Citation Nr: 21062738 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 18-38 235 DATE: October 12, 2021 ORDER Service connection for tinnitus is granted. REMANDED Service connection for bilateral flatfoot is remanded. Service connection for a jaw condition is remanded. Service connection for a left shoulder condition is remanded. Service connection for a right shoulder condition is remanded. Service connection for left wrist tendinitis is remanded. Service connection for right carpal tunnel syndrome is remanded. Service connection for sleep apnea is remanded. FINDING OF FACT Resolving any reasonable doubt in favor of the Veteran, she has a diagnosis of tinnitus which is attributable to her active duty service. CONCLUSION OF LAW The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 2011 to September 2011 and from September 2012 to April 2013. The Veteran and her husband testified before the undersigned Veterans Law Judge at a hearing in March 2020; a copy of the transcript is of record. Service Connection for Tinnitus Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that it was incurred in service. 38 C.F.R. § 3.303(d). The Veteran contends that her tinnitus is related to her in-service noise exposure. Specifically, the Veteran reported onset of tinnitus after her deployment in 2012. See February 2017 VA examination. The evidence of record shows the Veteran has a diagnosis of tinnitus. See February 2017 VA examination. The Veteran's military occupational specialty (MOS) included that of an air transport helper and an air transport journeyman. See DD-214s. Her service personnel record (SPR) contains an achievement medal for performance of her duties as a cargo and ramp specialist. See June 2013 Achievement Medal. The Veteran testified in her hearing that her MOS duties required her to be on the flight line unloading and loading planes for a majority of her active service, including the duration of her 2012 deployment. See March 2020 hearing testimony. She also stated that her only firearms noise exposure was while she was in-service; her civilian occupation as a correctional officer did not require her to use a firearm. Based on the foregoing, including the Veteran's credible and unrefuted testimony about her in-service noise exposure, the Board finds that the Veteran was exposed to excessive noise while on active duty. Based on the foregoing and resolving any reasonable doubt in favor of the Veteran, the Board finds that service connection for tinnitus is warranted. The Board is aware of a VA examination which found against a link between the Veteran's hearing loss and her service. The examination, however, is inadequate for adjudication purposes and the Board does not afford it any weight as the examination appears to rely on the Veteran's normal hearing at separation as well as a misstatement regarding the Veteran's in-service and occupational noise exposure. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). As such, resolving reasonable doubt in the Veteran's favor, service connection for tinnitus is granted. 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND Jaw Condition Left Shoulder Condition Right Shoulder Condition The Veteran has stated that her jaw condition and her bilateral shoulder conditions are related to her service connected cervical spine disability. A VA examination on the possible link between these conditions and the Veteran's cervical spine has not been conducted. Remand is necessary as the low threshold for obtaining such an examination and medical opinion has been surpassed in this case. See 38 U.S.C. § 5103A (d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Bilateral Flatfoot Left Wrist Tendinitis Right Carpal Tunnel Syndrome Sleep Apnea The Veteran has not been afforded VA examinations for her flatfeet or sleep apnea. Also, though the Veteran has undergone some VA examinations for her bilateral wrist conditions, an opinion on the etiology of her conditions is not of record. Remand is necessary as the low threshold for obtaining an examination and medical opinion has been surpassed in this case. See 38 U.S.C. § 5103A (d); McLendon, 20 Vet. App. 81. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the nature and etiology of any diagnosed condition of her jaw and/or bilateral shoulders. The claims file, including a copy of this Remand, must be made available to the examiner and the examiner should indicate in his/her report whether or not such was reviewed. All necessary tests and studies should be accomplished. The examiner should identify whether the Veteran has any diagnosed disability associated with her jaw and/or her left and/or right shoulder. The examiner must opine whether any diagnosed disability associated with the Veteran's jaw or left and/or right shoulder are at least as likely as not (50 percent or greater probability) proximately due to or aggravated beyond their natural progression by any of the Veteran's service connected disabilities, specifically including her cervical spine disability or her right upper extremity radiculopathy. The Veteran's lay assertions as to onset and continuity of symptomatology, including her March 2020 hearing testimony, should be recorded and considered. A rationale for all opinions must be provided. 2. Additionally, schedule the Veteran for examinations by an appropriate clinician to determine the nature and etiology of any diagnosed flatfeet, left wrist condition, right wrist condition, and sleep apnea. The claims file should be made available to the examiner for review. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that any diagnosed disability of the Veteran's feet, left wrist, right wrist, or diagnosed sleep apnea was incurred in, or due to, the Veteran's service. The Veteran's lay statements, including the March 2020 testimony of both the Veteran and her husband, regarding onset and continuity of symptomology should be recorded and considered. A rationale for all opinions must be provided. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish, 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.