Citation Nr: 21005017 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 17-65 564 DATE: January 28, 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 began during active service. CONCLUSION OF LAW The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably in the United States Air Force from February 1971 to April 1972. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (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 of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease initially diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). 1. Entitlement to service connection for tinnitus The Veteran contends that he is entitled to service connection because his current tinnitus is the result of in-service noise exposure. For VA purposes, tinnitus has been specifically found to be a disorder with symptoms that can be identified through lay observation alone. See Charles v. Principi, 16 Vet. App. 370, 374 (2002) (noting that the Veteran was competent to testify as to ringing in the ears in service and that he experienced such ringing ever since service “because ringing in the ears is capable of lay observation”). Here, the evidence indicates that the Veteran has a current disability. Specifically, in the October 2017 VA audiological examination, the Veteran reported tinnitus. Thus, the Board finds that the first element of service connection is established. See Shedden, supra. Second, the evidence of record indicates in-service noise exposure. At the October 2020 Board hearing, the Veteran reported that while working on the flight line to load planes and building housings for the planes, he had no hearing protection and was exposed to the noises of planes taking off. The Veteran’s military personnel records indicate his MOS was an inventory management specialist. The Board finds there was exposure to noise during service, giving due consideration to the places, types, and circumstances of the Veteran’s service as shown by his hearing testimony. See 38 U.S.C. § 1154(a). Thus, the Board finds that the second element of service connection is established. See Shedden, supra. As to nexus, the evidence conflicts. The October 2017 VA examiner opined it was less likely than not that the Veteran’s tinnitus was initiated by his exposure to hazardous noise while in service. The examiner provided that the Veteran’s MOS of an inventory specialist carries a low probability for hazardous noise exposure. Further, the Veteran’s hearing tests from enlistment to separation show stable auditory thresholds. complaints of tinnitus during service and the Veteran was uncertain as to the onset. The Board affords this opinion less probative weight as it did not consider the Veteran’s lay assertions of noise exposure during service nor the Veteran’s statement that he has experienced ringing in his ears since service. Conversely at the October 2020 Board hearing, the Veteran stated he first noticed ringing in his ears while he was still in service. The Board finds the Veteran’s reports as to the onset of symptoms in service, as well as the continuity of his symptoms since service, to be credible. In light of the Veteran’s competent and credible statements, and in the absence of probative evidence to the contrary, the Board finds that the preponderance of the competent evidence shows that the Veteran’s tinnitus is related to his conceded in-service noise exposure, and nexus is established. See id. As all three elements of service connection have been met, service connection for tinnitus is warranted. REASONS FOR REMAND Although the Board regrets the delay, remand is required to ensure there is a complete record on which to decide the Veteran’s claim. 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran asserts that his bilateral hearing loss is associated with noise exposure while serving on the flight line working in his MOS as an inventory specialist. Alternatively, the Veteran alleges that his hearing loss is due to the motor vehicle accident and resulting coma/unconsciousness he experienced while in service. The Veteran was afforded a VA examination in October 2017. The examiner found it was less likely than not that the Veteran’s current hearing loss is related to active service due to the normal hearing thresholds found bilaterally during active service and low probability of hazardous noise exposure. However, the examiner did not consider the Veteran’s significant noise exposure during service as documented by the Veteran’s hearing testimony, nor the impacts of the motor vehicle accident and resulting coma/unconsciousness. As no VA examiner has addressed the Veteran’s contentions regarding unprotected noise exposure while in service or the motor vehicle accident and resulting coma/unconsciousness, an additional VA medical opinion is warranted. The matter is REMANDED for the following action: 1. Schedule the Veteran for examination pertaining to the claimed bilateral hearing loss. The entire claims file must be made available to the designated examiner, including this remand. All indicated tests and studies should be accomplished, and all clinical findings should be reported in detail. The examiner should identify whether the Veteran has bilateral hearing loss disability for VA purposes. Then, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that bilateral hearing loss disability was incurred in service or are otherwise medically related to service, to include noise exposure therein. The examiner is advised that the Veteran is competent to report symptoms and treatment, and that his reports must be taken into account. The examiner must address the Veteran’s credible reports of exposure to noise during service. A statement that there was not a significant threshold shift in service is not sufficient rationale. The examiner should note that the Board has conceded in-service noise exposure. The examiner is also asked to address the Veteran’s motor vehicle accident and resulting coma/unconsciousness, and how this may support the Veteran’s claim for entitlement to service connection for bilateral hearing loss. In rendering the requested opinion, it should be noted that the absence of in-service evidence of a hearing disability during service is not always fatal to a service connection claim. Evidence of a current hearing loss disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting the regulatory requirements for hearing loss disability for VA purposes, and a medically sound basis upon which to attribute the post-service findings to the injury in service. (Continued on the next page)   The examiner should set forth all examination findings, along with the complete rationale for any conclusions reached. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Laura C. Owens 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.