Citation Nr: 18147702 Decision Date: 11/05/18 Archive Date: 11/05/18 DOCKET NO. 15-21 307 DATE: November 5, 2018 ORDER Entitlement to service connection for tinnitus is granted. Entitlement to service connection for hypertension is granted. FINDINGS OF FACT 1. The Veteran’s tinnitus had its onset during his active service. 2. The Veteran’s hypertension is causally related to his service-connected posttraumatic stress disorder. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from March 1987 to March 1990, October 1990 to July 1991, December 2003 to January 2005, and from April 2008 to June 2009. For his meritorious service, the Veteran was awarded (among other decorations) the Army Commendation Medal and the Southwest Asia Service Medal. Service Connection Generally, service connection will be granted for a disability resulting from an injury or disease caused or aggravated by service. 38 U.S.C. §§ 1110, 1131. A grant of service connection for a disability requires: (1) a present disability or persistent or recurrent symptoms of a disability; (2) an in-service incurrence of aggravation of a disease or injury; and (3) a causal relationship (“nexus”) between the present disability and the in-service event, injury, or disease. 38 C.F.R. § 3.303 (2018); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be warranted for disabilities found to be proximately due to, the result of, or aggravated by separately service-connected disabilities. 38 C.F.R. § 3.310. Lay assertions may serve to support a claim for service connection by establishing the occurrence of observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C. § 1153 (a) (2012); 38 C.F.R. § 3.303 (a) (2018); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F. 3d 1331, 1336 (Fed. Cir. 2006) (addressing lay evidence as potentially competent to support presence of disability even where not corroborated by contemporaneous medical evidence). The United States Court of Appeals for the Federal Circuit (Federal Circuit) has clarified that lay evidence can be competent and sufficient to establish a diagnosis or etiology when (1) a lay person is competent to identify a medical condition; (2) the lay person is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2018). 1. Entitlement to service connection for tinnitus is granted The Veteran himself has stated, and a June 2014 VA examination has confirmed, that the Veteran suffers from tinnitus. The current disability criterion is met. The Veteran’s service treatment records do not explicitly document that he complained of or was treated for tinnitus during his active service. However, VA has acknowledged that the Veteran’s complete service treatment records are not available for review. Regardless, the Veteran has stated that he was exposed to hazardous noise as a result of his active service, and that his disability began during his first period of service in the late 1980s. The Veteran is competent to state the noise he was exposed to as well as to observe tinnitus, and the Board finds his statements to be credible. The in-service incurrence criterion is met. The third requirement for service connection is that there is a nexus between the in-service injury, event, or disease and the current disability. The Veteran contends that his onset of tinnitus started while he was in service. A VA Examination in June 2014 that stated that it was less likely than not that the Veteran’s tinnitus was caused by military noise exposure. The Examiner noted that the Veteran states that he was unable to correlate the ringing in his ears to a particular event during service. The Veteran has been consistent with his lay statement as to the onset of his tinnitus, however. In his initial claim, the Veteran stated that his tinnitus began during his first period of service, but he did not recognize the ringing in his ears as a disability. In a VA Examination from June 2014, the Veteran stated that he was exposed to a variety of loud noises including aircraft, truck engines, generators, bombs, and small arms fire. The Veteran also noted that he held jobs with relative low ambient noise levels including working on a golf course, as a mail carrier, and in water maintenance. The Veteran again notes that he was around loud gunfire, without hearing protection, in his notice of disagreement from June 2014. Here, the Veteran made consistent statements regarding the onset of his tinnitus and did not contradict himself when making these assertions. The Veteran asserts that he experienced high levels of noise in the course of his deployment. The Veteran is competent to make these statements as they are easily perceived by lay persons. As such, the third requirement of service connection is met and service connection for tinnitus is granted. Upon careful review of the record, the Board finds that the evidence in this claim for service connection for the Veteran’s tinnitus is, at minimum, in equipoise. 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 claimant. 38 U.S.C. § 5107 (2012); 38 C.F.R. § 3.102 (2018); see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). As such, entitlement to service connection for tinnitus is warranted. 2. Entitlement to service connection for hypertension is granted The Veteran also seeks service connection for hypertension; for the reasons that follow, this claim shall also be granted. First, VA treatment records confirm that the Veteran currently suffers from hypertension. As noted above, the Veteran’s complete service treatment records are not available for review. However, the Veteran does not contend that his hypertension had its onset during or is otherwise directly related to his active service. Instead, he contends that his disability is secondary to his service-connected PTSD. In support of that contention, the Veteran submitted a letter from his VA treatment provider. She noted the Veteran’s contention that he may have developed hypertension as a result of the symptoms he experiences of his PTSD, including stress sensitivity. The Veteran’s psychologist then concluded that “it is at least as likely as not that the Veteran’s hypertension was caused by having PTSD and stressors for which he has been treated post-discharge.” This opinion alone is sufficient for the Board to find that the Veteran’s hypertension is secondary to his service-connected PTSD. Service connection for this disability is therefore also warranted. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. N. P. Jochem, Associate Counsel