eye problems in June 1974. The examiner explained that jaundice did not cause eye or vision abnormalities described as blurry vision, loss of vision, pain, loss of field vision, or blindness. The Veteran concluded that the Veteran' cataracts was most likely from his age or age related circumstances. Such opinion is also consistent with the STRs, which associated blurry vision with low blood pressure. There is no competent and credible evidence linking the Veteran's current eye disability with service, to include the symptoms of jaundice and redness noted in STRs. No medical professional has rendered a nexus opinion, and in the absence of such, service connection is denied.

The persuasive evidence of record weighs against the claim of service connection. There is no reasonable doubt to be resolved in this case. 38 U.S.C. § 5107(b); 38 C.F.R. §
vision, pain, loss of field vision, or blindness. The Veteran concluded that the Veteran' cataracts was most likely from his age or age related circumstances. Such opinion is also consistent with the STRs, which associated blurry vision with low blood pressure. There is no competent and credible evidence linking the Veteran's current eye disability with service, to include the symptoms of jaundice and redness noted in STRs. No medical professional has rendered a nexus opinion, and in the absence of such, service connection is denied.

The persuasive evidence of record weighs against the claim of service connection. There is no reasonable doubt to be resolved in this case. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, at 1 Vet. App. 49 (1990).

Respiratory Disability

STRs are silent for any complaints, treatments, or diagnosis of COPD or bronchitis. A January 1974 treatment note indicated the Veteran had left lower chest wall pain for six months, primarily in the morning and when walking. His breathing felt restricted due to the pain. Muscle spasms were noted. In April 1974, the Veteran again complained of chest pain and a "difference in ventilation" in the left lower lobe of the lungs. Testing showed hypotension accompanied by chest wall pain. There were no nodes on x-ray, and lungs were clear. Anterior chest wall pain was diagnosed, not a respiratory or lung condition. A November 1975 treatment note documented that the Veteran complained of chest pain. There was an impression of heartburn. A January 1976 treatment record documented that he complained of chest pains on the left side. The Veteran reported that when he took a deep breath his pain occurred. The Veteran was assessed with acid reflux, for which he took Gelusil, an antacid and anti-gas medication. An April chest radiographic report noted no gross abnormality. An undated chest radiographic report noted that the findings were normal. The July 1976 separation examination had a normal clinical evaluation.

A December 2020 VA pulmonary function note documented his December 2020 pulmonary function test had an interpretation of small airways disease.

In January 2022, the Board noted that the Veteran had a VA respiratory examination in November 2012. However, since that time the Veteran asserted that an in-service diagnosis of small air passage disease caused his current disability. The Board remanded this matter for a VA examination to render an opinion addressing the Veteran's new contention.

In a March 2022 VA opinion, the VA examiner provided a negative nexus opinion. The examiner noted that the Veteran had a mild diagnosis of COPD with an onset date of January 1997, after a hospital stay. The examiner noted that the Veteran had a history of nicotine (smoking) use. The examiner explained that nicotine use was a primary cause of COPD.

In an August 2022 Remand, the Board found that March 2022 VA opinion was inadequate for adjudication purposes. The Board noted that the March 2022 VA examiner did not address the Veteran's contentions in the opinion. Therefore, the Board remanded this matter to obtain an opinion to address the Veteran's contention.

In a September 2022 VA opinion, the VA examiner provided a negative nexus opinion. The examiner explained that the Veteran's condition was more likely due to his years of smoking and tobacco use. The examiner indicated that the Veteran was not diagnosed until many years after service. Therefore, his current disability was not likely due to service.

In January 2023 Remand, the Board found that September 2022 VA examiner did not address the Veteran's assertions, as requested in the previous August 2022 Remand. Therefore, the Board remanded this matter to obtain an opinion addressing the Veteran's contention.

In a February 2023 VA opinion, the VA examiner provided a negative nexus opinion. The examiner indicated that there were no suspicions, concerns, or pathology for a diagnosis of COPD. The examiner noted that the chest pain documented during service was not a symptom of COPD. The examiner remarked that the Veteran was not diagnosed with COPD until 1997, many years after service. The examiner explained that without chronicity during service and after service, a post service event, illness, smoking, or injury was considered the more likely etiology. In March 2023, the VA examiner provided a negative nexus opinion.

In September 2023, the Board found that the February 2023 VA opinion was inadequate, as it was based on the absence of treatment records. The March 2023 opinion applied the incorrect legal standard, citing clear and unmistakable evidence and pre-existence. Lastly, the VA examiners did not address the Veteran's assertion that his claimed disability was caused by his in
COPD. The examiner remarked that the Veteran was not diagnosed with COPD until 1997, many years after service. The examiner explained that without chronicity during service and after service, a post service event, illness, smoking, or injury was considered the more likely etiology. In March 2023, the VA examiner provided a negative nexus opinion.

In May 2024, the Board denied the claim. The Board denied the claim as a matter law due to the Veteran not attending a scheduled VA examination.

The Veteran filed an appeal to the Court of Appeals of Veterans Claims (the Court) contesting the Board's May 2024 decision. In May 2025, on the basis of a Joint Motion for Remand (JMR), the Court vacated and remanded the Board's decision for further consideration and scheduling of an examination. In October 2025, the Board in turn remanded this matter.

