Citation Nr: 21073695 Decision Date: 12/10/21 Archive Date: 12/10/21 DOCKET NO. 17-54 958 DATE: December 10, 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 doubt in favor of the Veteran, tinnitus is etiologically related to his in-service noise exposure. CONCLUSION OF LAW The criteria for service connection for tinnitus have been 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 from February 1, 1968 to January 31, 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In May 2020, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the claims file. Entitlement to service connection for tinnitus The Veteran contends that his symptom of ringing in his ears, later diagnosed as tinnitus, began during his active service. The Board concludes that the Veteran has a current disability that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The Board notes that the Veteran is wholly competent to self-diagnose and report the onset and course of simple, lay-observable conditions such as tinnitus (which is diagnosed primarily based on subjective reports), as well as the onset and frequency of tinnitus. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (2007); Charles v. Principi, 16 Vet. App. 370 (2002). Thus, his own account of experiencing the initial onset of tinnitus during service with an increase in severity (worsened) over the years is competent evidence of the history and course of his tinnitus. The Board finds no reason to doubt the veracity of those statements and finds them credible. Thus, those statements, alone, are sufficient to establish entitlement to service connection on the basis that tinnitus began in service and has persisted since. In so finding, the Board is mindful of the negative VA opinion. However, the March 2017 opinion fails to give the Veteran's lay reports due consideration. Rather the examiner based his opinion on the lack of evidence of a threshold shift during the Veteran's service. Therefore, he found that the Veteran's tinnitus was less likely than not related to his military noise exposure. However, the Veteran testified at the August 2021 hearing that ringing in his ears began in service, but he did not report to sick call because he thought it was normal following his exposure to acoustic trauma from a jet engine and has continued to the present. As the examiner did not discuss the Veteran's allegations of in-service incurrence, the Board affords the opinion little probative weight. Accordingly, the Board finds the evidence is at least in relative equipoise as to whether the Veteran's tinnitus began in service and has persisted. Resolving all remaining reasonable doubt in the Veteran's favor, the Board finds the appeal in this matter must be granted. REASONS FOR REMAND Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends that his current bilateral hearing loss is the result of acoustic trauma experienced in service while serving in his MOS as an airplane electrician around jet engine aircraft. The Veteran was originally afforded a VA examination in March 2017. The examiner concluded that the Veteran had bilateral sensorineural hearing loss. The examiner also opined that there was not a permanent positive threshold shift greater than normal measurement variability at any frequency between 500 and 6000 Hz for either ear. The examiner opined that the current bilateral hearing loss was less likely than not related to the Veteran's military service because there were "no significant within normal threshold shifts in either ear." The examiner also indicated that normal hearing was seen in both ears on enlistment audiogram and a separation audiogram. In an August 2017 addendum opinion, the examiner opined that the Veteran's documented "significant temporary threshold shift" at 6000 Hz in both ears during service was only temporary as there was a less than significant by the time of the separation examination. The examiner also opined that the Veteran's hearing loss was likely related to recreational noise exposure following service based on the Veteran's use of a bicycle. At his November 1967 enlistment examination (the Board notes the Veteran did not enter service until February 1968), the Veteran had normal hearing. Audiometric readings during service show that the Veteran had threshold shifts at all levels in August 1970, August 1971, and at his separation examination in December 1971. Notably, the Veteran had shift from 0 Hz to 30 Hz from his enlistment examination to his August 1970 examination. As an initial matter, the Board notes that when audiometric test results at a veteran's separation from service do not meet the requirements of 38 C.F.R. § 3.385, a veteran may nevertheless establish service connection for current hearing disability by submitting medical evidence that the current disability is causally related to service. Hensley v. Brown, 5 Vet. App. 155 (1993). Further, CAVC held "the threshold for normal hearing is from 0 to 20 dB [decibels], and higher threshold levels indicate some degree of hearing loss." See Hensley v. Brown, 5 Vet. App. 155, 157 (1993). The Board also notes that it is unclear whether such thresholds were recorded in using American Standards Association (ASA) units or International Standards Organization-American National Standards Institute (ISO-ANSI) units. As it relates to VA examinations and VA records, audiological reports were routinely converted from ISO-ANSI results to ASA units until the end of 1975 because the regulatory standard for evaluating hearing loss was not changed to require ISO-ANSI units until September 9, 1975. Additionally, The Board notes that at his August 2021 hearing, the Veteran testified that he did not have any occupational or recreational exposure to motorcycle noise following service, but, instead, that he drove a small-engine motorcycle while in service. Thus, the examiner's addendum opinion was based on an inaccurate factual statement. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that an opinion based upon an inaccurate factual premise has no probative value). For these reasons, the Board finds that the March 2017 VA examination with August 2017 addendum opinion is inadequate. Barr v. Nicholson, 21 Vet. App. 303 (2007) (holding that once VA undertakes an examination, it must provide an adequate one). The matters are REMANDED for the following action: Schedule the Veteran for a VA examination for his bilateral hearing loss. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to the following: Is the Veteran's bilateral hearing loss at least as likely as not related to service, including acoustic trauma caused by exposure to jet engines during as part of his MOS during service? Provide a rationale to support the opinion(s). In providing the requested opinion, consider the Veteran's description of his/her in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of his/her current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? Additionally, the examiner should consider the Veteran's lay statements regarding his lack of exposure to recreational or occupational acoustic trauma following service. In providing the opinion, the examiner should also discuss the Veteran's hearing loss documented by audiometric testing during his service in August 1970 and August 1971. Did the Veteran's hearing loss during service result in additional hearing loss following service? The examiner is also reminded that audiometric test results at a veteran's separation from service that do not meet the requirements of 38 C.F.R. § 3.385 do not preclude establishing service connection for a current hearing disability. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.D. Taylor, 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.