Citation Nr: 21020856 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 18-24 540 DATE: April 8, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. Entitlement to service connection for tinnitus is granted. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran’s favor, his bilateral hearing loss is at least as likely as not related to active duty service. 2. Resolving reasonable doubt in the Veteran’s favor, his tinnitus is at least as likely as not related to active duty service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.385. 2. The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.385. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from February 2000 to August 2001. The Veteran appeared and testified at a February 2020 hearing before the undersigned Veterans Law Judge. A transcript is of record. Service Connection Under the relevant laws and regulations, 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. Generally, the evidence 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. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). 1. Entitlement to service connection for bilateral hearing loss 2. Entitlement to service connection for tinnitus The Veteran asserts that his hearing loss and tinnitus are related to his exposure to artillery fire due to his military occupation specialty as a field artillery fire direction control specialist. After reviewing the evidence of record, the Board of Veterans’ Appeals (Board) determines that service connection is warranted for the Veteran’s bilateral hearing loss and tinnitus. As an initial matter, the Board finds the Veteran’s statements regarding his in-service acoustic trauma competent and credible given the nature of his service and his duties associated with being a field artillery fire direction control specialist. Thus, the Board concedes exposure to hazardous noise for purposes of establishing an in-service event. Moreover, there appears to the Board to be a perceptible tonal threshold shift from the time the Veteran entered and separated from service. Specifically, his service treatment records reflect that he underwent an in-service audiological examination in February 2000 and June 2001, which reflect a significant tonal threshold shift of approximately 5 – 55 dB bilaterally at most frequencies. Next, audiological evaluations performed since active duty reflect findings which demonstrate bilateral hearing loss for VA purposes. Therefore, the Board finds that the evidence is at least in equipoise to support service connection. With respect to the Veteran’s tinnitus claim, as discussed, the Veteran is now service connected for bilateral hearing loss and the Board has already conceded in-service noise exposure. Further, the Board finds the Veteran’s statements regarding tinnitus to be competent and credible. Moreover, the Board also recognizes that tinnitus is a common symptom of nearly all ear disorders including sensorineural or noise-induced hearing loss. See The MERCK Manual, Sec. 7, Ch. 82, Approach to the Patient with Ear Problems; see also Fountain v. McDonald, 27 Vet. App. 258 (2015). As such, service connection is warranted. In arriving at this conclusion, the Board acknowledges the negative evidence, including the March 2018 VA examiner’s opinions, which indicate the Veteran’s hearing loss and tinnitus are not related to service. The Board notes that the examiner’s opinions were based primarily on the fact that his hearing was normal at separation, and that he did not seek treatment for hearing loss or tinnitus after service until filing this claim in 2016. However, the Board observed that two examinations two months before separation from service demonstrated significant tonal threshold shifts bilaterally. Additionally, the Veteran explained that he was unable to seek medical treatment for hearing loss or tinnitus prior to filing his claim due to financial constraints. This is consistent with evidence in the record demonstrating that the Veteran had periods of experiencing homelessness.   As a result, the Board finds that the evidence is at least in equipoise. Therefore, service connection is warranted. 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. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Veltri, Associate Counsel