Citation Nr: 21070379 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 19-04 715 DATE: November 23, 2021 ORDER The issue of entitlement to service connection for a bilateral tinnitus disability is granted. REMANDED The issue of entitlement to service connection for a bilateral hearing loss (BHL) disability is remanded. FINDING OF FACT The Veteran has experienced the symptoms of bilateral tinnitus since service. CONCLUSION OF LAW The criteria for service connection for a bilateral tinnitus disability are met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2021). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1966 to December 1967. In November 2021, the Veteran and his spouse testified under oath before the undersigned Veterans Law Judge at a virtual hearing. Entitlement to service connection for a bilateral tinnitus disability. The Board finds that the Veteran meets the criteria for service connection for a bilateral tinnitus disability. First, the Veteran has a diagnosed disability. See VA examination, November 2018. Second, at the November 2021 virtual hearing, the Veteran indicated that he had buzzing in his ears in service, which has continued. The Veteran is competent to report that he experienced ringing in his ears in and since service. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). Further, the Board concedes in-service noise exposure. The Veteran contends that he experienced noise exposure in service. For example, according to the November 2018 Notice of Disagreement (NOD): Vet was a medic in Germany and every time there was a tank exercise he was required to be in the field with the tanks. When they fired a round he was less than 30 feet away with no ear protection. During one exercise that lasted 3 days the tanks fired several 100 rounds. Similar descriptions appear in the November 2018 VA examination report, which also indicate in-service noise exposure with no issued hearing protection. The Veteran's service personnel records support his contentions as they identify duties as an auto maintenance apprentice, as well as a wheeled vehicle mechanic, in a medical battalion. The Board acknowledges the November 2018 VA opinion that states that it is "Less likely than not (less than 50% probability)" that the Veteran's tinnitus is "caused by or a result of military noise exposure." However, the rationale provided does not address the contention that the Veteran's symptoms occurred during service and continued thereafter. Accordingly, the Board finds that the rationale provided is inadequate and affords it little probative weight. Given the above, the Board cannot conclusively disassociate the current disability from the Veteran's service. Therefore, the Board resolves reasonable doubt in the Veteran's favor and finds that criteria for service connection have been met. Accordingly, service connection for a bilateral tinnitus disability is warranted, and the issue is granted. REASONS FOR REMAND Entitlement to service connection for a BHL disability. The Board finds that additional development is needed regarding the issue of entitlement to service connection for a BHL disability. The November 2018 VA examination report shows that the Veteran has a diagnosed disability of bilateral hearing loss. See 38 C.F.R. § 3.385. In addition, as addressed above, the Board concedes in-service noise exposure. However, the Board seeks the following clarification. The Veteran's August 1965 pre-induction examination notes "Defective hearing." However, next to this notation is the word "ok." In addition, audiometer readings are provided. As these readings were prior to January 1, 1967, the Board assumes that the ASA standard was used and, therefore, has converted the readings to the ISO-ANSI standard. HERTZ 500 1000 2000 3000 4000 RIGHT 30 20 5 45 45 LEFT 25 5 20 55 45 The July 1967 separation examination notes mild, bilateral, sensorineural hearing loss, secondary to acoustic trauma. However, it also notes that this was not in the line of duty ("LOD"), but rather existed prior to service ("EPTS"). Autometer readings are provided from this examination as well. However, this examination took place between January 1, 1967, and December 31, 1970, and it is unclear whether such thresholds were recorded in using ASA units or ISO-ANSI units. Accordingly, the Board will consider the recorded metrics under both standards, relying on the unit measurements most favorable to the Veteran's appeal. ASA: HERTZ 500 1000 2000 3000 4000 RIGHT 15 10 -5 X 40 LEFT 10 -5 10 X 40 ISO-ANSI: HERTZ 500 1000 2000 3000 4000 RIGHT 30 20 5 X 45 LEFT 25 5 20 X 45 The above would suggest that the Veteran had a diagnosed disability at entrance and that his audiometer results did not change during his period of service. However, the Board seeks clarification regarding the following. First, the Veteran's military personnel records show PUHLES evaluation reports for August 1695 and December 1965. Interestingly, for hearing (i.e., "H") the Veteran received a 3T rating in August 1965, but then a 1 for December 1965. In addition, a "Record of Induction" from November 1965 states "None" to the following prompt regarding physical defects: "List all defects and diseases claimed by the registrant and any defects or diseases which the registrant may have, and which are known to the local board (If no defects, indicate by "None")." (Emphasis in original). The Board acknowledges the November 2018 VA opinion of record, but this opinion did not address this evidence. Accordingly, a new opinion is needed. The remaining issue on appeal is REMANDED for the following action: 1. After securing any necessary consent forms from the Veteran, obtain any outstanding treatment records, to include any VA and/or private treatment records, pertaining to the issue on appeal. All efforts should be documented in the claim file. If any records could not be obtained, this should be noted in the claim file. 2. Upon completion of the above, schedule the Veteran for a new VA examination and obtain an opinion that addresses the following: (a) Whether it is at least as likely as not that the disability(ies) clearly and unmistakably pre-existed service. In particular, the Board seeks clarification regarding the following. First, the Veteran's military personnel records show PUHLES evaluation reports for August 1695 and December 1965. Interestingly, for hearing (i.e., "H") the Veteran received a 3T rating in August 1965, but then a 1 for December 1965. In addition, a "Record of Induction" from November 1965 states "None" to the following prompt regarding physical defects: "List all defects and diseases claimed by the registrant and any defects or diseases which the registrant may have, and which are known to the local board (If no defects, indicate by "None")." (Emphasis in original). (b) If there is clear and unmistakable evidence that the claimed disability(ies) preexisted service, then the examiner should address whether there is clear and unmistakable evidence that the claimed disability was not permanently aggravated by service. If not, the examiner should then address whether it is at least as likely as not that it was caused by the Veteran's active duty service. The Board notes that a preexisting injury or disease will be considered to have been aggravated by active service, where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease. See 38 C.F.R. § 3.306 (a). (c) If it is determined that the disability(ies) did not clearly and unmistakably preexist service, then the examiner should address whether it is at least as likely as not that it was caused by the Veteran's active duty service. 3. If upon completion of the above action the issue is denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. F., 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.