Citation Nr: 18152561 Decision Date: 11/23/18 Archive Date: 11/23/18 DOCKET NO. 16-49 482 DATE: November 23, 2018 ORDER Service connection for tinnitus is granted. Service connection for posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. Resolving all reasonable doubt in favor of the Veteran, the evidence is at least in equipoise that the Veteran’s tinnitus is etiologically related to military noise exposure. 2. The Veteran does not have a current diagnosis of PTSD. CONCLUSIONS OF LAW 1. The criteria for service connection for tinnitus have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2017). 2. The criteria for service connection for PTSD have not been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1970 to March 1973, including service in the Republic of Vietnam. These matters are on appeal from a March 2013 rating decision. Duties to Notify and Assist With respect to the Veteran’s claims herein, VA has met all statutory and regulatory notice and duty to assist provisions. See 38 U.S.C. §§ 5100, 5102, 5103, 5103A; 38 C.F.R. § 3.159. Neither the Veteran nor his representative have advanced any procedural arguments in relation to VA’s duty to notify and assist; therefore, the Board will proceed with appellate review. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015). Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, service connection requires: (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. See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). For certain chronic disorders, to include tinnitus, service connection may be granted if the disease becomes manifest to a compensable degree within one year following separation from service. See 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. In such cases, the disease is presumed under the law to have had its onset in service even if there is no evidence of such disease during service. 38 C.F.R. § 3.307(a); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Alternatively, when a disease at 38 C.F.R. § 3.309(a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service. See 38 C.F.R. § 3.303(b). However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309(a) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker, 708 F.3d at 1331. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the claimant prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the claimant. Gilbert, 1 Vet. App. at 53. 1. Entitlement to service connection for tinnitus The Veteran seeks service connection for tinnitus, which he contends was incurred in service due to military noise exposure. Specifically, he asserts that the ringing in his ears began while serving in Vietnam, where he operated heavy machinery and was exposed to acoustic trauma from helicopters and guns firing. He describes the ringing as constant and states that it has continued to increase in severity ever since service. Initially, the Board notes that the Veteran is competent to describe the nature and extent of his in-service noise exposure. See C.F.R. § 3.159(a)(2); Washington v. Nicholson, 19 Vet. App. 362, 368 (2005); Layno v. Brown, 6 Vet. App. 465, 469-70 (1994). Moreover, there is no dispute in the record that the Veteran has a current diagnosis of tinnitus. Therefore, the question before the Board is whether the Veteran’s tinnitus is etiologically related to his active duty service. Based on a careful review of all the subjective and clinical evidence, and resolving all reasonable doubt in favor of the Veteran, the Board finds that service connection for tinnitus is warranted. The record includes a private treatment record from December 2001 in which the Veteran reported to his physician that his tinnitus began about eight months prior when he started taking a new blood pressure medication. The doctor noted that tinnitus is not a common side effect of the medication. The Veteran underwent a VA audiological examination in December 2012. The VA examiner opined that the Veteran’s tinnitus is at least as likely as not a symptom associated with his (nonservice-connected) bilateral hearing loss, as tinnitus is known to be a symptom associated with hearing loss. No further rationale was provided. In a January 2013 addendum opinion, the same VA examiner noted the private treatment record from December 2001. The examiner opined that the Veteran’s tinnitus was less likely than not incurred in or caused by service due to evidence that the Veteran’s tinnitus began in 2001. The Board finds that the December 2012 and January 2013 VA opinions both discounted the Veteran’s assertions that he was exposed to noise from operating heavy machinery in Vietnam, which resulted in acoustic trauma. On that basis, the Board finds neither VA opinion persuasive. In a March 2013 statement, the Veteran argued that he has experienced tinnitus ever since leaving service, but that he did not seek medical treatment for it for many years only after the insistence of family. He also stated to his VA examiner that when he left service his tinnitus was low and intermittent, but that through the years it continued to get louder and is now constant. The Veteran underwent another VA audiological examination in June 2016. The VA examiner opined that the Veteran’s tinnitus is at least as likely as not a symptom associated with his bilateral hearing loss. However, the examiner did not provide a medical rationale for this