Citation Nr: 21023287 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 18-27 391 DATE: April 20, 2021 ORDER Entitlement to service connection for bilateral hearing loss disability. Entitlement to service connection for tinnitus is granted. REMANDED Entitlement to service connection for skin condition to include as related to exposure to herbicides is remanded FINDING OF FACT Bilateral hearing loss disability and tinnitus are etiologically related to acoustic trauma sustained in active service. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss disability are met. 38 U.S.C. §§ 1110, 1112, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385 (2020). 2. The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 1112, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2020). REASONS AND BASES FOR FINDING AND CONCLUSIONS The Veteran had active naval service from April 1964 to August 1967. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge in March 2021. A transcript of that hearing has been added to the record. Service Connection – Bilateral Hearing Loss Disability and Tinnitus The Veteran contends that he has bilateral hearing loss disability and tinnitus as a result of acoustic trauma sustained in active service. Specifically, the Veteran has claimed hazardous noise exposure while performing his duties as a radio operator. The Veteran reported wearing headphones consistently throughout his time in service. In addition, he noted that he was near helicopters on a constant basis and actually slept below the hanger deck. He specifically noted weapons being fired near him which caused him to be unable to hear for several minutes at a time. A review of the service record show that the Veteran’s military occupational specialty (MOS) during service was radio operator. Further, the Veteran served aboard naval vessels while in active service. Therefore, the Board finds that the Veteran’s report of noise exposure is consistent with the facts and circumstances of his service, and the Board concedes that the Veteran sustained acoustic trauma while in active service. Service treatment records (STRs) are silent for complaints of, treatment for, or a diagnosis of tinnitus or bilateral hearing loss disability for VA purposes while the Veteran was in active service. However, the Veteran is competent to report that he first experienced decreased hearing acuity and tinnitus while in active service, and that his symptoms have continued since that time. Moreover, the Board finds the Veteran credible in that regard. Heuer v. Brown, 7 Vet. App. 379 (1995); Falzone v. Brown, 8 Vet. App. 398 (1995); Caldwell v. Derwinski, 1 Vet. App. 466 (1991). Of record is a September 2018 private audiology report. At that time, audiometric testing revealed that the Veteran had bilateral hearing loss disability for VA purposes. See 38 C.F.R. § 3.385. Further, the private audiologist diagnosed tinnitus. The private audiologist opined that it was at least as likely as not that the Veteran’s bilateral hearing loss disability and tinnitus were the result of, or caused by noise exposure sustained in active service. In so finding, the audiologist noted that the Veteran was exposed to loud noises while in active service, and that such noise exposure was well documented. Further, the Veteran reported tinnitus and instances where he could not hear for several minutes following exposure to excessive noise. The audiologist also noted that tinnitus was one of the most common, and often the first, symptom of acoustic trauma. It was also noted that the Veteran did not have a history of occupational noise exposure prior to, or subsequent to his active service. The Board finds that the September 2018 private medical opinion is adequate. In this regard, the audiologist thoroughly discussed the relevant evidence, considered the contentions of the Veteran, and provided a supporting rationale for the conclusions reached. Barr v. Nicholson, 21 Vet. App. 303 (2007); Stefl v. Nicholson, 21 Vet. App. 120 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). As such, the Board finds that the September 2018 private audiology opinion is the most probative evidence of record. The Board acknowledges that there is a May 2017 VA medical opinion of record against the claim. However, the VA examiner failed to adequately consider the Veteran’s lay statements regarding the onset and continuity of his symptoms of decreased hearing acuity and tinnitus. As such, the opinion is not adequate and is of little probative value. Accordingly, the Board finds that the preponderance of the evidence is for the claims and entitlement to service connection for bilateral hearing loss disability and tinnitus is warranted. 38 U.S.C. § 5107 (b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND Service Connection – Skin Condition The Veteran has asserted that he has a skin disability that had its onset during his active service. Specifically, the Veteran has reported that he has a rash that he believes is related to exposure to herbicides while serving aboard the U.S.S. Princeton in the Republic of Vietnam. He reported that he reported his rash in service and was given an ointment for treatment. He reported that his rash has continued intermittently since that time. Current treatment records show that the Veteran has a current diagnosis of eczema. The Board notes that the U.S.S. Princeton is a naval vessel that has been identified to have traveled through the inland waterways of the Republic of Vietnam while the Veteran was aboard. As such, the Veteran’s exposure to herbicides during service is conceded. Though eczema and other rashes are not listed as a disease associated with herbicide exposure under 38 C.F.R. § 3.309 (e), the governing regulations do not preclude the Veteran from establishing service connection with proof of direct causation. Combee v. Brown, 34 F.3d 1039 (1994). As such, the Board finds that the Veteran should be provided a VA examination to determine the nature and etiology of any currently present skin disability. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The matters are REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Then, schedule the Veteran for an examination by an examiner with appropriate expertise to determine the nature and etiology of any currently present skin disability. The claims file must be made available to, and reviewed by the examiner. Any indicated studies should be performed. Based on the examination results and a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that any currently present skin disability had its onset during the Veteran’s active service, or is otherwise etiologically related to such service, to specifically include his herbicide exposure while serving in the inland waterways of the Republic of Vietnam. In forming the opinion, the examiner must consider the Veteran’s lay statements regarding the onset and continuity of his symptoms. The examiner should note that the fact that any diagnosed skin disability is not presumed to be related to herbicide exposure is not a sufficient rationale to support a negative opinion regarding direct causation. The rationale for all opinions expressed must be provided. 3. Confirm that the VA examination report and all medical opinions provided comport with this remand, and undertake any other development determined to be warranted. (Continued on the next page)   4. Then, readjudicate the remaining issue 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 D. Andrew Ledman II 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.