Citation Nr: 21065263 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 17-08 333 DATE: October 25, 2021 ORDER Entitlement to service connection for bilateral tinnitus is denied. REMANDED Entitlement to service connection for bilateral eye damage is remanded. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran's tinnitus began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for tinnitus are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from June 1966 until his honorable discharge in June 1968. During the Veteran's service, his military occupational specialty (MOS) was 44C20, Welder and Blacksmith, and was awarded the National Defense Service Medal and the Sharpshooter Badge (Rifle M-14). These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2014 rating decision by the St. Louis, Missouri Regional Office (RO) of the United States Department of Veterans Affairs (VA). In February 2017, the Veteran perfected his appeal to the Board and requested a hearing in the Washington, D.C. office. Subsequently, the Veteran was scheduled for a Board hearing on August 6, 2019. See July 2019 Correspondence. However, the Veteran failed to appear at the August 2019 Board hearing. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (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 - the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In addition, service connection for certain chronic diseases, including tinnitus, may be established on a presumptive basis by showing that the condition manifested to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258, 271-72 (2015). Although the disease need not be diagnosed within the presumptive period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). Additionally, for certain chronic diseases with potential onset during service, there is required 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 may support the claim. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Entitlement to service connection for bilateral tinnitus The Veteran asserts that his tinnitus is related to his in-service MOS as a Blacksmith and Welder. The evidence of current disability is not in question. 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 during service and that he experienced such ringing ever since service "because ringing in the ears is capable of lay observation"). As will be addressed in greater detail below, the Board notes that in September 2013, the Veteran denied tinnitus and in January 2014, filed a claim for entitlement to service connection for tinnitus. Therefore, the Board finds that the Veteran's tinnitus began at some point between September 19, 2013 and his application for entitlement to service connection on January 16, 2014. Second, affording the Veteran the benefit of the doubt, the Board finds that there was an in-service event, injury or disease. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). Specifically, the Board finds that the Veteran was exposed to hazardous noise exposure during service due to his MOS. The Board notes that the MOS "Metal Worker" (MOS 91W, formerly MOS 44B) and "Allied Trades Specialist" (MOS 91E, formerly MOS 44E) both have a high probability of hazardous noise exposure. Although the Veteran's MOS was 44C, affording the Veteran the benefit of the doubt, finds that the Veteran did have hazardous noise exposure during service. However, the Board also notes that the Veteran's service treatment records and post-service treatment records are both silent for any audiological problems prior to September 19, 2013, 45 years after his separation from service which demonstrated mild hearing loss (30 dB) at 3000 Hz in the right ear. See September 2013 St. Louis VA Medical Center treatment records. Third, the Board finds that the evidence of record does not support a finding that the Veteran's tinnitus is related to active service. The Veteran was afforded a VA examination in June 2014. The June 2014 VA examiner found that the test results were invalid and unreliable. The June 2014 VA examiner explained that although the Veteran was pleasant in demeanor, the test results were inconsistent and do not appear to reflect the Veteran's maximal effort. Furthermore, (after the preliminary inconsistent results), the Veteran was reinstructed and encouraged throughout the testing with no improvement in his admitted responses, noting that there was poor interest (in) reliability and concluded that the test results were invalid and unreliable and therefore not reported. The examiner further explained that the Veteran was also tested in September 2013 (9 months prior) at the St. Louis, Missouri VA Medical Center and that these results were also inconsistent with the Veteran's September 2013 test results. The Board notes that the September 2013 VA treatment records from the St. Louis, Missouri VA Medical Center were normal hearing bilaterally with 100 percent word recognition scores, except for a mild hearing loss (30 dB) at 3000 Hz in the right ear. Furthermore, the Veteran's St. Louis, Missouri VA Medical Center treatment records reflect that the Veteran denied hearing loss or hearing problems and wanted to get a baseline of his hearing. The Veteran also denied pain, pressure, dizziness, otosurgery, family history of hearing loss, and denied tinnitus. Therefore, the Board finds that the Veteran's tinnitus did not begin within 1-year of his separation from service and presumptive service connection is therefore not applicable. Accordingly, entitlement to service connection for tinnitus is denied. The Board notes that the Veteran asserts that he was exposed to loud noise as a blacksmith during service and that he attributes his tinnitus to his MOS. See June 2015 Notice of Disagreement (NOD) (VA Form 21-0958); see also Appeal to Board of Veterans' Appeals (VA Form 9). The Board has considered the Veteran's reports attributing his tinnitus to service, but the evidence of record does not demonstrate that the Veteran has the requisite medical training, expertise, or credentials needed to render a competent opinion as to medical causation. In reaching this decision the Board considered the doctrine of reasonable doubt, however, as the preponderance of the evidence is against the Veteran's claim, the doctrine is not for application. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND Entitlement to service connection for bilateral eye damage Evidence indicates that there may be outstanding relevant VA treatment records. During the Veteran's December 2016 VA examination, the examiner referenced VA examinations in 1999, 2000, and 2001. However, those records are not included within the file. A remand is required to allow VA to obtain them. Furthermore, the Board cannot make a fully-informed decision on the issue of entitlement to service connection for bilateral eye damage because no VA examiner has opined whether the May 1968 separation evaluation indicating "[e]yes have started hurting when I read" and a "burning sensation." Although the December 2016 VA examination attributes the Veteran's irritation to his diagnosed bilateral blepharitis, the examiner does not appear to consider if the Veteran's in-service report of eye pain and burning sensation had their onset during service. Accordingly, the case is REMANDED for the following action: 1. Obtain all of the Veteran's VA treatment records that are not already included within the record, specifically for the period from 1999 to 2000, and 2000 to present. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's bilateral eye disabilities are at least as likely as not related to his active military service, to include onset of the disability. Specifically, are the Veteran's one-time complaints of eyes hurting when he reads and the burning sensation at separation the onset of a current disability. M. Tenner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Deemer, 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.