Citation Nr: 18155607 Decision Date: 12/04/18 Archive Date: 12/04/18 DOCKET NO. 15-03 428 DATE: December 4, 2018 ORDER Service connection for bilateral hearing loss is denied. Service connection for bilateral tinnitus is denied. FINDINGS OF FACT 1. The Veteran’s bilateral hearing loss first manifested many years after his separation from service and is not related to his service or any incident therein, including noise exposure. 2. The Veteran’s bilateral tinnitus first manifested many years after his separation from service and is not related to his service or any incident therein, including noise exposure. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss are not met. 38 U.S.C. §§ 1110, 1111, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307, 3,309. 2. The criteria for service connection for bilateral tinnitus are not met. 38 U.S.C. §§ 1110, 1111, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307, 3,309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1945 to June 1946. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Nashville, Tennessee. The RO in Winston-Salem, North Carolina certified the appeal to the Board. The Veteran’s claims file remains in the jurisdiction of the Winston-Salem RO. The Veteran originally requested a Board hearing in his January 2015 substantive appeal, but withdrew that request in January 2018 correspondence. No other hearing request remains pending. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c); 38 U.S.C. § 7107(a)(2). Service Connection The Veteran seeks service connection for bilateral hearing loss and tinnitus. He asserts that he was exposed to excessive noise while in service. He describes spending “quite a bit of time at the rifle rage as a target puller.” According to the Veteran, the rifle range was “a loud location with all ranges/lanes firing.” Additionally, the Veteran stated that his occupational environment was loud due to “multiple personnel typing . . . [on] old noisy typewriters.” In addressing whether the Veteran’s hearing loss and tinnitus are related to his active service, the Board concludes that although the Veteran has current diagnoses of bilateral hearing loss for VA disability purposes, see 38 C.F.R. § 3.385, as well as tinnitus, and the evidence supports that the Veteran was exposed to noise in service, the preponderance of the evidence weighs against finding that the Veteran’s hearing loss and tinnitus began during service or are otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Evidence of continuity of symptomatology from the time of service until the present is required where the chronicity of a condition manifested during service either has not been established or might reasonably be questioned. 38 C.F.R. § 3.303(b). Establishing service connection generally requires competent evidence of: (1) a current disability; (2) an in-service precipitating disease, injury, or event; and (3) a causal relationship, i.e., a nexus, between the current disability and the in-service event. Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Consistent with this framework, service connection is warranted for a disease first 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). Additionally, certain chronic diseases are subject to a grant of service connection on a presumptive basis when present to a compensable degree within the first post-service year, to include organic diseases of the nervous system. 38 C.F.R. §§ 3.307, 3.309(a). The United States Court of Appeals for Veterans Claims (Court) recently held that tinnitus was a disease, rather than merely a symptom, and that 38 C.F.R. § 3.309(a) “includes tinnitus, at a minimum where there is evidence of acoustic trauma, as an ‘organic disease’ of the nervous system.” Fountain v. McDonald, 27 Vet. App. 258, 271 (2015). The Court also indicated that, as such a presumptive condition, tinnitus warranted consideration of the continuity of symptomatology provisions found at 38 C.F.R. § 3.303(b). Id. at 272. In August 2013, the Veteran was afforded a VA audiological examination. The examination report documented the Veteran’s reports of working a “paperwork job for the military . . . serving for 10 months.” The examiner opined that the Veteran’s hearing loss and tinnitus were less likely than not related to an in-service injury, event, or disease, including in-service noise exposure. For support, the VA examiner stated that there was “no exit audiogram to review. There was only a watch tick test, coin click test, whispered voice test, and spoken voice test; all of which were passed.” The examiner added that “[n]one of these tests are considered a replacement for an audiogram. Other factors that the examiner relied upon were the facts that the Veteran principally worked in an office setting during service and the Veteran served for ten months. In regards to tinnitus, the VA examiner opined that the Veteran’s tinnitus is at least as likely as not a symptom associated with the hearing loss, as tinnitus is known to be a symptom associated with hearing loss. For support, the examination report documented the Veteran’s statement that his tinnitus began two to three years earlier. The Board finds that the probative evidence weighs against a relationship of either hearing loss or tinnitus to service, such that service connection is not warranted. The August 2013 VA examiner determined that a causal link could not be established between the Veteran’s hearing loss and noise exposure because in service audiograms were not conducted during service. While service treatment records did not include audiograms, the examiner cited to the entrance and separation examination whisper and spoken word tests, which did not find any diminishment in hearing. Also, the examiner concluded that tinnitus was more likely to be a symptom of his hearing loss. Notably, the Veteran’s statements place an onset of tinnitus in 2007, he did not otherwise report a history of tinnitus symptoms since service. The examiner’s opinion addressed the Veteran’s history of noise exposure. But, the examiner found the fact that the Veteran did not use a firearm in service and his short period of military service were “major factors” for his opinion. The examiner’s cumulative opinion are probative, because they are based on an accurate medical history and provide an explanation that contains clear conclusions and supporting rationale. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). To the extent that the Veteran’s September 2013 and July 2015 statements are opinions as to the etiology of his bilateral hearing loss or tinnitus, such is not competent medical evidence. Although the Veteran is competent to report his in-service symptoms, he has not shown that he has specialized training sufficient to diagnose medical conditions or render etiological opinions. Thus, the Veteran’s opinions as to the underlying causes of his in-service symptoms and the etiology of his current bilateral hearing loss and tinnitus, both of which require medical expertise and testing to determine, are not competent medical evidence. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). As a final matter, hearing loss was not shown in service or within a year of separation. Nor does the credible evidence support an onset of tinnitus within a year of service. Thus, service connection is also not warranted on a presumptive basis. 38 C.F.R. §§ 3.307, 3.309. In reaching this conclusion, the Board remains sympathetic to the Veteran and grateful for the Veteran’s miliary service, and regrets that more favorable outcome could not be reached. The Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the appellant’s claims, that doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001). S.C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD I. Altendorfer, Associate Counsel