Citation Nr: 21071600 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 20-02 227A DATE: November 30, 2021 ORDER Entitlement to service connection for tinnitus is granted. REMANDED Entitlement to service connection for bilateral hearing loss is remanded. FINDING OF FACT Resolving all reasonable doubt in the Veteran's favor, it is at least in equipoise that the Veteran's tinnitus is related to his period of service. CONCLUSION OF LAW The criteria for service connection for tinnitus have been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served active duty in the United States Army from April 1969 to April 1971 and from September 1978 to April 1983. In October 2021, the Veteran testified before the undersigned Veterans Law Judge at a Virtual hearing. A copy of the transcript has been associated with the claims file. 1. Service connection for tinnitus The Veteran contends that his tinnitus is due to his period of service. In December 2018, the Veteran was afforded a VA examination where he reported onset of recurrent tinnitus for at least over 20 years. The Veteran stated he hears high-pitched ringing in one ear at a time for a few seconds, with a duration of no longer than a minute and frequency of once or twice a week. The Veteran stated that it comes on suddenly then fades away. In a December 2018 VA addendum opinion, the examiner stated that the Veteran denies tinnitus as defined in the Dauman and Tyler (1992) statement cited in the Tinnitus Handbook (Tyler) and reports transient ear noise that is likely due to normal changes in vascular flow. The examiner stated that this type of tinnitus is prevalent among the general population without auditory damage or pathology. The examiner went on to explain that this transient ear noise is not consistent with noise-induced tinnitus or hearing loss-related tinnitus. Therefore, the examiner concluded that it is less likely than not related to military noise exposure or hearing loss. At an October 2021 Board hearing, the Veteran stated that the ringing in his ear began around the time of his second period of active duty. The Veteran stated that he had heard ringing but could not pinpoint the noise. He also reported that he asked his wife if she heard the noise in the house, and she informed him that there was no noise. While the Board acknowledges the December 2018 medical opinion, the Board notes that the experience of tinnitus is subjective in nature and can be identified by lay observation alone. Therefore, the Board concludes that the evidence is at least in equipoise and the benefit of the doubt doctrine has been applied. Service connection is thus warranted for tinnitus. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990); Ortiz v. Principi, 274 F.3d 1361 (Fed Cir. 2001). REASONS FOR REMAND 1. Service connection for bilateral hearing loss is remanded. The Veteran contends that his hearing loss is due to his period of service. In a December 2018 VA examination, the examiner opined that it is less likely than not that the Veteran's hearing loss is due to his period of active duty service. The examiner stated, in part, that there was no separation audio examination for review, and in the absence of serial service audiograms, it is not possible to ascertain whether the Veteran's asymmetrical hearing loss developed during or due to military service. The Board notes that the Veteran's service treatment records include several in-service audiograms, to include a February 1983 audiogram during the Veteran's active duty service. It is not clear that the examiner considered this evidence. Therefore, a remand is necessary. The matters are REMANDED for the following action: Send the Veteran's claims file to an appropriate examiner for an addendum opinion to determine the nature and etiology of his claimed bilateral hearing loss. After review of the record, the examiner should address whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran's claimed bilateral hearing loss was manifested in, caused by, or is otherwise etiologically related to the Veteran's period of active military service. The examiner is asked to consider and discuss the audiograms in the Veteran's service treatment records, to include the February 1983 audiogram. The examiner should note that the absence of hearing loss pursuant to 38 C.F.R. § 3.385 during service cannot, standing alone, serve as a basis of a negative opinion. However, if the examiner cannot respond to the inquiry without resort to speculation, he or she should state whether the inability is due to the limits of the examiner's medical knowledge, the limits of medical knowledge in general, or if there is additional evidence, which if obtained, would permit the opinion to be provided. JENNIFER HWA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Ford 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.