Citation Nr: 21022957 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 17-08 730 DATE: April 19, 2021 ORDER Entitlement to service connection for a bilateral hearing loss disability is granted. Entitlement to service connection for tinnitus is granted. REMANDED Entitlement to service connection for a back disability is remanded. Entitlement to service connection for right upper extremity neuropathy, to include a secondary to a back disability, is remanded. FINDING OF FACT Resolving reasonable doubt in his favor, the Veteran’s bilateral hearing loss disability and tinnitus are etiologically related to his active service. CONCLUSIONS OF LAW 1. The criteria for service connection for a bilateral hearing loss disability are met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.385 (2020). 2. The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from August 1968 to August 1971, to include service in the Republic of Vietnam. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). In February 2021, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is of record. Service Connection – Hearing Loss and Tinnitus The Veteran maintains that his current bilateral hearing loss disability and tinnitus are related to in-service noise exposure. In this case, the evidence demonstrates that the Veteran has a current diagnosis of tinnitus and that his hearing loss meets the minimum threshold requirements to be considered a disability under 38 C.F.R. § 3.385. In addition, his assertions that he was exposed to loud noise as a generator mechanic are consistent with his service. Therefore, a current disability and in-service noise exposure are conceded. The remaining and dispositive question is whether the Veteran’s current bilateral hearing loss and tinnitus are etiologically related to in-service noise exposure. The Veteran’s service treatment records are unremarkable for any complaints, treatment, or diagnoses related to hearing loss and tinnitus. At the February 2021 Board hearing, the Veteran stated that he first noticed tinnitus when he returned from service in the Republic of Vietnam in 1970. He stated that he has continued to experience tinnitus since service and that it has progressively worsened over the years. He also stated that his wife noticed that he could not hear as well when he returned from service. He stated that he experienced hazardous noise exposure from helicopters and diesel engines on generators. He recalled one mission where he road in the open belly of a helicopter without hearing protection and experienced a severe headache and ringing in his ears. He stated that he worked in carpentry after service and was exposed to some noise, but not as loud as during military service. He stated that he did not have any hobbies in civilian life where noise exposure was a factor. The Veteran is competent to identify hearing loss and tinnitus, including onset and continuity of symptomatology. See Charles v. Principi, 16 Vet. App. 370, 374 (2002). The Board has no reason to doubt the credibility of his statements that he experienced tinnitus during service and that those symptoms have continued since service. His statements that his wife noticed a decrease in his hearing acuity when he returned from service are also competent and credible. A July 2015 VA examiner stated that she could not provide an opinion regarding the etiology of the Veteran’s hearing loss without resorting to speculation. The examiner noted that audiograms at induction and in 1970 were normal, and that whispered voice test at separation was normal. However, the examiner stated that a whispered voice test was only a gross assessment of hearing acuity and would not rule out or identify high frequency or unilateral hearing loss. Regarding tinnitus, the examiner indicated that it was less likely than not caused by military noise exposure, noting that the Veteran reported a gradual onset of tinnitus that had become noticeable about three years ago. In July 2017, a private audiologist opined that the Veteran’s hearing loss and tinnitus were more likely than not caused by or worsened by military noise exposure. The audiologist noted the Veteran’s history of noise exposure during service and his statements regarding onset and continuity of symptomatology. The audiologist also noted the average hearing thresholds for adults over 60 and stated that the amount of the Veteran’s hearing loss may be attributed to factors other than age. It was also noted that the Veteran did not have any other illnesses, injuries, familial history of hearing loss, or other exposure to excessively loud noise. Based on the foregoing, the Board finds that the evidence for and against the claims for service connection for hearing loss and tinnitus are at least in relative equipoise. Resolving reasonable doubt in the Veteran’s favor, the Board finds that service connection for a bilateral hearing loss disability and tinnitus is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). REASONS FOR REMAND The Board finds that additional development is required before the remaining claims on appeal are decided. Regarding the claim for a back disability, the Veteran maintains that he injured his back while changing a tire on a military vehicle during service. He stated that he was taken to the hospital in Long Binh and received inpatient care for several days. The Agency of Original Jurisdiction (AOJ), however, has not requested any inpatient treatment records (clinical records). Therefore, the Board finds that a remand is necessary so that an attempt can be made to obtain any records that may exist during active service. In addition, the Veteran’s sister stated that the Veteran had back pain while visiting her and was taken to Skyridge Medical Center in Cleveland, Tennessee. It does not appear that any efforts were made to obtain those records. Therefore, a remand is necessary for additional development. Furthermore, as the Veteran claims that his right upper extremity neuropathy is related to his back disability, those issues are inextricably intertwined. Therefore, a determination on that claim should be deferred pending a final disposition on the claim for service connection for a back disability. Harris v. Derwinski, 2 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. The AOJ should attempt to obtain any separately stored inpatient treatment records (clinical records) during the Veteran’s service in the Republic of Vietnam, i.e., from January 1969 to January 1970. 2. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file, to include private treatment records from Skyridge Medical Center in Cleveland, Tennessee. 3. Then, after undertaking any other development found to be warranted, readjudicate the issues remaining on appeal. If a decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Mishalanie, 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.