Citation Nr: 18158361 Decision Date: 12/14/18 Archive Date: 12/14/18 DOCKET NO. 16-60 080 DATE: December 14, 2018 ORDER Service connection for tinnitus is denied. REMANDED Service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD) and depression, is remanded. FINDING OF FACT The Veteran’s current tinnitus did not have onset during service, did not manifest within one year of separation from service and was not caused by service.. CONCLUSION OF LAW The criteria for service connection for tinnitus are not all met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 2005 to October 2008. 1. Entitlement to service connection for tinnitus. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Certain chronic diseases, including tinnitus, may be presumed to have been incurred in or aggravated by service if manifest to a compensable degree within one year of discharge from service, even though there is no evidence of such disease during service. 38 U.S.C. §§ 1101, 1112 (2012); 38 C.F.R. §§ 3.307, 3.309(a) (2017). The Board notes that because of the inherently subjective nature of tinnitus, it is readily capable of lay diagnosis. See Charles v. Principi, 16 Vet. App. 370, 374 (2002) (“ringing in the ears is capable of lay observation”). The Veteran has competently and credibly asserted that she has experienced tinnitus symptomatology since service. Because the Veteran is competent to identify when tinnitus began, and its history, her nexus opinion is also competent evidence and probative of a nexus between current tinnitus and service. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Service treatment records contain no complaints of or treatment for tinnitus symptoms. On the contrary, in a November 2006 post-deployment health assessment the Veteran marked “no” to having ringing of the ears. In a July 2008 report of medical history she marked “no” to having ear trouble. Clinical evaluation of the ears was normal. The claims file does not contain a separation examination. The evidence does not show that tinnitus manifested during service or within one year of separation from service. Presumptive service connection is not warranted. The Veteran was afforded a VA audiological examination in June 2014. She had normal hearing. As for tinnitus, she reported an onset of several years ago that had gradually worsened. The examiner indicated review of the claims file and stated that an opinion could not be provided on the etiology of tinnitus without restoring to speculation. As rationale, the examiner stated that tinnitus is a symptom of hearing loss, but hearing loss is not present. Further, the Veteran was unsure regarding the onset of tinnitus symptoms. In her December 2016 substantive appeal to the Board, the Veteran reported an onset of tinnitus symptoms since service. She explained that she did not know her symptoms were a medical condition because her hearing tests were normal. Based on the foregoing, the Board finds the preponderance of evidence is against the claim. Although the Veteran provided an explanation as to why she did not report tinnitus earlier, the Board finds the explanation unconvincing in light of all of the evidence of record. The examiner’s explanation as to why the claimed tinnitus could not be related to service without speculation is adequate and evidence against the claim as are the Veteran’s earlier denials of symptoms and unsureness as to when symptoms were first experienced. Hence, the appeal as to entitlement to service connection for tinnitus must be denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Entitlement to service connection for an acquired psychiatric disability, to include PTSD and depression, is remanded. The Veteran claims to have PTSD and depression disabilities due to service. Specifically, she alleges that she developed PTSD after witnessing a 2006 motor vehicle accident that caused the death of two soldiers and one child during deployment in Iraq. She reports taking medication for her psychiatric symptoms during service. A review of the claims file indicates that there are outstanding pertinent medical records. In a May 2014 statement in support of claim, the Veteran reported two psychiatric hospitalizations at facilities in Germany during service. Specifically, she reported a December 2006 hospital admission at “Klinikum Mannheim” in Germany to treat a prescription overdose, and a February 2007 hospital admission at Landstuhl Regional Medical Center (LRMC) in Germany. July 2008 service treatment records also document the Veteran’s report of being diagnosed with mild depression and treatment at Heidelberg in Germany. However, medical records from these facilities are not associated with the claims file. As such, a remand is necessary. The matter is REMANDED for the following action: 1. Obtain and associate any outstanding service treatment records with the claims file, including psychiatric treatment at LRMC and Heidelberg in Germany. 2. Send a letter to the Veteran requesting that she identify all records of past and ongoing treatment and provide releases authorizing VA to obtain all records of private treatment, including December 2006 treatment at “Klinikum Mannheim” in Germany. If the Veteran fails to complete necessary authorizations, tell her that she may obtain and submit the records herself. If any records cannot be obtained after attempting to do so, inform the Veteran of this fact, tell her what efforts were made to obtain the records, and advise her of any additional development that will be undertaken. 3. Readjudicate the claim that is the subject of this remand. If any benefit sought on appeal is not granted in full, furnish the Veteran a supplemental statement of the case and allow the appropriate time for response. Thereafter, the case should be returned to the Board, if in order. JAMES G. REINHART Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Amanda Baker, Associate Counsel