Citation Nr: A19001575 Decision Date: 09/26/19 Archive Date: 09/25/19 DOCKET NO. 190318-4149 DATE: September 26, 2019 ORDER The issue of entitlement to service connection for tinnitus is granted. The issue of entitlement to service connection for hearing loss is granted. REMANDED The issue of entitlement to service connection for a prostate disability is remanded. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran’s favor, tinnitus is at least as likely as not related to service. 2. Resolving reasonable doubt in the Veteran’s favor, bilateral hearing loss is at least as likely as not related to service. CONCLUSIONS OF LAW 1. The criteria for readjudicating the claim for service connection for tinnitus have been met. Veterans Appeals Improvement and Modernization Act, Pub. L. No. 115-55, § 5108, 131 Stat. 1105 (2017). 2. The criteria for readjudicating the claim for service connection for bilateral hearing loss have been met. Veterans Appeals Improvement and Modernization Act, Pub. L. No. 115-55, § 5108, 131 Stat. 1105 (2017). 3. The criteria for readjudicating the claim for service connection for a prostate disability have been met. Veterans Appeals Improvement and Modernization Act, Pub. L. No. 115-55, § 5108, 131 Stat. 1105 (2017). 4. The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.326(a). 5. The criteria for service connection for bilateral hearing loss are met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from December 1976 to December 1980 and additional periods of service in the National Guard. In March 2019, the Veteran appealed a March 2019 RO decision directly to the Board, electing the direct review process. Based on the Veteran's choice to pursue a direct review of his appeal, the Board will decide the appeal based on the evidence of record at the time of the prior decision and no additionally submitted evidence may be considered. Service Connection Service connection may be established for disability caused by disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. In order to establish service connection for a claimed disability, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence, generally medical, of a causal relationship between the claimed in service disease or injury and the current disability. Hickson v. West, 12 Vet. App. 247 (1999). Service connection may also be established for any disease initially diagnosed after service, when the evidence establishes that the disease was incurred in service. 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d); Cosman v. Principi, 3 Vet. App. 503 (1992). The disease entity for which service connection is sought must be chronic rather than acute and transitory in nature. For the showing of chronic disease in service, a combination of manifestations must exist 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. Furthermore, service incurrence will be presumed for certain chronic diseases if manifest to a compensable degree within the year after active service. 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307, 3.309. 1. Entitlement to service connection for tinnitus The Veteran asserts that service connection for tinnitus is warranted as he initially experienced tinnitus during active service. The service medical records do not refer to tinnitus. The service personnel records show that the Veteran served in the Air Force as an environmental systems repairman and performed aircraft maintenance duties on the flight line. Therefore, the Veteran's exposure to aircraft related noise is conceded. On VA examination of January 2019, the examiner diagnosed tinnitus. The Veteran reported recurrent tinnitus during active service “which stopped when they changed his duties” and began again five years ago. On examination the Veteran described a constant, bilateral ringing tinnitus. The examiner opined that the tinnitus was less likely than not related to service, noting that it “did not return until five years ago.” In a March 2019 statement appealing the RO decision, the Veteran asserted that his tinnitus “has occurred to some level since 1979, becoming worse over time.” The Veteran is competent to report that tinnitus was present in service and that it has existed from service to the present. 38 C.F.R. § 3.159(a)(2); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Charles v. Principi, 16 Vet. App. 370 (2002). The Veteran is credible to report that tinnitus has been present since service. Resolving all reasonable doubt in the Veteran’s favor, the Board concludes that service connection is warranted for tinnitus. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 2. Entitlement to service connection for hearing loss A current diagnosis of hearing loss disability shall be established when the thresholds for any of the frequencies of 500, 1000, 2000, 3000 or 4000 Hertz are 40 decibels or more; or the thresholds for at least three of these frequencies are 26 decibels; or speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. The service medical records show hearing loss. The Veteran's in-service exposure to hazardous noise is conceded. On the Veteran’s enlistment examination of July 1976, pure tone thresholds, in decibels, were: HERTZ 500 1000 2000 3000 4000 RIGHT 5 5 5 5 15 LEFT 5 5 5 10 15 On the Veteran’s separation examination in August 1980, pure tone thresholds, in decibels, were: HERTZ 500 1000 2000 3000 4000 RIGHT 20 15 5 15 35 LEFT 15 10 10 25 30 Reference audiogram results of September 1982 showed pure tone thresholds, in decibels, were: HERTZ 500 1000 2000 3000 4000 RIGHT 5 5 5 15 35 LEFT 5 5 0 20 30 On the authorized audiology evaluation in November 1986, pure tone thresholds, in decibels, were: HERTZ 500 1000 2000 3000 4000 RIGHT 0 0 0 5 25 LEFT 0 0 0 15 25 On the VA audiology evaluation in January 2019, pure tone thresholds, in decibels, were: HERTZ 500 1000 2000 3000 4000 RIGHT 10 15 15 35 50 LEFT 5 10 15 40 50 Speech audiometry found speech recognition ability of 94 percent in the right ear and of 96 in the left ear. Bilateral sensorineural hearing loss was diagnosed. The examiner concluded that the Veteran’s current hearing loss disability was “less likely as not (50% probability or greater) related to his military service” because the Veteran’s hearing loss “was not noted on the 1986 physical which was within normal limits…in both ears, did not have any significant decreases in thresholds from 1976, and did not meet the VA criteria for a service connected disability.” The Board notes that audiological testing has shown consistent hearing loss apart from a National Guard 1982 examination. The inconsistency of those results calls into question the validity of the 1982 examination. The Board finds that the Veteran’s diagnosed bilateral sensorineural hearing loss at least as likely as not is due to noise exposure during active service. Exposure to hazardous noise in service is conceded. The Veteran’s reports of loud noise are consistent with duties on the flight line as an environmental systems repairman. Exposure to hazardous noise for this military occupational specialty is considered highly probable. The evidence also shows hearing loss due to a puretone threshold of 20 decibels or more in both ears at separation from service. Bilateral sensorineural hearing loss has been diagnosed. The evidence shows symptoms of hearing loss during and since service, and establishes a continuity of symptomatology. Resolving reasonable doubt in favor of the Veteran, the Board concludes that service connection for bilateral hearing loss is warranted as symptoms were shown in service that have continued to the present. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND The issue of entitlement to service connection for a prostate disability is remanded. The record shows that the Veteran served with the Arkansas Air National Guard. The Veteran's periods of active duty, active duty for training, and inactive duty for training with the Arkansas Air National Guard have not been verified. VA should obtain all relevant service records and medical records which could potentially be helpful in resolving the Veteran's claims. Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for any private medical treatment for a prostate disability. Make attempts to obtain those records. If those attempts are unsuccessful, notify the Veteran. 2. Contact the appropriate service entity and request verification of the Veteran's complete periods of active duty for training and inactive duty for training with the Arkansas Air National Guard and that any outstanding service medical and personnel records associated with the Veteran's service be provided for incorporation into the record. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Duke, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.