Citation Nr: 18147262 Decision Date: 11/05/18 Archive Date: 11/02/18 DOCKET NO. 16-03 466 DATE: November 5, 2018 ORDER Entitlement to service connection for tinnitus is granted. FINDING OF FACT Resolving doubt in the Veteran’s favor, his tinnitus is at least as likely as not related to active duty service. CONCLUSION OF LAW The criteria for service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1154 (a), 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307 (a), 3.309 (a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March of 1967 to March of 1971. Entitlement to service connection for tinnitus. The Veteran is claiming entitlement to service connection for tinnitus. He asserts that his tinnitus is related to acoustic trauma from in-service exposure to the sound of aircraft engines while working as a support equipment mechanic. Specifically, under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110. Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Moreover, for such chronic diseases, an alternative method of establishing the second and third Shedden element is through a demonstration of continuity of symptomatology if the disability claimed qualifies as a chronic disease listed in 38 C.F.R. 3.309 (a); See 38 C.F.R. 3.303 (b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2014). Certain chronic diseases, including tinnitus, are subject to presumptive service connection although not otherwise established as incurred in or aggravated by service if manifested to a compensable degree within one year from separation from service even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307 (a)(3), 3.309(a). VA must give due consideration to all pertinent medical and lay evidence in a case where a veteran is seeking service connection. 38 U.S.C. § 1154 (a). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the veteran. 38 U.S.C. § 5107 (b). The Veteran’s service treatment records (STRs) indicate an in-service incurrence of tinnitus. In an audiogram performed in August 1968, the Veteran reports bilateral tinnitus after exposure to aircraft engines. In the Veteran’s post-service medical records, he reports long-standing tinnitus, and the Veteran has a present diagnosis of tinnitus through his private physician, which is noted in the private medical records from August 2012. The Board also notes that in a September 2015 VA examination, the Veteran reported a history of in-service exposure to loud aircraft, gunfire, explosions, and flightline noise, and moreover in the December 2015 Rating Decision, the Rating Decision Officer stated that the Veteran’s military occupational specialty of Support Equipment Mechanic is consistent with acoustic trauma. Further, there is no evidence of intercurrent causes of tinnitus as the Veteran’s post-service work did not include exposure to acoustic trauma. Rather, he worked in sales and in the restaurant business, as noted in his May 2012 VA treatment records. The Board finds this evidence regarding in-service exposure and incurrence, and the Veteran’s reporting of symptoms to be competent and credible. Thus, the Board this evidence highly probative of the 38 C.F.R. 3.309(a) presumption for service connection. The Board also acknowledges the negative opinion from the September 2015 VA examination in which the examiner concluded that the delay in the onset of symptoms, as the Veteran did not seek prior medical treatment, made it less likely than not that the Veteran’s tinnitus was a result of in-service noise exposure. However, the Board notes that the examination did not consider the Veteran’s in-service report of tinnitus noted in the August 1968 STRs. Thus, as the examination failed to analyze this critical evidence, the examination opinion is inadequate. Further, the Board takes notice of the fact that as a result of the 2015 VA examination, the Veteran was granted service-connection for bilateral hearing loss. Accordingly, the Board recognizes that tinnitus is a common symptom of nearly all ear disorders including sensorineural or noise-induced hearing loss. See The MERCK Manual, Sec. 7, Ch. 82, Approach to the Patient with Ear Problems; see also Fountain v. McDonald, 27 Vet. App. 258 (2015).   Therefore, considering the totality of the evidence, the Board finds that the evidence is at least in equipoise and service connection for tinnitus is warranted. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Page-Nelson, Associate Counsel