Citation Nr: 18156665 Decision Date: 12/11/18 Archive Date: 12/10/18 DOCKET NO. 16-62 709 DATE: December 11, 2018 ORDER Entitlement to service connection for tinnitus is denied. FINDING OF FACT The most probative evidence of record does not demonstrate that it is at least as likely as not that the Veteran’s tinnitus had its onset during active service. CONCLUSION OF LAW The criteria for entitlement to service connection for tinnitus are not met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (b); 38 C.F.R. §§ 3.102, 3.303, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1969 to November 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of an April 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Nashville, Tennessee. Duty to Notify and Assist With respect to the Veteran’s claim herein, VA has met all statutory and regulatory notice and duty to assist provisions. See 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126 (2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326 (2017); see also Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015), Dickens v. McDonald, 814 F.3d 1359 (Fed. Cir. 2016). Service Connection – Legal Criteria Service connection may be established for a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation during service of a preexisting injury or disease. 38 U.S.C. §§ 1110, 1131. To establish service connection for a disability on a direct-incurrence basis, a veteran 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, 1167 (Fed. Cir. 2004). Service Connection – Tinnitus The Veteran seeks entitlement to service connection for tinnitus. Tinnitus is readily observable by laypersons and medical expertise is not required to establish its existence. See Charles v. Principi, 16 Vet. App. 370 (2002). Although a Veteran is competent to report tinnitus symptoms, attribution of tinnitus symptoms to a particular cause is a complex medical matter that does not lend itself to lay opinion. See Kahana v. Shinseki, 24 Vet. App. 428 (2011). Service treatment records do not show any symptoms or diagnoses of tinnitus. The Veteran did not report tinnitus during active service or at the time of separation. The Veteran had a VA examination in April 2016. The examiner reviewed the claims file and evaluated the Veteran. She stated that the Veteran reported tinnitus in the left ear beginning in the late 1970s, and that he did not experience tinnitus in service. The Veteran’s occupational noise exposure included working in plants, and around trucks and equipment. He denied recreational noise exposure. The examiner opined that it was less likely than not that tinnitus was caused by or a result of military noise exposure. As rationale, she indicated that the Veteran reported his symptoms of tinnitus began in the late 1970s, several years after his discharge from service, and that it is “widely accepted” that noise-induced tinnitus occurs at the time of exposure, and does not develop years later. She cited medical treatise evidence to support her findings. She later submitted an addendum opinion stating that it is less likely than not that the Veteran’s tinnitus is a symptom of, or caused by, his service-connected bilateral hearing loss. VA treatment records contain reports of audiological treatment in September 2016. The audiologist, Dr. M.G., noted that the Veteran reported having tinnitus in his left ear for “20 or so years,” and began to hear it in his right ear about a year ago. The Veteran submitted lay statements with his VA Form 9, Appeal to Board of Veterans’ Appeals. He indicated that he had never told the examiner that tinnitus began in the 1970s. Rather, he reported that it began during basic training and during combat in Vietnam. He stated that he was not issued hearing protection in the military, and was exposed to noise from small arms, explosives, and mortars. The Board, as fact finder, is fully justified in determining whether lay evidence is credible in and of itself. Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006). When determining the credibility of lay evidence, the Board may properly consider internal consistency, facial plausibility, and consistency with other evidence of record. Caluza v. Brown, 7 Vet. App. 496, 511 (1995). In this regard, the Board attaches high credibility to the reports of the VA examiner in April 2016, and Dr. M.G in September 2016. The VA examiner reported that the Veteran stated that his tinnitus symptoms began in the late 1970s, and he did not experience symptoms during military service. Dr. M.G noted that the Veteran reported having symptoms of tinnitus for “20 or so years,” which would mean that his symptoms started in about 1996, 26 years after his discharge from service. The April 2016 VA examiner opined that it was less likely than not that there was a nexus between the Veteran’s tinnitus and active duty service. She reviewed the claims file, and explained that medical evidence does not support tinnitus occurring years after noise exposure. As the examiner provided a well-reasoned opinion, supported by medical evidence, the Board affords her findings high probative weight. See Prejean v. West, 13 Vet. App. 444, 448-49 (2000). Although the Veteran denied telling the April 2016 VA examiner that his symptoms began in the late 1970s, the record nevertheless contains reports from two separate medical providers, both of whom noted that the Veteran reported that his symptoms onset after his discharge from service. See White v. Illinois, 502 U.S. 346, 352 (1992) (a statement made when procuring medical services, where the declarant knows that a false statement may cause a misdiagnosis or treatment, carries special guarantees of credibility). Because the Veteran’s lay statements are not consistent with the most probative medical evidence of record, the Board affords them lower probative weight. Caluza, 7 Vet. App. at 511. In sum, the most probative evidence does not show that it is at least as likely as not that the Veteran’s tinnitus had its onset during, or is etiologically related to, active duty service. As the preponderance of the evidence is against the claim, the benefit of the doubt does not apply and the claim is denied. 38 U.S.C. § 5107 (b). U. R. POWELL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Reed, Associate Counsel