Citation Nr: 1318456 Decision Date: 06/06/13 Archive Date: 06/11/13 DOCKET NO. 13-05 916 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri THE ISSUE Entitlement to service connection for tinnitus. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD Harold A. Beach, Counsel INTRODUCTION The Veteran served on active duty from January 1943 to November 1945. This matter came to the Board of Veterans' Appeals (Board) on appeal from an February 2012 rating decision by the RO. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). FINDINGS OF FACT The Veteran's tinnitus is causally related to his service-connected bilateral hearing loss disability. CONCLUSION OF LAW The criteria for secondary service connection for tinnitus have been met. 38 U.S.C.A. §§ 5103, 5103A, 5107(b) (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.102, 3.310(a) (2012). REASONS AND BASES FOR FINDING AND CONCLUSION VA's Duty to Notify and Assist Prior to consideration of the merits of the Veteran's appeal, the Board must, usually, determine whether VA has met its statutory duty to assist him in the development of his claim. 38 U.S.C.A. §§ 5103, 5103A; 38 C.F.R. § 3.159. In this case, however, the Board does not need to make such a determination, as the Veteran's claim of entitlement to service connection for tinnitus is being granted herein. Therefore, there is no need to determine whether VA's statutory duties to notify and assist have been fully satisfied, as any error in complying with those duties would be non-prejudicial to the Veteran. Accordingly, the Board will proceed to the merits of the appeal. The Merits of the Appeal Service connection may be granted for disability or injury incurred in or aggravated by active military service. 38 U.S.C.A. § 1110 (West 2002). Generally, the evidence must show (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. See Cuevas v. Principi, 3 Vet. App. 542 (1992). Service connection may also be granted when the evidence shows that a particular disability is proximately due to or the result of a disability for which service connection has already been established. 38 C.F.R. § 3.310(a). In addition, 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). In this case, the evidence shows that the Veteran was a turret gunner on a torpedo bomber during World War II. The Board acknowledges that such duties would have exposed the Veteran to acoustic trauma. In August 2011, the Veteran filed claims of entitlement to service connection for a hearing loss disability and tinnitus due to acoustic trauma in World War II. He stated that he had had a progressively deteriorating hearing loss since that time, as well as a noise in his ears. The Veteran's service treatment records and the reports of his December 1942 service entrance examination and his November 1945 service separation examination are negative for any complaints or clinical findings of tinnitus. His hearing acuity was 15/15, bilaterally. In January 2012, the Veteran was examined by VA to determine the nature and etiology of any hearing loss disability found to be present. It was noted that prior to service, the Veteran had been a stock clerk and that following his separation from service, he had been a police officer for 30 years and a security officer for 16.5 years. He denied any civilian occupational or recreational noise exposure. Following the examination, the diagnoses were a moderate to severe sensorineural hearing loss in the Veteran's right ear and a moderate to profound sensorineural hearing loss in his left ear. The examiner noted that the whispered voice test, such as given during the Veteran's service separation examination, was insensitive to high frequency hearing losses, the most common type of hearing loss following noise exposure. Therefore, the examiner concluded that it was likely that the Veteran's hearing loss began prior to when he noticed the symptoms. Due to the type of noise exposure experienced by the Veteran in service, and the lack of quantitative audiometric information available, the examiner concluded that it was at least as likely as not that the Veteran's bilateral hearing loss disability was due to his inservice noise exposure. As to tinnitus, the Veteran complained of ringing in his ears but was unable to recall when he first noticed it. He did not relate it to the military, and the examiner noted that there were no complaints of tinnitus in his records. Therefore, she concluded that it was not as likely as not that the Veteran's tinnitus was related to his military noise exposure or to any service-connected hearing loss disability. While the examiner is correct that there were no complaints or clinical findings of the Veteran's tinnitus in service, the Veteran was unable to recall when he first noticed it, the Veteran's representative maintains that the Veteran's tinnitus is the result of his sensorineural hearing loss. He directs the Board's attention to the Merck Manual for evidence of such a relationship. The Merck Manual states that "tinnitus may occur with almost any ear disorder." The Merck Manual 778-779 (18th ed. 2006) "Common causes include acoustic trauma (noise-induced sensorineural hearing loss)." Id. In essence, the cited provisions from The Merck Manual confirm that tinnitus usually accompanies noise-induced hearing loss. Significantly, the RO granted service connection for the Veteran's bilateral hearing loss in February 2012, based on the Veteran's inservice noise exposure. Given the Veteran's service-connected bilateral hearing loss disability, his diagnosis of tinnitus, and the provisions from The Merck Manual cited above, the Board finds that the evidence supports the Veteran's claim of entitlement to service connection for tinnitus on a secondary basis. At the very least, there is an approximate balance of evidence both for and against the claim that the Veteran's tinnitus is associated with his service-connected hearing loss disability. Under such circumstances, all reasonable doubt is resolved in favor of the Veteran, and the claim will be decided on that basis. 38 U.S.C.A. § 5107(b) ; 38 C.F.R. § 3.102. Accordingly, service connection for tinnitus is warranted. ORDER Entitlement to service connection for tinnitus is granted. ____________________________________________ JOHN Z. JONES Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs