Citation Nr: 21003535 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 17-31 137 DATE: January 21, 2021 ORDER Entitlement to service connection for tinnitus is granted. REMANDED Entitlement to service connection for bilateral hearing loss is remanded. FINDING OF FACT The Veteran’s tinnitus is etiologically related to his service. CONCLUSION OF LAW The criteria for service connection for tinnitus have been met. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from June 1988 to July 1993. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma. In November 2020, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. The record was held open for 30 days following the hearing to allow for evidence submission. To date, no such evidence has been received in connection with the Veteran’s claim. Service Connection Service connection is granted for any current disability that is the result of a disease contracted or an injury sustained while on active duty service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). Service connection requires competent evidence showing: (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). 1. Entitlement to service connection for tinnitus. The Veteran contends that his tinnitus is related to service, to include due to noise exposure. He testified that he had tinnitus, which began in service due to noise exposure that included working near jet engines. See November 2020 Hearing Transcript As he is competent to describe the symptoms of tinnitus, and tinnitus is a disease which is capable of self-diagnosis, the Board finds that he has tinnitus and the first element is met. He is competent to testify on factual matters of which he has first-hand knowledge. Washington v. Nicholson, 19 Vet. App. 362 (2005). His tinnitus has also been formally diagnosed upon examination. See May 2017 private examination and January 2018 VA examination. As he has a current disability and his duty of service supports that he suffered acoustic trauma, the remaining question is whether his tinnitus is related to his service, to include noise exposure. May 2017 private audiological examination showed a diagnosis of bilateral tinnitus. The Veteran reported that he was exposed to hazardous noise from jet engines while serving as a weapons release specialist during the Gulf War with active combat duty. He felt that this exposure initiated the hearing loss and tinnitus that he experiences today. He described his tinnitus as constant, bilateral “low hum” that varies to a “loud high pitch ring. Dr. C opined that it is at least as likely as not that the Veteran’s service history of exposure to hazardous noise/acoustic trauma while in service may have initiated his tinnitus since recurrent exposure to hazardous noise such as jet engines has been known to result in the development of tinnitus. January 2018 VA examination showed a diagnosis of tinnitus. The examiner opined that tinnitus was less likely than not (less than 50 percent probability) caused by or a result of military noise exposure. The examiner stated that the Veteran did not link the onset of his tinnitus to his military service and noted that his tinnitus likely began after his discharge from military service. The examiner further stated that the Veteran did not link the onset of his tinnitus to a specific event or a time period during or directly following his military service. Additionally, the examiner stated, the Veteran’s file is absent for any report or treatment of tinnitus, hearing loss or other auditory related difficulties during his military service. Given the above findings, the examiner opined, it is less likely than not that his bilateral constant tinnitus is due to his military service. The Board finds the VA examination less probative as it fails to fully consider the Veteran’s reports of noise exposure in service and competent report of symptoms. Further, it relies too heavily on lack of in-service treatment and complaints. Moreover, the private audiologist opined that the Veteran’s tinnitus is at least as likely as not related to his service. Additionally, the Veteran’s competent and credible testimony regarding onset of tinnitus in service is probative. As such, the Board finds the evidence to be at least in relative equipoise as to whether his tinnitus is related to service. The claim is granted on this basis. 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS FOR REMAND 2. Entitlement to service connection for bilateral hearing loss. The Veteran contends that his bilateral hearing loss is related to service. The Board has reviewed both the private and VA examinations of record. As discussed at the time of the hearing before the undersigned, the Board finds that based on this review and the testimony the duty to assist extends to again seeking evidence of whether there is a hearing loss disability as defined by VA regulations, and if so, whether such is attributable to service. The matter is REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Upon completion of directive #1, schedule the Veteran for an examination with an appropriate clinician to determine the nature and etiology of his hearing loss. The Veteran should perform a full review of the record and, then, opine on the following: Does the Veteran have hearing loss as defined by VA? If so, is it at least as likely as not (50 percent or greater probability) that the Veteran’s hearing loss is related to his service, to include conceded noise exposure? In this regard, service connection is in effect for tinnitus. The examiner should consider and address all disabling hearing loss noted during the Veteran’s appeal, to include the July 2015 audiological examination. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Wilson, 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.