Citation Nr: 18156843 Decision Date: 12/11/18 Archive Date: 12/11/18 DOCKET NO. 14-35 926 DATE: December 11, 2018 ORDER Service connection for tinnitus is granted. REMANDED Bilateral hearing loss is remanded. FINDING OF FACTS The Veteran’s tinnitus began during his military service. CONCLUSION OF LAW The criteria for service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION Service Connection Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated in active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). In general, service connection requires (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) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran served on active duty from 1968 to 1972 and from 1973 to 1989. He contends that he has tinnitus that onset in service. He asserts that while serving on the USS Mckean DD-784, he was exposed to hazardous noise such as cannon fire without hearing protection. At his April 2011 VA examination, the Veteran reported experiencing constant tinnitus. At another VA examination in June 2012, the Veteran continued to report tinnitus, but greater in the right ear. He stated that he began to experience the ringing in service. The Court of Appeals for Veterans Claims (Court) has specifically held that tinnitus is a type of disorder associated with symptoms capable of lay observation. See Charles v. Principi, 16 Vet. App. 370 (2002). As such, the primary role of the Board in adjudicating the tinnitus claim is to assess the credibility of the Veteran’s statements. See Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). In this case, the Board finds the Veteran’s testimony as to the onset of his tinnitus credible, and he has credibly reported that his tinnitus began in-service and has continued to the present time. The Veteran has not attempted to bolster or exaggerate his symptoms. His statements regarding the onset of his tinnitus and military noise exposure are found to be credible. As such, the criteria for service connection for tinnitus have been met and the claim is granted. REASONS FOR REMAND The Veteran contends that he developed bilateral hearing loss as a result of military noise exposure. Specifically, he asserts that he was exposed to loud cannon fire while aboard the USS McKean DD-784 without hearing protection. Audiometric testing confirms that the Veteran has bilateral hearing loss for VA purposes. The question in this case is whether a causal relationship or nexus exists between the Veteran’s hearing loss and either military noise exposure or in-service complaints of ear pain. The Veteran’s entrance examination revealed normal hearing. His service treatment records show that a head injury was noted in March 1974. The Veteran reported right ear pain (otitis media) in March 1978. That same month, it was also noted that he had wax impaction, with right ear pain, with some hearing loss. Audiometric testing was conducted on several occasions in service and the results are summarized in the November 2018 Appellant’s Brief. Unfortunately, audiometric testing does not appear to have been conducted at separation in At his April 2011 VA examination, the Veteran demonstrated hearing loss in both ears for VA purposes. His audiometry readings were as follows: Hertz 1000 2000 3000 4000 RIGHT 20 40 35 45 LEFT 20 30 30 40 The examiner opined that it was at least as likely as not (50 percent or greater) that the Veteran’s bilateral hearing loss was the result of his military noise exposure based on a notch in the in-service hearing tests. However, the notch was not specifically identified. At another VA examination in June 2012, the Veteran underwent another audiology testing. His purtone thresholds were as follows: Hertz 1000 2000 3000 4000 RIGHT 20 25 35 45 LEFT 15 25 25 40 The VA examiner confirmed that the Veteran had mild sensorineural hearing loss, but found that the hearing loss was less likely related to his military service. The examiner explained that throughout the Veteran’s tours, his audiological results were within normal limits bilaterally. His MOS is not consistent with noise exposure, as he was not involved in combat. His service treatment record noted no significant shifts in his hearing threshold between 1966 and 1984. Furthermore, his current audiometric configuration is not consistent with acoustic trauma. When evaluating his current degree of hearing loss, one cannot rule out contributions from his occupational noise exposures and aging effects. The Veteran told the examiner that he was a store keeper when he served in the Navy between 1969 to 1972 and 1973 to 1989. He denied being exposed to combat, but reported being exposed to helicopter noise and gun fire, with the use of hearing protection. The examiner noted that prior to entering service, the Veteran worked with tractors on his family farm. He was also employed at a grocery store and went to college before entering service. Between his two tours of duty, he was an assistant manager at a grocery store for 9 months. Following his separation, he was in data entry for BestTemps for 2 years, at Roll-O-Matic in production for 1 year, in care sales for 1 year, a purchasing agent for the Corp of Engineers for 5 years, a purchasing agent for the F.A.A., a warehouse manager, a contractor, a bike repairman, a customer representative, and a security employee at Boy Scouts of America for 7 years. Recreationally, he owned a motor cycle for 15 years and hunted on occasion. No other otologic conditions were noted except for a history of right ear pain, external otitis, and wax production. This examination concluded that the Veteran did not have military noise exposure, but in his substantive appeal the Veteran explained that he was based on a ship for four years and his office was approximately six feet from the main gun battery, exposing him to noise on a daily basis. The Veteran also reported having to go to the flight deck to meet helicopter shipments. As such, the Board finds that the Veteran did in fact have significant in-service noise exposure. Given this determination, another medical opinion should be obtained. The matters are REMANDED for the following action: Obtain a medical opinion to address the etiology of the Veteran’s bilateral hearing loss. If an opinion cannot be provided without a physical examination, one should be scheduled. The examiner should opine as to whether it is at least as likely as not (50 percent or greater) that the Veteran’s bilateral hearing loss either began during or was otherwise caused by his military service, to include as a result of military noise exposure or in-service ear pain? Why or why not? (Continued on the next page)   In so doing, the examiner is informed that the Veteran has credibly reported being exposed to noise on a daily basis based on his office’s proximity to the main guns of a ship for four years. The examiner should also review the conclusions of the April 2011 and June 2012 VA examiners. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N.Yeh, Associate Counsel