Citation Nr: 21030263 Decision Date: 05/18/21 Archive Date: 05/18/21 DOCKET NO. 19-01 881 DATE: May 18, 2021 ORDER Entitlement to service connection for tinnitus is granted. FINDING OF FACT Affording the Veteran the benefit of the doubt, his current diagnosis of tinnitus first manifested during service. 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, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1976 to June 1980. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). A Board hearing was held in May 2021. The transcript is not yet available. However, this appeal may be granted in full. To provide an immediate and favorable response to the Veteran after his hearing, a transcript of the hearing will be added to the Veteran's file at a later date. 1. Entitlement to service connection for tinnitus. The Veteran seeks entitlement to service connection for bilateral tinnitus. Establishing service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). For Veterans who have served 90 days or more of active service after December 31, 1946, there is a presumption of service connection for certain chronic diseases, including organic disease of the nervous system, if the disability is manifest to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309. Tinnitus due to acoustic trauma is deemed an organic disease of the nervous system. Fountain v. McDonald, 27 Vet. App. 258, 274-75 (2015) (holding that tinnitus is considered an organic disease of the nervous system where there is evidence of acoustic trauma). At the outset, the Board clarifies that tinnitus is a medical term referring to symptoms of noise in the ears, such as ringing, buzzing, roaring or clicking. See Dorland's Illustrated Medical Dictionary, 1322 (32nd ed. 2012). In adopting the current rating criteria for tinnitus under Diagnostic Code (DC) 6260, VA described tinnitus as follows: Tinnitus is classified either as subjective tinnitus (over 95% of cases) or objective tinnitus. In subjective or "true" tinnitus, the sound is audible only to the patient. In the much rarer objective tinnitus (sometimes called extrinsic tinnitus or "pseudo-tinnitus"), the sound is audible to other people, either simply by listening or with a stethoscope. 67 Fed. Reg. 59033-0 (Sept. 19, 2002). Thus, tinnitus is a rare type of disability that, in the vast majority of cases, may be established on the basis of lay evidence alone. See Charles v. Principi, 16 Vet. App. 370 (2002). Military personnel records document that the Veteran's MOS was an administrative specialist. The VA notes that his MOS is considered to be at low to moderate risk of noise exposure. However, based on the circumstances of the Veteran's service, serving as an administrative specialist with an aviation unit near flight lines, and his competent and credible statements, the Board finds that the Veteran was exposed to hazardous noise during his active duty service. Therefore, the primary question before the Board is whether the Veteran's confirmed in-service noise exposure caused his current tinnitus and/or whether tinnitus first began in service. The Veteran was afforded a VA examination in May 2018. The examiner opined that it was less likely than not that his tinnitus was caused by service. The examiner reasoned that the Veteran did not have hearing loss and therefore could not have tinnitus. Additionally, the examiner states that the Veteran's STRs are silent for any complaint, diagnosis, or treatment for tinnitus, and it was developed tinnitus many years after military discharge. However, the Veteran testified in his May 2021 hearing that the onset of tinnitus began during service. He testified that his place of duty was near flight lines for jets and helicopters, and that he was frequently exposed to loud engine noises throughout his typical duty schedule. He also contends that his symptoms have continued since service. He reported that he did not realize that his ear ringing during service was an abnormal symptom. In analyzing the probative value of the medical opinion, the Board must consider the factual basis the examiner relied upon. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). The Board finds that the VA examiner's findings are inconsistent with the evidence presented by the Veteran, as well as the VA's own findings that tinnitus can occur without accompanying hearing loss. Resolving reasonable doubt in favor of the Veteran, the Board accepts his sworn testimony that his tinnitus began during service. As such, the VA examiner opinion is afforded little probative value. On the other hand, as discussed above, the vast majority of diagnosable tinnitus cases is based solely on the patient's perception of ear ringing, buzzing or clicking sounds. As tinnitus in the presence of acoustic trauma is deemed a chronic disease under 38 C.F.R. § 3.303(b), the Veteran's testimony alone satisfies the service connection criteria and medical opinion as to etiology is not necessary. Walker, 708 F.3d 1331 (Fed. Cir. 2013); Fountain, 27 Vet. App. at 271-72. Accordingly, resolving reasonable doubt in his favor, service connection for tinnitus is granted. See Wise v. Shinseki, 26 Vet. App. 517, 531 (2014) ("By requiring only an 'approximate balance of positive and negative evidence'..., the nation, 'in recognition of our debt to our veterans,' has 'taken upon itself the risk of error' in awarding... benefits.") T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael J. O'Connor 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.