During the December 2025 VA examination, the Veteran reported that he was short of breath when he was a smoker. The Veteran reported that he smoked 2 packs a day while in service. The examiner provided a negative nexus opinion. The examiner indicated that there was a lack of substantiating evidence supporting a nexus between the Veteran's COPD/bronchitis and military service. The examiner explained that without chronicity during service or after service, a post service event, illness, or injury was a more likely etiology. The examiner explained that both conditions' main risk was smoking. The Veteran reported that while in service he smoked 2 packs of cigarettes daily. Post service medical records indicated that the Veteran was an active smoker when diagnosed with COPD and bronchitis. The examiner remarked that determining whether COPD and bronchitis were caused or aggravated by military evidence in the absence of toxic exposure required consideration of multiple risk factors, with cigarette smoking being the predominant cause in most cases, though occupational and environmental exposures during military service could contribute. The examiner listed that the primary causal factor was cigarette smoking for COPD in the United States, accounting for more than 80 percent of cases. The examiner noted that the VA guidelines noted that the VA spent billions of dollars annually treating COPD patients, with the majority of cases associated with smoking. The examiner also indicated that recent evidence demonstrated that inhalational exposures during routine military activities outside combat zones were associated with chronic respiratory symptoms. She remarked that heavy equipment maintenance and aircraft maintenance exposures were significantly associated with dyspnea and wheeze in veterans, even during non-deployment service time. She explained that veterans who served from 1973 to 1976 would have engaged in training exercises and equipment maintenance involving potentially harmful inhalational exposures to exhaust fumes, welding fumes, combustion products, construction dust, and solvents. She provided the definition of chronic bronchitis and indicated that smoking was the primary risk for chronic bronchitis. She explained that inhalational exposures to dust, chemical fumes, or occupational exposures could be important contributors. She also provided a negative TERA nexus opinion on the same rationale.

In the December 2025 VA addendum opinion, the examiner provided a negative TERA nexus opinion. The Veteran had symptoms of chronic bronchitis as early as 1994, which was 18 years after service. The Veteran was diagnosed with COPD in 2023, which was 47 years after service. The Veteran reported that he was smoking "10-15 a day" at the time of his COPD diagnosis. The examiner provided the summaries of medical articles he reviewed for his rationale. The examiner noted that while occupational exposures to vapors, gases, dust, and fumes, jet fuels, fuel fumes, exhaust, and oil fumes were associated with increased COPD risk. The Veteran indicated that during service he smoked 2 packs of cigarettes daily. The examiner indicated that there was no evidence that demonstrated that the Veteran's possible toxic exposure due to his military occupational specialty caused his COPD and chronic bronchitis.

In March 2026 the Veteran submitted a VA Form 20-0996, Request for Higher Level Review, as discussed above. He included statements which must be addressed under the currently applicable Legacy system. He wrote that during his tour in Vietnam he was assigned to a truck detail that exposed him to gas fumes that affected his ability to breathe. He indicated that the fumes caused him to cough up phlegm on a daily basis.
, and oil fumes were associated with increased COPD risk. The Veteran indicated that during service he smoked 2 packs of cigarettes daily. The examiner indicated that there was no evidence that demonstrated that the Veteran's possible toxic exposure due to his military occupational specialty caused his COPD and chronic bronchitis.

In March 2026 the Veteran submitted a VA Form 20-0996, Request for Higher Level Review, as discussed above. He included statements which must be addressed under the currently applicable Legacy system. He wrote that during his tour in Vietnam he was assigned to a truck detail that exposed him to gas fumes that affected his ability to breathe. He indicated that the fumes caused him to cough up phlegm on a daily basis. The Veteran felt that was the start of his COPD symptoms. The Veteran indicated that shortly after his return from Vietnam he was diagnosed with COPD. He also felt that the Army contributed to his nicotine addiction by giving him 2 cigarettes with each meal.

The Veteran is simply not credible in this instance. The Veteran indicated that his disability has its onset and was caused by an in service diagnosis of small air passage disease. STRs were silent for any treatment, complaints, or diagnosis of small air passage disease. STRs documented that the Veteran complained of chest pain and breathing problems. However, he was diagnosed with acid reflux, muscle spasm, and hypotension. X-rays during service showed no nodes and his lungs were clear. The medical evidence of record demonstrated that the Veteran was not diagnosed until 2020 with small air passage disease.

The Veteran also reported that during his tour in Vietnam he was assigned to a truck detail. A review of the records do not show that the Veteran was ever deployed to Vietnam. The Veteran's military personnel record demonstrate that he was deployed to Germany. The Board finds that the Veteran's statements regarding onset of his disability in service are not credible as they are not consistent with the evidence of record. Therefore, the Board assigns no probative weight to the Veteran's statements that his disability was caused by service or had its onset in service.

The Board acknowledges the assertion that the Veteran's COPD is due to the military providing him with cigarettes. However, the law mandates that, for claims received by VA after June 9, 1998, a disability will not be considered service-connected on the basis that it resulted from injury or disease attributable to a veteran's use of tobacco products during service. See 38 U.S.C. § 1103; 38 C.F.R. § 3.300(a). Therefore, service connection for COPD and bronchitis due to the use of tobacco products is precluded.

Service connection for COPD must be denied because the competent evidence of record shows that this disability was neither caused nor aggravated by service; nor does it show that the Veteran experienced symptoms of such a condition that continued from service until the present. There is no credible evidence of COPD within the first post service year.

Service connection for COPD is not warranted. There is no reasonable doubt to be resolved in this case. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, at 1 Vet. App. 49 (1990).

WILLIAM H. DONNELLY

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Baxter, Sikenah

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.

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