Citation Nr: 18159839 Decision Date: 12/20/18 Archive Date: 12/20/18 DOCKET NO. 17-03 268 DATE: December 20, 2018 ORDER Entitlement to service connection for tinnitus is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his tinnitus began during active service with a continuity of symptoms after service. CONCLUSION OF LAW The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 1112, 1113, 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Navy from April 1967 to June 1974. The Board acknowledges that the Veteran submitted a RAMP (Rapid Appeals Modernization Program) opt-in election form in July 2018, but this appeal had already been activated at the Board and is therefore no longer eligible for the RAMP program. Service Connection A veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in line of duty in active service. 38 U.S.C. §§ 1110, 1131. To establish a right to compensation for a present disability, 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” - the so-called “nexus” requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word “Chronic.” When the disease identity is established (leprosy, tuberculosis, multiple sclerosis, etc.), there is no requirement of evidentiary showing of continuity. Continuity of symptomatology is required only where the condition noted during service (or in the presumptive period) is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. 3.303 (b). Service connection for a recognized chronic disease can also be established through continuity of symptomatology. Walker v. Shinseki, 708 F.3d 1331 (2013); 38 C.F.R. §§ 3.303(b), 3.309. In February 2015, the United States Court of Appeals for Veterans Claims (Court) held that tinnitus was a disease, rather than merely a symptom and 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.” See Fountain v. McDonald, 27 Vet. App. 258 (2015). As the Court held tinnitus to be a chronic disease subject to applicable presumptions, the disease now falls within the parameters of 38 C.F.R. § 3.303 (b), as to claims of chronicity. Entitlement to service connection for tinnitus The Veteran contends service connection is warranted for tinnitus. The Board concludes that the Veteran has a current diagnosis of tinnitus that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Lay statements and treatment records note the Veteran has a current diagnosis of tinnitus. The Veteran served in the U.S. Navy as a submarine missile technician. Veteran contends his tinnitus began in service and is a result of in-service noise exposure. The Veteran reports exposure to pressurized missile tubes which resulted in ongoing ringing in his ears and hearing loss. The Veteran’s DD-214 notes his rating was missile technician with ongoing training in the operation and maintenance of submarine nuclear weapons. The Board finds exposure to hazardous noise is conceded. The Veteran further contends that he began experiencing ringing in his ears after being exposed to loud noises in service and while aboard the USS Abraham Lincoln as a missile technician where he was regularly working in and was exposed to pressurized missile tubes and ongoing loud noise. Specifically, the Veteran contends he was regularly exposed to hazardous noise in service which resulted in ongoing ringing in his ears. The Veteran reports in-service and since he has had ongoing ringing and noise in his ears. The Veteran has further clarified at the April 2016 VA examination he was not asked if he experienced tinnitus, and was not given an opportunity to explain the ongoing ringing in his ears, that began when he noticed his bilateral hearing loss in-service. The Board finds the Veteran’s statements to be competent and credible as to the onset of his current tinnitus, ongoing symptoms and noise exposure in service. The Veteran was afforded a VA examination in April 2016. The VA examiner noted sensorineural hearing loss and military noise exposure with inconsistent use of hearing protection while serving as a missile technician. The VA examiner noted exposure to firing various weapons, noise from carbines, construction in the shipyard, generators and noise from pressurized missile tubes during simulated launch tests. Post-service the examiner noted occupational noise exposure with the use of hearing protection as the supervisor of a substation for an electric utility company. The examiner noted the Veteran had in service noise exposure and found his hearing loss was caused by or a result of an event in service. The examiner noted no reports of recurrent tinnitus. The examiner found as there were no reports of recurrent tinnitus an etiology opinion was not provided. Based on the evidence of record the Board finds that the evidence is in relative equipoise as to the onset of his tinnitus and resolves reasonable doubt in the Veteran’s favor as to the onset of tinnitus in-service. The Board notes there is both favorable and unfavorable evidence regarding the onset of the Veteran’s tinnitus but finds the Veteran’s reports of his symptoms of tinnitus developing in service while as missile technician and being exposed to ongoing hazardous noise with continuous symptoms since service to be credible. The examiner conceded ongoing hazardous noise exposure and attributed the Veteran’s current hearing loss to such. However, the April 2016 VA examiner failed to fully consider the Veteran’s lay statements finding no reports of tinnitus which is inconsistent with the evidence of record. The examiner failed to address the Veteran’s credible lay statements noting his onset of tinnitus during service and symptoms since. Thus, resolving reasonable doubt in the Veteran’s favor, the Board finds it is at least as likely as not that the Veteran’s tinnitus had onset in service after noise exposure, with continuous symptoms since. As such service connection for tinnitus is warranted. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Kardian