Citation Nr: 18155924 Decision Date: 12/06/18 Archive Date: 12/06/18 DOCKET NO. 15-14 439 DATE: December 6, 2018 ORDER Service connection for bilateral hearing loss is granted. Service connection for tinnitus is granted. FINDINGS OF FACT 1. The evidence is at least in equipoise that the Veteran’s current bilateral hearing loss for VA purposes is at least as likely as not related to his noise exposure from service. 2. The Veteran has experienced ringing in his ears related to tinnitus since he separated from service. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss are met. 38 U.S.C. §§ 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.385. 2. The criteria for entitlement to service connection for tinnitus are met. 38 U.S.C. §§ 1112, 1113, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the United States Army from March 1955 to March 1956. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a July 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a videoconference Board hearing in September 2018. A transcript is of record. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1131; 38 C.F.R. § 3.303. In order to establish entitlement to service connection, there must be 1) evidence of a current disability; 2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and 3) causal connection between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection for certain diseases, such as an organic disease of the nervous system, including sensorineural hearing loss and tinnitus, may also be established on a presumptive basis by showing that such a disease manifested itself to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307(a)(3), 3.309(a). In such cases, the disease is presumed under the law to have had its onset in service even though there is no evidence of such disease during the period of service. 38 C.F.R. § 3.307(a). A nexus between a current disability and an in-service injury or event may be established by evidence of continuity of symptomatology, if the condition is a chronic disease enumerated under 38 U.S.C. § 1101. Walker v. Shinseki, 708 F.3d 1331, 1338-40 (Fed. Cir. 2013). Tinnitus is considered an organic disease of the nervous system, and as such is an enumerated chronic disease. See 38 U.S.C. §§ 1101, 1112; Memorandum, Characterization of High Frequency Sensorineural Hearing Loss, Under Secretary for Health, Oct. 4, 1995; see Fountain v. McDonald, 27 Vet. App. 258, 271 (2015) (holding 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’”); 38 C.F.R. §§ 3.307, 3.309. The Veteran is competent to report symptoms and experiences observable by his senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed Cir. 2009). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 57–58 (1990). 1. Entitlement to service connection for bilateral hearing loss. The Veteran asserts service connection for bilateral hearing loss. The Veteran underwent a VA audiological examination in July 2014. For the Veteran’s right ear, the results were: A B C D E F G 500 Hz 1000 Hz 2000 Hz 3000 Hz 4000 Hz 6000 Hz 8000 Hz 50 70 95 100 105 105+ 105+   For his left ear, the results were as follows: A B C D E F G 500 Hz 1000 Hz 2000 Hz 3000 Hz 4000 Hz 6000 Hz 8000 Hz 40 70 85 95 100 95 85 His right ear average was 93 Hz, and his left ear was 88 Hz. His speech discrimination score was 36 percent in both ears. The Veteran has a current diagnosis of bilateral hearing loss for VA purposes, and the examiner noted he had sensorineural hearing loss. However, regarding the etiology, the examiner was unable to determine the cause of the Veteran’s hearing loss without resorting speculation. The examiner explained that the entrance and exit audiograms were unavailable due to fire, and that no hearing tests were performed during service. During the examination, the Veteran stated that he noticed hearing loss following service, had noise exposure during service, and the examiner concluded that military noise exposure could not be ruled out as a cause of the Veteran’s hearing loss. The Board finds this examination to have probative weight as the examiner conducted an in-person examination, and accounted for the Veteran’s lay statements. While the examiner did not provide a conclusive opinion, the Board finds it to still have weight as the examiner found that military noise exposure could be the cause of the Veteran’s hearing loss, but was unable to say concretely as service treatment records are not available. In September 2018, the Veteran testified that he was exposed to loud noises while in service due to large caliber weapons and small arms fire on a consistent basis, and that he has had hearing related problems since service. Moreover, he explained that he has not had noise exposure in his post-service career as he has worked as a salesman. He also explained that he was unable to afford hearing aids until his mid-thirties. The Veteran is competent to report his hearing problems. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). His testimony is credible and entitled to probative weight, as it is internally consistent and consistent with other evidence of record. After review of the competent and probative evidence, the Board concludes the evidence is at least in equipoise that the Veteran’s bilateral hearing loss is related to his noise exposure in service. 38 U.S.C. §§ 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The above noted VA examination report shows that the Veteran has a current diagnosis of bilateral hearing loss for VA purposes. However, the July 2014 VA examiner was unable to opine on the etiology of the Veteran’s hearing loss, but noted that his military noise exposure could be the cause. The Veteran has competently and credibly testified that his hearing loss began soon after service because of his military noise exposure. Therefore, when resolving reasonable doubt in favor of the Veteran, the Board finds that the evidence is at least in equipoise that the Veteran’s current bilateral hearing loss for VA purposes is related to hazardous noise exposure in service. The Board acknowledges that there is not a conclusive positive medical nexus opinion, but the examiner noted it was possible that his hearing loss is related to military noise exposure. This, combined with the Veteran’s hearing problems since service for his sensorineural hearing loss, place the evidence regarding nexus into equipoise on this material issue. 38 U.S.C. § 5107(b). As such, the Board finds that service connection for bilateral hearing loss is warranted. 38 C.F.R. § 3.303. 2. Entitlement to service connection for tinnitus. The Veteran contends that he has had tinnitus since service. The Board concludes that while the Veteran’s tinnitus was not diagnosed during service, there has been continuity of the same symptomatology beginning in service. The Veteran has a current diagnosis of tinnitus as noted at the July 2014 VA examination; however, this VA examiner did not opine regarding the Veteran’s tinnitus. The examiner did note that the Veteran stated that his tinnitus began after noise exposure in the military, and that military noise exposure could not be ruled out as the cause of the Veteran’s tinnitus. The Board finds this examination to have some probative value as the examiner’s rationale acknowledged the Veteran’s statements regarding the onset of his tinnitus and his military noise exposure. In September 2018, the Veteran explained that he has tinnitus, but that it is not constant. As noted above, the Veteran had heavy noise exposure in service. He also explained that hearing aids can help with the hissing noise that he has dealt with. He is competent to report that he experienced symptoms of ear ringing during service. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). The Board finds that his lay statements are credible and competent and are entitled to probative weight as they are internally consistent and consistent with other evidence of record. (Continued on the next page)   Therefore, the Board finds that the evidence shows that Veteran’s tinnitus is related to hazardous noise exposure while in service, and that his tinnitus began in service and has continued since then. 38 C.F.R. § 3.303(b), 3.309(a). While there is not a positive, conclusive medical opinion regarding the etiology of the Veteran’s tinnitus, the Veteran has testified as to the onset of his tinnitus beginning while in service. As such, the Board finds that service connection for tinnitus is warranted. 38 C.F.R. § 3.303. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD G. Morales, Associate Counsel