Citation Nr: 19124792 Decision Date: 04/03/19 Archive Date: 04/02/19 DOCKET NO. 17-43 494 DATE: April 3, 2019 ORDER Service connection for tinnitus is denied. FINDING OF FACT Tinnitus is not attributable to service and was not manifest within one year of separation from service. CONCLUSION OF LAW The criteria for service connection for tinnitus have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1968 to May 1973 in the United States Air Force. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In August 2018, the Veteran testified before the undersigned during a hearing at the RO. A transcript of the hearing is included in the electronic claims file. The electronic filing system contains additional records that were associated with the file by VA, rather than the Veteran, since the RO’s last readjudication of the claim without a waiver of RO jurisdiction. See 38 U.S.C. § 7105(e)(1), (2) (2012) (applicable in cases where the substantive appeal is filed on or after Feb. 2, 2013). However, the records do not contain information pertinent to the decision below. As such, there is no risk of prejudice to the Veteran from proceeding without the waiver. Service Connection Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to show a service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). For certain chronic diseases, such as tinnitus, a presumption of service connection arises if the disease is manifested to a degree of 10 percent within one year following discharge from service. 38 C.F.R. §§ 3.307(a)(3), 3.309(a); Fountain v. McDonald, 27 Vet. App. 258 (2015). For those listed chronic diseases, a showing of continuity of symptoms affords an alternative route to service connection when the requirements for application of the presumption are not met. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F. 3d 1331 (Fed. Cir. 2013). The Veteran has current tinnitus, documented on VA examination in April 2017. On his service entrance examination, tinnitus was not noted and the Veteran raised no pertinent complaints. Tinnitus was not documented in the service treatment records (STRs), or on his separation examination report. However, service records show that his military occupational specialty (MOS) was in communication systems, a MOS associated with a moderate to high probability of exposure to hazardous noise. On VA examination in April 2017, the examiner noted the Veteran’s in-service noise exposure. The Veteran reported he could not remember the circumstances under which his tinnitus began, but stated he had experienced it for many years. Upon clinical examination and a review of the claims file, the examiner opined that the tinnitus was less likely than not caused by or the result of in-service noise exposure. The examiner stated that the main cause of tinnitus is hearing loss, and the Veteran has normal hearing in both ears. In the absence of hearing loss induced by in-service noise exposure, and/or documentation of tinnitus in the STRs, the etiology of tinnitus was less likely than not acoustic trauma from the military. The examiner further explained that tinnitus can arise from a number of medical conditions, including arthritis, cervical spine problems, stress, thyroid disorders, and the side-effects of certain medications. In August 2018, the Veteran testified before the undersigned regarding his hazardous noise exposure in service caused by wearing ear phones and a headset for many hours per day in a radar facility at an airport. He testified that his tinnitus began during service and has persisted ever since discharge. He stated that his tinnitus causes difficulty sleeping, and he has been prescribed medication for nearly 20 years to help with his sleep problems. Considering the pertinent evidence in light of the governing legal authority, the Board finds that the preponderance of the evidence is against the claim. The Veteran was clearly exposed to acoustic trauma in service. However, the fact that he sought treatment for other conditions after service, but not tinnitus, suggests, but is not dispositive of the fact, that either the condition was not then-present or that it was not continuous since service. On an August 1973 VA examination, there were no abnormal findings related to the ears and there was no hearing loss. The credibility of his report of tinnitus since service, including within one year of service, is undermined by his inconsistent reports of whether the disability has been constant or occasional and the circumstances under which it began. See Madden v. Gober, 125 F.3d 1477, 1481 (holding the Board is entitled to discount the credibility of evidence in light of its own inherent characteristics and its relationship to other items of evidence). As noted, he reported to the VA examiner that he was unclear of the onset of the disability. In VA treatment records of April 2015, September 2015, January 2016, April 2016, June 2016, October 2016, and March 2017, and in private medical reports of July 2017 and August 2017, medical providers indicated no current tinnitus. Further, as the record indicates the Veteran has severe sleep apnea, which is also shown to interfere with sleep, it is unclear that he has been prescribed sleeping medication due to tinnitus as reported. Even if it has been prescribed for tinnitus, the records documenting the prescriptions do not indicate the etiology of tinnitus. Moreover, the probative medical opinion evidence does not show that the Veteran’s tinnitus is related to his active military service, including his in-service noise exposure. The April 2017 VA examiner addressed the contentions of direct service connection but opined that the Veteran’s tinnitus was not related to acoustic trauma in the military in the absence of hearing loss. This conclusion was based on an examination of the claims file, including the Veteran’s reported history and symptoms. A rationale for the conclusions reached was provided. The only evidence to the contrary of the VA examination reports is the lay evidence. As noted above, the inconsistent nature of his reports regarding the onset of tinnitus renders his reports unreliable for purposes of determining the etiology of the condition. In reaching this decision the Board considered the doctrine of reasonable doubt, however, the doctrine is not for application. M. Tenner Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Smith, Counsel