Citation Nr: 20052011 Decision Date: 08/05/20 Archive Date: 08/05/20 DOCKET NO. 18-04 018 DATE: August 5, 2020 ORDER Entitlement to service connection for diabetes mellitus, type II (DM), is granted. Entitlement to service connection for tinnitus is granted. Entitlement to service connection for bilateral hearing loss is granted. FINDINGS OF FACT 1. The Veteran has DM. 2. DM is associated with exposure to certain herbicide agents. 3. While stationed at U-Tapao RTAFB in Thailand from at least July 1970 to May 1971, the Veteran was near the air base perimeter and was exposed to herbicide agents. 4. The Veteran’s tinnitus began in service and has continued to the present. 5. The Veteran’s bilateral hearing loss began in service and has continued to the present. CONCLUSIONS OF LAW 1. The criteria to establish service connection for DM have been met. 38 U.S.C. §§ 1110, 1131, 1116, 5107; 38 C.F.R. §§ 3.102, 3.307, 3.309. 2. The criteria to establish service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.307, 3.309. 3. The criteria to establish service connection for hearing loss have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1968 to November 1980. He served various periods of active duty for training (ACDUTRA) and inactive duty training (INACDUTRA) as part of the Air Force Reserve from January 1983 to December 2002. He appeals a February 2017 rating decision by the Agency of Original Jurisdiction (AOJ) denying service connection for DM, tinnitus, and hearing loss. A Board hearing was held in September 2019. A transcript is of record. Service Connection A Veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. §§ 1110, 1131. Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an 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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). Under 38 C.F.R. § 3.303(b), claims for chronic diseases enumerated in 38 C.F.R. § 3.309(a) benefit from a relaxed evidentiary standard. See Walker v. Shinseki, 708 F.3d 1331, 1339 (Fed. Cir. 2013). DM, hearing loss, and tinnitus are such diseases. To show a chronic disease in service, the record must contain 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 is required to support the claim. 38 C.F.R. § 3.303(b). 1. DM VA has determined that special consideration of exposure to an herbicide agent on a factual basis should be extended to veterans who served on or near the perimeters of Thailand military bases during the Vietnam era. In pertinent part, exposure to an herbicide agent will be conceded on a direct/facts found basis where a veteran served in the United States Air Force at U-Tapao Thai Air Force Base (RTAFB) near the air base perimeter as shown by evidence of daily work duties, performance evaluation reports, or other credible evidence. See VA Adjudication Procedure Manual M21-1 (M21-1), pt. IV, subpt. ii, § 1.H.4.b (last accessed August 4, 2020) Here, several foundational facts are not in dispute. The Veteran has DM. See March 2016 Dr. J.Z. medical opinion. He served on U-Tapao RTAFB from at least July 1970 to May 1971. See military personnel record. As a medical nexus between herbicide agent exposure and DM is not in dispute, the dispositive factual inquiry in this case is whether the Veteran was exposed to herbicide agents during service. In other words, if the Veteran was exposed to herbicide agents at U-Tapao RTAFB, entitlement to service connection for DM is warranted. The record reflects that the Veteran worked as a special investigations officer as well as accounting and finance officer during his time in service. See DD Form 214. On at least eight occasions, the Veteran left U-Tapao to transport priority high value cargo to other bases. See, e.g., February 1971 temporary duty assignment. In March 1971, the Veteran went to both Korat and Ubon RTAFB to distribute cash to accounting and financing offices in Thailand. See March 1971 temporary duty assignment. The Board notes that both Korat and Ubon RTAFB are also listed as bases for which an Air Force serviceman can show he was otherwise near the air base perimeter for VA to concede herbicide agent exposure during the Vietnam era. At his Board hearing, the Veteran explained that his living quarters were adjacent to the perimeter fence, and that his work duties, to include crossing over the perimeter several times to deliver high priority cargo, placed him near or around the perimeter fence very often. See September 2019 Board hearing transcript, at 3-4. The Veteran has also submitted maps showing the proximity of his living quarters to the perimeter fence. See, e.g., January 2018 maps. Therefore, as to this particular Veteran, the Board finds sufficient corroborative evidence showing he was exposed to herbicide agents in service on a facts-found basis. As a result, the Board also finds the Veteran’s DM is related or attributable to service, and service connection is granted. 2. Tinnitus The Veteran has tinnitus. See September 2019 Board hearing transcript at 9. He contends that his tinnitus began in service and has continued since. Id. The Board finds that the Veteran continued to experience tinnitus from his time in service to the present. The Veteran is competent to report that he experienced tinnitus though he did not seek treatment. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). His statements are credible and entitled to probative weight, as they are internally consistent. Further, gaps in treatment are not the same as gaps in symptoms. The presence of the former does not imply the presence of the latter. Accordingly, the Board finds that the Veteran’s claim for service connection for tinnitus has met the relaxed evidentiary requirements under 38 C.F.R. § 3.303(b). Therefore, the criteria for service connection for tinnitus have been met. 3. Hearing Loss The Veteran has bilateral hearing loss for VA purposes and was exposed to loud noises in service as a special investigations officer. See February 2017 VA examination report. As the Veteran explained, he had to qualify on his assigned weapon quarterly as part and parcel of his job as a special agent in the military. See September 2019 Board hearing transcript at 5-6. Thus, he had to fire his weapon often, and earmuffs did not completely stunt the loud noises. Id. The Veteran remembered having bad hearing from when he left active duty through his time in the Reserve. Id. As the February 2017 VA examiner acknowledged, the Veteran had normal hearing at enlistment and the examiner could not read the Veteran’s separation examination. See February 2017 VA examination report. While the examiner noted an enlistment examination for Reserve service in 1982 showed hearing within normal limits, subsequent Reserve examinations showed the Veteran had bilateral hearing loss. See, e.g., June 1989 and December 2001 service treatment records. (Continued on the next page) Therefore, resolving reasonable doubt in the Veteran’s favor, the Board finds the Veteran had bilateral hearing loss in service that he continued to experience ever since. Accordingly, the Board finds that the Veteran’s claim for service connection for bilateral hearing loss has met the relaxed evidentiary requirements under 38 C.F.R. § 3.303(b). Therefore, the criteria for service connection for bilateral hearing loss have been met. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Salazar, 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.