Citation Nr: 18148453
Decision Date: 11/07/18	Archive Date: 11/07/18

DOCKET NO. 14-38 570
DATE:	November 7, 2018
REMANDED
Entitlement to service connection for tinnitus, to include as secondary to service-connected bilateral hearing loss, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from February 1971 to January 1976.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2012 rating decision of the Department of Veteran Affairs (VA) Regional Office (RO) in Atlanta, Georgia. 
The Veteran underwent a VA audiological examination in July 2011, at which time the examiner noted that he did not report experiencing recurrent tinnitus.  See July 2011 VA C&P Examination Report.  Therefore, the examiner did not provide a medical opinion as to the etiology of tinnitus.
However, in an August 2013 Statement in Support of Claim and in his June 2013 notice of disagreement and October 2014 substantive appeal, the Veteran reported that he did experience ringing in his ears which he believed was the result of his exposure to loud noises during service while working as a helicopter mechanic and/or was secondary to his service-connected bilateral hearing loss.    
When a condition may be diagnosed by its unique and readily identifiable features, the presence of the disorder is not a determination "medical in nature" and is capable of lay observation.  Barr v. Nicholson, 21 Vet. App. 303, 309.  Tinnitus is, by definition, "a noise in the ears, such as ringing, buzzing, roaring, or clicking. It is usually subjective in type."  DORLAND'S ILLUSTRATED MEDICAL DICTIONARY, 1914 (30th ed. 2003).  Tinnitus is "subjective," as its existence is generally determined by whether or not the veteran claims to experience it.  For VA purposes, tinnitus has been specifically found to be a disorder with symptoms that can be identified through lay observation alone.  See Charles v. Principi, 16 Vet. App. 370 (2002).  
Thus, if a veteran reports ringing in his ears, then a diagnosis of tinnitus is generally provided without further examination.  Here, the Board finds the Veteran’s statements that he currently suffers from ringing in his ears to be both competent and credible.  As such, a remand is required in order to obtain a medical opinion, as described below.
The matter is REMANDED for the following action:
1. Send the Veteran a VCAA letter addressing the issue of service connection for tinnitus as secondary to service-connected hearing loss.  See 38 C.F.R. § 3.310.
2. Make arrangements to obtain the Veteran’s VA treatment records, dated from March 2012 forward.
3. Schedule the Veteran for an appropriate VA examination to determine the etiology of his tinnitus.  The Veteran’s claims file, including a copy of this remand, must be made available to and reviewed by the VA examiner.  The examination report must reflect that such a review was undertaken.  
(a) The examiner must provide an opinion as to whether it is at least as likely as not (50% or greater probability) that the Veteran’s tinnitus was caused by his in-service noise exposure while working as a helicopter mechanic.
(b) The examiner must provide an opinion as to whether it is at least as likely as not (50% or greater probability) that the Veteran’s tinnitus was either (i) caused by, or (ii) aggravated by his service-connected bilateral hearing loss.
The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached.
 
P.M. DILORENZO
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	L. Sinckler, Associate Counsel