Citation Nr: 18161000 Decision Date: 12/28/18 Archive Date: 12/28/18 DOCKET NO. 16-61 425 DATE: December 28, 2018 ORDER Entitlement to service connection for tinnitus is denied. FINDING OF FACT There is not a nexus between the Veteran’s currently diagnosed tinnitus and his in-service noise exposure. CONCLUSION OF LAW The criteria for entitlement to service connection for tinnitus have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131 (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably on active duty in the U.S. Air Force from September 1986 until March 1995. This matter comes to the Board of Veterans Appeals (Board) on appeal from a March 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Manchester, New Hampshire. In an April 2018 letter from the RO, the Veteran was provided an opportunity to participate in VA’s Rapid Appeals Modernization Program (RAMP). See April 2018 RAMP Opt-In Notice. On May 31, 2018, the Veteran elected to participate in RAMP, selecting the option for “Higher-Level Review.” See May 2018 RAMP Opt-In Election. However, appeals that have been activated by the Board are not eligible for RAMP processing. The issue listed on the front page of this decision was activated by the Board prior to the Veteran’s decision to participate in RAMP. The Veteran was subsequently notified of the RAMP determination via a VA letter sent to him shortly thereafter. See June 2018 Correspondence. The Board will thus continue with the adjudication of the issues listed on the front page of this decision pursuant to current appeals procedures. Entitlement to service connection for tinnitus Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303(a) (2018). 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. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2018). In addition, service connection for certain chronic diseases, including organic disease of the nervous system such as tinnitus, may be established on a presumptive basis by showing that the condition manifested to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137 (2012); 38 C.F.R. §§ 3.307, 3.309(a) (2018); Fountain v. McDonald, 27 Vet. App. 258, 271-72 (2015). Although the disease need not be diagnosed within the presumptive period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). Additionally, for certain chronic diseases with potential onset during service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. §§ 3.303(b), 3.309 (2018); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The Veteran asserts that his tinnitus is due to exposure to loud noises from weapons fire, sirens, and aircraft engines. See March 2016 notice of disagreement. The Veteran’s service department records show that his occupational specialty in the Air Force was that of a military policeman, which includes moderate exposure to noise. Thus, in-service exposure to hazardous noise is established. At a February 2016 VA examination, the Veteran reported symptoms of ear buzzing and the examiner diagnosed tinnitus. Accordingly, there is evidence of a current disability and in-service noise exposure. Significantly, however, the evidence of record does not show a nexus between the currently diagnosed tinnitus and the Veteran’s period of service. At the February 2016 VA examination, the Veteran reported that he could not recall when his tinnitus began or whether it was related to a specific incident, but that it had been present for years. He described it as a constant buzzing sound. The Veteran denied noticing any hearing changes in service, and had normal hearing bilaterally. The audiologist reviewed the STRs and concluded that there was no evidence of any significant threshold shifts in service. The VA examiner opined that the Veteran’s tinnitus was not due to his period of service, because there was no verifiable noise injury that could have contributed to the development of tinnitus. The examiner explained that in most cases tinnitus is accompanied by a measurable hearing loss and is not expected to arise from an undiagnosed, latent hearing injury. The 2016 VA examiner opined that the Veteran’s tinnitus was not due to his conceded in-service noise exposure. This opinion was supported by review of the record and well-supported rationale. There is also no evidence that tinnitus began during service or within one year of separation, or that the Veteran has experienced continuity of tinnitus symptoms since separation. Rather, the Veteran specifically denied ringing in his ears upon hearing conservation examinations in April 1994 and November 1994. At the 2015 examination, the Veteran denied hearing changes in service, and did not report that his tinnitus began in service or shortly after separation. Rather, he simply stated that it had been present for many years. Without a showing of continuity of symptoms since service or onset within one year of separation, service connection for tinnitus may not be presumed. While the Veteran has competently and credibly reported in-service noise exposure, that does not demonstrate a nexus between tinnitus and his period of service. In conclusion, entitlement to service connection for tinnitus is not warranted on either a direct or presumptive basis. In reaching this decision, the Board considered the doctrine of reasonable doubt. However, as the preponderance of the evidence is against the Veteran’s claim, the doctrine is not for application. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Smith, Associate Counsel