Citation Nr: 18149567 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 16-42 963 DATE: November 9, 2018 ORDER Entitlement to service connection for tinnitus is granted. FINDING OF FACT The evidence is at least in equipoise as to whether the Veteran’s tinnitus is related to his active service. CONCLUSION OF LAW The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R § 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Air Force from November 2000 through October 2014. He was discharged under honorable conditions. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in North Little Rock, Arkansas. Entitlement to service connection for tinnitus The Veteran contends his tinnitus was caused by acoustic trauma he experienced in service and should be granted service connection. The Board notes that the Veteran has specified that the tinnitus is his left ear. However, as a Veteran is limited to a single disability rating for tinnitus, regardless whether the tinnitus is unilateral or bilateral, the issue has been recharacterized. Smith v. Nicholson, 451 F.3d 1344 (Fed. Cir. 2006). 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. § 1131. 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); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). Certain chronic diseases, including organic diseases of the nervous system, are subject to presumptive service connection if manifest 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). Tinnitus qualifies as a chronic disease as it is an organic disease of the nervous system. See Fountain v. McDonald, 27 Vet. App. 258 (2015). A diagnosis of tinnitus is well established. Shedden element (1) is thereby met. There is also sufficient evidence to meet Shedden element (2), in-service incurrence. The Veteran’s service treatment records (STRs) are silent as to any complaints, treatment, or diagnosis of tinnitus. However, he has provided competent and credible evidence that he was exposed to loud explosions on October 2010 while serving at Balad Air Base, Iraq and on September 2012 while serving at Bagram Air Field, Afghanistan. He describes the noise as “deafening” and “extremely loud.” There is also evidence of minor changes in auditory thresholds at 1000 – 4000 Hertz in both ears. Turning to Shedden element (3), the Veteran made several lay statements regarding the onset of tinnitus, including the intensity and effect of acoustic trauma in 2010 and 2012. He intimated that his tinnitus had originated in service. Tinnitus is, by definition “a noise in the ears, such as ringing, buzzing, roaring, or clicking. It is usually subjective in type.” See Dorland’s Illustrated Medical Dictionary, 1914 (30th ed. 2003). Because tinnitus is “subjective,” 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). Here the Veteran’s statements establish that tinnitus began during military service. Consideration has been given a negative 2016 VA examination. The examiner opined tinnitus was less likely than not caused by or as a result of military noise exposure. However, that opinion is no more or less probative than the Veteran’s statement. Such places the evidence of there being a medical nexus in equipoise. The Veteran has satisfied Shedden element (3). In view of the totality of the evidence, including in-service noise exposure and tinnitus, current finding of tinnitus, and credible lay evidence, the Board finds the evidence is at least in relative equipoise regarding tinnitus. When the evidence is (CONTINUED NEXT PAGE) in relative equipoise, the benefit of the doubt doctrine provides that such reasonable doubt will be resolved in favor of the Veteran. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Service connection for tinnitus is warranted. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Mahmoudi, Associate Counsel