Citation Nr: 18158771 Decision Date: 12/17/18 Archive Date: 12/17/18 DOCKET NO. 16-57 034 DATE: December 17, 2018 ORDER Entitlement to service connection for tinnitus is denied. FINDING OF FACT Tinnitus is not etiologically related to active service and may not be presumed to have been incurred in service. CONCLUSION OF LAW The criteria for service connection for tinnitus have not been met. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from April 1962 to September 1966. 1. Tinnitus The Veteran asserts that he has tinnitus due to noise exposure during active service. In addition to serving in an artillery company, he asserts that he was exposed to hazardous noise from firing M-16s, M-14s, .45 caliber pistols, recoilless rifles, and rocket launchers without the aid of hearing protection. See VA Form 9, formal appeal to the Board, received November 22, 2016. The Board finds the Veteran’s account credible and consistent with the circumstances of his service, and concedes in-service hazardous noise exposure. 38 U.S.C. § 1154 (a) (2012). To prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (a) (2017). The question for the Board is whether the Veteran’s current diagnosis of tinnitus either began during active service, or is etiologically related to an in-service disease or injury. The Board finds that competent, credible, and probative evidence does not establish that tinnitus is etiologically related to the Veteran’s active service. The Veteran’s April 1962 service entrance examination and August 1966 service separation examination show that his hearing was within normal limits. His service treatment records (STRs) do not show any complaints of tinnitus. Here, the Board notes that the “whisper test” (or speaking to him from 15 feet away) is not very reliable, and those results do not assist in determining the extent of change in the Veteran’s hearing loss levels during his service. See Fagan v. Shinseki, 573 F.3d 1282, 1284 (Fed. Cir. 2009) (quoting a VA examiner’s statement that, “although Mr. Fagan did not exhibit signs of hearing loss during the ‘whisper’ test at discharge from the military, a ‘whisper’ test does not provide frequency or ear specific information and therefore does not rule out, or confirm, high frequency hearing loss”). The Veteran’s VA treatment records show that he denied any tinnitus symptoms during an evaluation in March 2015, and simultaneously wanted a tinnitus and deafness evaluation, as he said he has experienced both for many years. He declined an audiology referral. See VA treatment records, March 18, 2015. In June 2015, the Veteran asserted that he experienced tinnitus since the 1960s/1970s, when he was in active service. See VA treatment records, June 24, 2015. A VA examiner reviewed the Veteran’s records in September 2015. See VA examination, September 25, 2015. The examiner opined that it was less likely as not that the Veteran’s current tinnitus was related to his service. The examiner reasoned that the Veteran reported that his tinnitus first began in 1980, about 14 years after separation from service. The examiner related that hearing loss and tinnitus often co-exist, and in many cases may have similar causes (like noise exposure), but one condition did not cause the other. The examiner stated that there are many possible causes for tinnitus beyond noise exposure, and there was no evidence in the form of a published, peer-reviewed journal article, to substantiate the claim that hearing loss causes tinnitus. The examiner added that anecdotal evidence, including that from website, has not been scientifically proven. In lay statements, the Veteran related that he was exposed to the noise resulting from firing M-16s, M-14s,.45 caliber pistols, recoilless rifles, and rocket launchers without the aid of hearing protection. He stated that his tinnitus started after he separated from active service, and that the tinnitus worsened in 1980, which is when he sought medical attention for it. The Veteran stated that the medical records from 1980 have been destroyed. See VA Form 9, formal appeal to the Board, received November 22, 2016. As a lay person, the Veteran is competent to report observable symptoms, such as having ringing in his ears. See Washington v. Nicholson, 21 Vet. App. 191, 195 (2007) (holding that, “[a]s a layperson, an appellant is competent to provide information regarding visible, or otherwise observable symptoms of disability”); see also Barr v. Nicholson, 21 Vet. App. 303 (2007) (Lay testimony is competent to establish the presence of observable symptomatology); Layno v. Brown, 6 Vet. App. 465 (1994). Lay evidence may be competent on a variety of matters concerning the nature and cause of disability. Jandreau, 492 F.3d at 1377 n.4. While the Veteran is competent to report having experienced symptoms of tinnitus, he is not competent to determine that these symptoms are somehow related to his active service or any service-connected disabilities. This issue is medically complex, as it requires specialized medical knowledge. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the medical evidence in this case. The Board has also considered continuity of symptomatology, especially where the Court has clarified that the Federal Circuit's decision in Walker does not preclude establishing service connection for tinnitus on the basis of continuity of symptoms, because tinnitus is an "organic disease of the nervous system," which is listed in § 3.309(a). Fountain v. McDonald, 27 Vet. App. 258, 272 (2015); see Walker v. Shinseki, 708 F.3d 1331, 1340 (Fed. Cir. 2013). His statements as to a continuity of symptomatology are less persuasive because his tinnitus was not shown in service, or after service until about 2015, and his claims of symptoms are not supported by evidence of record. In addition, no evidence exists in the Veteran’s STRs to show that he had any hearing-related issues in active service. Here, the Board acknowledges that the Veteran asserts that he saw a physician for his tinnitus in 1980, and that those records have been destroyed. However, there is no assertion that the physician tied the Veteran’s tinnitus to his service in any way, or opined that the Veteran’s in-service hazardous noise exposure over 14 years before 1980 caused his tinnitus. In sum, no medical evidence supports the Veteran’s contentions that his tinnitus is in any way related to his active service. The evidence of record is against a finding that any tinnitus the Veteran experienced is related to service or to any in-service issues. The Board finds it significant that the Veteran has not presented or identified any medical opinion that supports the claim for service connection for tinnitus. And no other opinion of record establishes that the Veteran’s tinnitus is etiologically related to, or the result of, an injury experienced during active service. No relationship between tinnitus and active service has been established by either competent evidence or continuity of symptomatology. Accordingly, the Board finds that the preponderance of the evidence is against the claim for service connection for tinnitus and the claim must be denied. 38 U.S.C. § 5107 (b) (2012); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Lech, Counsel