Citation Nr: 18153221 Decision Date: 11/28/18 Archive Date: 11/27/18 DOCKET NO. 16-43 722 DATE: November 28, 2018 ORDER Entitlement to service connection for residuals of a ruptured right tympanic membrane is granted. FINDING OF FACT Residuals of a ruptured right tympanic membrane are related to service. CONCLUSION OF LAW The criteria for service connection for residuals of a ruptured right tympanic membrane have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (West 2014); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The appellant is a veteran (the Veteran) who had active duty service from August 1967 to August 1971, and from October 1972 to September 1977. He is a recipient of the Bronze Star Medal. This appeal comes before the Board of Veterans’ Appeals (Board) from an October 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio. In July 2017, the Veteran presented testimony at a Board hearing, chaired via videoconference by the undersigned Veterans Law Judge, and accepted such hearing in lieu of an in-person hearing before a Member of the Board. See 38 C.F.R. § 20.700(e) (2017). At the Board hearing, the Veteran was informed of the basis for the RO’s denial of his claim and he was informed of the information and evidence necessary to substantiate the claim. 38 C.F.R. § 3.103 (2017). He was afforded 60 days following the hearing to submit additional evidence. A transcript of the hearing is associated with the claims file. Service connection for residuals of a ruptured right tympanic membrane. VA law provides that, for disability resulting from personal injury suffered or disease contracted in line of duty, or for aggravation of a preexisting injury suffered or disease contracted in line of duty, in the active military, naval, or air service, during a period of war, or other than a period of war, the United States will pay to any veteran thus disabled and who was discharged or released under conditions other than dishonorable from the period of service in which said injury or disease was incurred, or preexisting injury or disease was aggravated, compensation, except if the disability is a result of the veteran's own willful misconduct or abuse of alcohol or drugs. 38 U.S.C. §§ 1110, 1131 (West 2014). For active duty service, entitlement to service connection on a direct basis requires (1) evidence of current nonservice-connected disability; (2) evidence of in-service incurrence or aggravation of disease or injury; and (3) evidence of a nexus between the in-service disease or injury and the current nonservice-connected disability. 38 C.F.R. § 3.303(a); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). After the evidence has been assembled, it is the Board's responsibility to evaluate the entire record. 38 U.S.C. § 7104(a) (West 2014). When there is an approximate balance of evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107 (West 2014); 38 C.F.R. §§ 3.102, 4.3 (2017). A VA claimant need only demonstrate that there is an approximate balance of positive and negative evidence in order to prevail. Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the preponderance of the evidence must be against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). The Veteran testified at the Board hearing that he was exposed to an explosion near him in service and that his right ear began to bleed. He did not seek treatment at the time, but later found that his eardrum had been ruptured (Record 07/21/2017). A March 4, 1975, Clinical Note reveals that the Veteran sustained a rupture of the left tympanic membrane while swimming (Record 02/19/2014 at 29). A February 3, 1977, ENT Consult reveals that examination of the ears was within normal limits (Record 02/19/2014 at 15). A report of medical examination performed on July 19, 1977, reveals normal findings for the ears (Record 02/19/2014 at 25). A November 8, 2007, ENT note reveals the Veteran’s report of bleeding from the right ear. The examiner described a known right tympanic membrane perforation from concussive injury from a mortar in Vietnam. The Veteran reported that it had never given him much trouble until recently (Record 02/10/2014 at 34). A December 12, 2007, Operative Report reveals the Veteran underwent a right tympanoplasty for a longstanding right tympanic membrane perforation resulting from a “concussion injury in Vietnam” (Record 02/10/2014 at 37). A December 5, 2012, Clinical Note reveals complaint of right-sided ear pain for 2 days. The Veteran denied trauma. He reported a history of a ruptured tympanic membrane in the past but could not recall which ear (Record 02/10/2014 at 30). A January 4, 2013, Clinical Note reveals a perforated right tympanic membrane and ear infection (Record 02/10/2014 at 28). The report of an April 2014 VA Audiology Examination reveals that hearing loss and tinnitus were related to incident reported by the Veteran of having a rocket explode near him (Record 04/17/2014). The Veteran submitted a buddy statement in December 2014 from an individual who served with him. That individual attested to remembering an incident where the Veteran took someone on a tour of the fire bases. When he returned he reported that a mortar had landed near him and this caused his right ear to bleed. He found out later that he had a burst ear drum (Record 12/10/2014). A July 13, 2016, ENT not reveals the Veteran’s report of a Q-tip trauma 15 to 20 years ago which resulted in a failed tympanoplasty (Record 08/12/2016 at 1). A March 15, 2018, Clinical Note reveals the Veteran reported surgery on his ear drum in 1995 (Record 08/14/2018 at 18). After a review of all of the evidence, the Board finds that the criteria for service connection for residuals of a right tympanic membrane rupture have been met. The resolution of this appeal centers on whether the ruptured tympanic membrane occurred during the Veteran’s service. The Board acknowledges that there is no documentation of the right tympanic membrane injury in service, and that the Veteran’s recollection of events has not always been clear or consistent. While there is documentation of an injury to the left tympanic membrane in the service treatment records, the circumstances surrounding that injury are different than the injury the Veteran has described to the right tympanic membrane. Therefore, it cannot be concluded that this is simply a case of a bad memory regarding which ear was injured. VA has granted service connection for hearing loss and tinnitus based on the same incident described by the Veteran in this claim. As noted above, the April 2014 VA examiner related hearing loss and tinnitus to the mortar explosion described by the Veteran as the basis for his current claim. The Board finds it significant that the Veteran attributed a ruptured right tympanic membrane to this incident as early as November 2007, many years prior to filing a claim for service connection; and, there is documentation of problems with the right tympanic membrane as early as 1995. The Board finds that the injury described to the right tympanic membrane is certainly plausible, and the Veteran is competent to report symptoms such as bleeding and ringing in the ear associated with such an injury. These details are further bolstered by competent lay evidence of a fellow servicemember. Accordingly, to the extent of any remaining doubt regarding the incurrence of the claimed disorder in service, such doubt is resolved in favor of the claim. The Board concludes that service connection for residuals of a ruptured right tympanic membrane is warranted. JONATHAN B. KRAMER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L. Cramp