finding. Therefore, the Board does not find the June 2016 examination findings to be probative. Based on the above, the Board finds that the record does not contain an adequate medical opinion. Nonetheless, there is still sufficient evidence in the record to decide the claim. The Veteran’s exposure to acoustic trauma has been conceded. Further, the Board finds that the Veteran’s lay assertions that the ringing in his ears began during service and that it continually worsened in severity since service are both competent and credible. See Layno v. Brown, 6 Vet. App at 469-70. Finally, the record does not include any evidence that the Veteran was exposed to any other hazardous noise since service that would account for his tinnitus symptoms. Therefore, the Board finds that based on the Veteran’s competent and credible statements regarding the onset and continuity of his tinnitus symptoms, the evidence is at least in equipoise, and service connection for tinnitus is warranted. Accordingly, resolving all reasonable doubt in favor of the Veteran, service connection for tinnitus is granted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 2. Entitlement to service connection for PTSD The Veteran seeks service connection for PTSD, which he contends is related to traumatic events he experienced while serving in Vietnam. The Veteran asserts that he has suffered symptoms of PTSD, including sleep disturbance and nightmares, ever since service. Establishing service connection for PTSD requires specific findings. These are: (1) a current medical diagnosis of PTSD; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a causal nexus between current symptomatology and the specific claimed in-service stressor. See 38 C.F.R. § 3.304(f). The existence of a current disability is the cornerstone of a claim for VA disability compensation; consequently, failure to establish a current disability results in the denial of a claim. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303; see Degmetich v. Brown, 104 F.3d 1328 (Fed. Cir. 1997). Specifically, a claimant must have a disability in order to be considered for service connection. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The Veteran’s service treatment records have been associated with the claims file. They include his January 1970 enlistment examination and February 1973 separation examination. The Veteran denied a history of psychiatric issues on both examinations. The records are silent for complaint, treatment, or diagnosis of any mental health problems or psychiatric issues during service. A review of the record reveals that the Veteran’s post-service medical records do not show complaint, treatment, or diagnosis of PTSD or any other mental health condition at any time following service. The Veteran underwent a VA PTSD examination in December 2012. Upon examination, which included review of the Veteran’s medical records and an interview of the Veteran, the examiner determined that the Veteran does not meet the criteria for a diagnosis of PTSD or any other mental disorder. There is no contrary medical evidence of record. Based on a careful review of the subjective and clinical evidence of record, the Board finds that the preponderance of the evidence weighs against finding that service connection for PTSD is warranted. In this case, the medical evidence of record does not reflect a current diagnosis of PTSD, and no such diagnosis has been rendered at any time during the pendency of this appeal. See McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). The Board notes that Congress specifically limits entitlement to service-connected disease or injury to cases where such incidents have resulted in a disability. See 38 U.S.C. § 1110. In the absence of proof of current disability there can be no valid claim for service connection. See Brammer, 3 Vet. App. at 225. Thus, in the absence of competent evidence showing a current diagnosis of PTSD, it is not necessary to address the remaining elements of the claim for service connection. See id. Finally, the Board does not doubt that the Veteran sincerely believes that he suffers from symptoms of PTSD. The Veteran is competent to report symptoms of disability, such as experiencing nightmares. See Layno v. Brown, 6 Vet. App. 465, 469-71 (1994). However, a probative medical opinion diagnosing the Veteran’s psychiatric symptomatology requires the specialized training of a medical professional. In this case, as a layperson not shown to possess medical training and expertise, the Veteran is not competent to render a diagnosis of PTSD. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir 2007); see also Young v. McDonald, 766 F.3d 1348, 1353 (Fed. Cir. 2014) (holding that “PTSD is not the type of medical condition that lay evidence... is competent and sufficient to identify”). Therefore, the Board finds the medical opinion of record, provided by a qualified medical professional, to be more probative. Accordingly, the Board finds that the preponderance of the evidence weighs against the Veteran’s claim for service connection for PTSD. Because the evidence fails to establish that the Veteran has a current diagnosis of PTSD, the claim does not satisfy the criteria for service connection. Therefore, the benefit-of-the-doubt rule does not apply and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Melissa Barbee, Associate Counsel