Citation Nr: 18160989 Decision Date: 12/28/18 Archive Date: 12/28/18 DOCKET NO. 14-23 273 DATE: December 28, 2018 ORDER Service connection for bilateral sensorineural hearing loss is denied. Service connection for bilateral tinnitus is granted. REMANDED The claim for an initial disability rating in excess of 30 percent for post-traumatic stress disorder (PTSD) is remanded. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran has bilateral hearing loss etiologically related to an in-service event, disease, or injury, to include in-service noise exposure. 2. The Veteran has credibly reported that he first noticed tinnitus during service, and has experienced it ever since. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bilateral sensorineural hearing loss have not been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for entitlement to service connection for bilateral tinnitus have been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1978 to February 1980. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131. Service connection can also be established on a secondary basis for a disability that is proximately due to, or the result of, a service connected disease or injury. 38 C.F.R. § 3.310(a). The Veteran asserts that his bilateral hearing loss and tinnitus are a result of military noise exposure. The record indicates that the Veteran currently has both tinnitus and bilateral hearing loss. Additionally, the record also indicates that during his active service the Veteran served as a fire protection specialist and suggests that he had military noise exposure during active service. As such, the remaining determination is whether the Veteran’s hearing loss and tinnitus were caused by his military service. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. § 3.303(a), (d). The February 2011 VA examiner opined that the claimed conditions were less likely than not related to the Veteran’s military service. The Veteran was assessed with bilateral hearing loss and tinnitus. The Veteran reported an onset of tinnitus during active service and an onset of hearing loss in approximately 1995. He reported decreased hearing in both ears with a gradual onset of hearing loss. He also reported difficulty hearing television, while on the telephone, during conversation, and high-pitched tones. The Veteran’s military and recreational noise exposure was fully documented. The examiner noted that the Veteran’s enlistment examination showed normal hearing with the exception of moderate hearing loss at 6000Hz in the right ear. The separation examination showed normal hearing bilaterally with a notation of a right eardrum perforation approximately eight years prior. Additional hearing tests during the Veteran’s active service were noted to demonstrate mild hearing loss in the right ear at 6000Hz and normal hearing in the left ear. The examiner also noted that hearing tests given in November and December 1979, shortly before the Veteran’s separation from service, indicated normal hearing bilateral at all threshold levels. The examiner further noted that the Veteran’s service records made no mention of tinnitus, but the Veteran’s reported symptoms were consistent with findings common to acoustic trauma. The examiner concluded that based on the Veteran’s military occupational specialty, service audiograms, and report of medical history, there was no basis to conclude that his hearing loss was caused by or the result of his military service as opposed to recreational or occupational noise exposure, or medical contributions. The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against finding that the Veteran’s bilateral hearing loss began during service or is otherwise related to an in-service injury, event, or disease, including military noise exposure. The Board finds the VA examiner’s opinion highly probative and affords it great weight. This opinion is grounded in the Veteran’s service medical history, current medical testing, and relevant medical knowledge. This opinion also provided an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). While the Veteran believes his hearing loss is related to military noise exposure, he is not competent to provide a nexus opinion in this case. This issue is medically complex, as it requires knowledge of organ systems in the body and the interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the VA medical opinion and the objective medical evidence of record. The Board acknowledges that Veteran’s assertion that his VA examination inaccurately states the he received a hearing test upon separation from service, that his only noise exposure was during active service, and that the benefit of the doubt rule should be applied to grant benefits. However, the evidence of record contains both objective medical evidence and opinion evidence indicating that the Veteran’s hearing loss is not causally related to his active service. Service medical records indicate that the Veteran received a separation examination in December 1979 along with an audiogram and the results are documented in the Veteran’s service medical records. Service medical records also indicate essentially normal hearing with improvements in right ear high frequency hearing thresholds during his active service and normal bilateral hearing upon discharge from service. Additionally, the Veteran reported a gradual onset of hearing loss that became noticeable approximately 16 years after his separation from service as well as post-service recreational noise exposure to include hunting and motorboats. Lastly, the examiner concluded that the Veteran’s medical history weighed against service connection. The improvements in hearing during active service, a delayed onset of hearing loss, recreational noise exposure, and a medical opinion all weigh against service connection. Accordingly, service connection for bilateral hearing loss is not warranted. The result with tinnitus is different. 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). Tinnitus, unlike hearing loss, is a disability which cannot at this time be tested on. Rather, the Veteran is uniquely situated to report when he first began to experience symptoms of tinnitus. Here, the Veteran credibly reported that he first noticed tinnitus while in service and that the condition has continued since that time. The Veteran did not seek to embellish his account in any way, and the Board finds it to be credible. Thus, the Veteran’s tinnitus, a chronic disability, began in service and has continued since. Therefore, the criteria for service connection have been met and service connection for tinnitus is granted. REASONS FOR REMAND In December 2018 written correspondence, the Veteran asserted, through his representative, that he has experienced increased occupational and social impairment since he was last evaluated by VA. The most recent VA examination of record is from April 2011 and the most recent mental health treatment encounter is from June 2014. Current medical evidence is needed for the Board to make a fully informed decision in this matter. The matter is REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period June 2014 to present. 2. Obtain a VA examination from an appropriate clinician to determine the current nature and etiology of the Veteran’s PTSD. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. I. Sims, Associate Counsel