Citation Nr: 18111908 Decision Date: 06/18/18 Archive Date: 06/18/18 DOCKET NO. 14-19 533 DATE: June 18, 2018 ORDER Entitlement to service connection for tinnitus is granted. REMANDED Entitlement to service connection for hypertension secondary to an acquired psychiatric disorder, diagnosed as anxiety disorder, claimed as posttraumatic stress disorder (PTSD) is remanded. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his tinnitus began during active service. CONCLUSION OF LAW The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1101, 1110; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from April 1968 to January 1970, including combat in the Republic of Vietnam. 1. Entitlement to service connection for tinnitus The Veteran asserts that his tinnitus began in 1969, during his active service. 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). Because of the Veteran’s combat service, acoustic trauma in service is conceded. The Veteran’s service treatment records (STR) are silent for any complaint, diagnosis, or treatment of tinnitus. His hearing was within normal limits on enlistment and separation examinations. The Veteran submitted a May 2011 statement that his ears have been ringing since 1969, shortly after his return from Vietnam. In his June 2011 psychiatric VA examination, the Veteran stated that he was close enough to an explosion in July 1969 that he was thrown backwards. On his May 2014 appeal form he clarified, stating that after the explosion in July 1969 he went deaf for a few days, and has had ringing in his ears since then. This description matches what he told VA audiologists treating him in June 2014, and his statements under oath at his February 2018 Board hearing. VA provided a June 2011 examination of the Veterans hearing and tinnitus. The examiner confirmed that the Veteran has a current diagnosis of tinnitus, and the June 2011 VA examiner opined that the Veteran’s bilateral hearing loss and tinnitus were less likely than not caused by service. The rationale was that the Veteran’s hearing was normal upon separation and there was no independent evidence of complaints of ringing or tinnitus in the Veteran’s STRs. The examiner opined that the Veteran’s tinnitus was at least as likely as not a symptom of his hearing loss. Service personnel records show that the Veteran has combat status, and the Board finds his lay testimony regarding what happened during combat consistent with the circumstances of his combat service as a combat infantryman, confirmed by his award of the Bronze Star with Valor. 38 U.S.C. § 1154(b). Specifically, the Veteran stated that in July 1969 he was near enough to an explosion that he was thrown backwards and lost his hearing for several days, followed by recurrent ringing in his ears. The Board finds that the June 2011 VA examiner’s opinion was inadequate for rating purposes, as it failed to provide a reason for questioning the Veteran’s version of events, other than the lack of contemporaneous medical records. Even if the opinion had been adequate, the examiner found that tinnitus was at least as likely as not a symptom of hearing loss. This leaves the evidence on this issue in equipoise, a situation which must be resolved in favor of the Veteran. The Board finds that the Veteran’s credible statements as to the first occurrence of his tinnitus symptoms are sufficient competent evidence to establish that the condition began in service, and the June 2011 VA examiner’s opinion is not adequate to overcome this evidence. Service connection for tinnitus must therefore be granted. REASONS FOR REMAND 1. Entitlement to service connection for hypertension secondary to an acquired psychiatric disorder, diagnosed as anxiety disorder, claimed as posttraumatic stress disorder is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for hypertension because no VA examiner has opined whether the Veteran’s hypertension is secondary to his acquired psychiatric disorder, diagnosed as anxiety disorder. Furthermore, no VA examiner has adequately opined whether or not the Veteran’s hypertension was aggravated by any service-connected disability, including his anxiety and diabetes mellitus type II. A December 2011 VA examiner offered an opinion that the Veteran’s hypertension was not caused by PTSD, but the Veteran has not been diagnosed with or granted service connection for PTSD, so this opinion is not adequate. It also failed to address the issue of aggravation. A June 2011 VA examiner opined that the Veteran’s hypertension was neither caused nor aggravated by diabetes, but no reasoning was offered in support of the aggravation part of that opinion. The matter is REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s hypertension is at least as likely as not related to, proximately due to, or aggravated beyond its natural progression by any service-connected disability. The Veteran is currently service-connected for anxiety disorder, not otherwise specified (claimed as PTSD) and for diabetes mellitus type II. 2. Readjudicate the claim. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Zimmerman, Associate Counsel