Citation Nr: 18147636 Decision Date: 11/06/18 Archive Date: 11/05/18 DOCKET NO. 14-04 450 DATE: November 6, 2018 ORDER Entitlement to service connection for tinnitus is granted. REMANDED Entitlement to service connection for bilateral hearing loss is remanded. FINDING OF FACT Competent and credible evidence indicates the Veteran’s current tinnitus began during service and has continued to the present time. CONCLUSION OF LAW The criteria for establishing service connection for tinnitus have been met. 38 U.S.C §§ 1101, 1110, 1112, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1970 to March 1974. This matter comes before the Board of Veterans’ Appeals (Board) from an April 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In January 2018, the Veteran testified at a hearing before a Veterans Law Judge of the Board of Veterans’ Appeals (Board). A transcript of the hearing is of record. 1. Entitlement to service connection for tinnitus The Veteran asserts he currently has tinnitus that began during service in connection with exposure to the noise of jet engines, and that the tinnitus has continued to the present time. The Board finds the Veteran’s statements that his tinnitus began during service and has continued since that time to be both competent and credible. At the January 2018 Board hearing, the Veteran testified he was exposed to acoustic trauma during service working in and around jet engines, without and without hearing protection, and that the ringing was worse after working around the engines, that he did not seek treatment after service because he typically is not the type of person to do so and that the ringing in his ears has continued since service. He denied occupational or recreational exposure. He testified that he sought treatment during service in late 1973 for ringing in his ears and an ear ache, was told the ringing was normal and would go away, and only the ear ache was documented in the treatment record. This statement is consistent with a September 1973 service treatment record. During the appeal period, the Veteran made additional statements regarding noise exposure and continuous symptoms of ringing in his ears that are consistent with his hearing testimony. See March 2012 VA audiology examination report and May 2013 statement. With regard to nexus, a March 2012 VA examiner opined the Veteran’s current tinnitus was less likely than not a result of military noise exposure. Conversely, a February 2018 letter from a private audiologist opined the Veteran’s current tinnitus was most likely caused by noise exposure during service. In light of the evidence of record, to include the Board testimony, service treatment records, medical opinions and lay statements, the Board finds the competent, credible and probative evidence is at least in equipoise as to whether the Veteran’s current tinnitus arose in service and has continued since. See Fountain v. McDonald, 27 Vet. App. 258, 272 (2015). Accordingly, resolving all doubt in the Veteran’s favor, service connection for tinnitus is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Entitlement to service connection for bilateral hearing loss is remanded. Upon review of the record, the Board finds an additional opinion is needed with respect to the claimed bilateral hearing loss disability. A March 2012 VA examiner provided a negative nexus opinion, concluding the in-service audiograms showed normal hearing with no threshold shift during service and there was no scientific basis for delayed onset of hearing loss. A February 2018 opinion letter from a private audiologist provided a positive nexus opinion, concluding that in-service noise exposure resulted in permanent progressive sensorineural hearing loss. In a January 2018 appellate brief, the Veteran’s representative pointed to several articles in support of the theory of delayed onset of hearing loss. The Board notes that hearing loss need not be shown in service for service connection to be established; rather, service connection may be established for a current hearing disability with evidence that the current disability is causally related to service. Hensley v. Brown, 5 Vet. App. 155, 160 (1993). Given the record before it, the Board finds that an addendum opinion is needed. Updated treatment records should also be requested. The matter is REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have treated him for hearing loss since his discharge from service. After securing the necessary release, request any relevant records identified that are not duplicates of those contained in the claims file. If any requested records are not available, the Veteran should be notified of such. (Continued on the next page)   2. After records development is completed, send the claims file to a VA audiologist to obtain an addendum medical opinion with respect to the Veteran’s claimed bilateral hearing loss. If a new examination is deemed necessary to respond to the questions presented, one should be scheduled. Following review of the claims file, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any current hearing loss disability is related to service? In rendering the opinion, the examiner should explain why or why not, to include addressing whether the Veteran’s current bilateral hearing loss is/is not a delayed response to in-service noise exposure. A rationale for any opinion expressed must be provided. ANTHONY C. SCIRE, JR. Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. C. Birder, Associate Counsel