Citation Nr: A25035483 Decision Date: 04/17/25 Archive Date: 04/17/25 DOCKET NO. 240910-472450 DATE: April 17, 2025 ORDER Service connection for tinnitus is denied. Service connection for bilateral hearing loss (BLHL) is denied. FINDINGS OF FACT 1. The Veteran served on active duty from October 1966 to October 1968. 2. Tinnitus was not shown in service, was not shown to a compensable degree within one year of service, and symptoms have not been continuous since service; current tinnitus is not causally or etiologically related to service. 3. BLHL was not shown in service, was not shown to a compensable degree within one year of service, and symptoms have not been continuous since service; current BLHL is not causally or etiologically related to service. CONCLUSIONS OF LAW 1. Tinnitus was not incurred in service and is not presumed to have been incurred in service. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385 (2024). 2. BLHL was not incurred in service and is not presumed to have been incurred in service. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385 (2024). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS This decision has been written under the guidelines of the Veterans Appeals Improvement and Modernization Act, also known as the Appeals Modernization Act (AMA). In January 2024, the agency of original jurisdiction (AOJ) denied the tinnitus claim. In February 2024, the Veteran filed a Supplemental Claim that was denied by the AOJ in a July 2024 decision. Also, the AOJ denied the BLHL claim in July 2023. In February 2024, the Veteran filed a Supplemental Claim that was denied by the AOJ in a March 2024 decision. Later in March 2024, the Veteran requested a Higher-Level Review (HLR). In June 2024, the AOJ issued the HLR decision on appeal, which considered the evidence of record at the time of the March 2024 decision. In September 2024, the Veteran appealed both claims to the Board via a VA Form 10182 and elected the Hearing docket. He testified before a Veterans Law Judge (VLJ) in December 2024. A copy of the transcript has been associated with the record. As such, the Board may only consider the evidence of record at the time of the prior decisions, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). Turning to the relevant laws and regulations, service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. Tinnitus and BLHL are recognized by VA as a "chronic disease" under 38 C.F.R. § 3.309 (a); therefore, the presumptive provisions of 38 C.F.R. §§ 3.303(b), 3.307, and 3.309 apply. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258 (2015). Thus, service connection will be considered on both a direct and presumptive basis. As the evidence for both claims is similar, tinnitus and BLHL will be discussed together. Turning to the evidence, tinnitus was diagnosed in June and September 2023 VA examinations and BLHL was diagnosed in the June 2023 VA examination. Thus, the first elements of service connection of a current diagnosis have been met for both disorders. As to an in-service incurrence, the Veteran served as a field artillery crewman and in his December 2023 testimony, he described noise exposure during live fire on the firing range. He is competent to describe having experienced noise exposure in service. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). Moreover, the June and September 2023 VA examiners noted that the Veteran had experienced noise exposure through his military occupational specialty (MOS). Accordingly, the second elements of an in-service incurrence are also met. However, the third elements of service connection, a nexus to service, are not met in either claim. The June 2023 VA examiner observed that there were no complaints of tinnitus and BLHL during service, and that the Veteran indicated that tinnitus had started when he was age 40 or 50. However, the September 2023 VA examiner noted the Veteran's onset of tinnitus as 1967. When asked when the tinnitus and BLHL began in the December 2024 hearing, the Veteran was unsure and could not put a date when either disorder began but that he had not noticed it so much in service but afterward following service. The June and September 2023 VA examiners concluded that the Veteran's tinnitus is less likely than not the result of military noise exposure as his medical record noted normal bilateral hearing throughout service with no significant threshold shifts or evidence of acoustic trauma, and there were no complaints of or treatment for tinnitus in the service treatment records (STRs). As to BLHL, the June 2023 VA examiner indicated there was no significant permanent shift in hearing thresholds beyond test variability from entrance to separation, which is objective evidence of no permanent auditory damage on active duty from the conceded noise exposure. The examiner opined that the evidence is against a nexus, and it was less likely than not that the hearing loss was related to military noise exposure. Next, the STRs were reviewed, and as the VA examiners noted in their respective reports, the STRs are silent for complaints of, treatment for, or a diagnosis of tinnitus or BLHL. Although the Veteran treated for other conditions while in service, including right knee instability, a heart murmur, and a chest contusion, there are no treatment records related to his hearing. Moreover, in the September 1968 separation examination, the Veteran endorsed no problems with his ears and no hearing loss. Similarly, the clinician noted following the separation examination that the Veteran had normal ears. There are no other VA or private medical opinions that allege any etiological connection between service and tinnitus and BLHL. As such, the medical evidence weighs against finding a nexus and does not support service connection on a direct basis. Next, tinnitus and BLHL are chronic diseases under 38 C.F.R. § 3.309 and presumptive service connection will be considered. However, no chronic disease or injury was shown in service. As noted above, while in-service noise exposure was conceded, the STRs are silent for complaints of, treatment for, or a diagnosis of tinnitus or BLHL. Therefore, the medical evidence does not support presumptive service connection on a "chronic disease or injury shown in service" basis. Next, the medical evidence does not support presumptive service connection based on continuity of symptomatology since service. Specifically, the medical evidence shows that the earliest date associated with tinnitus was in VA treatment records from May 2015, and BLHL was first noted in VA treatment records in November 2011. The Veteran separated from service in November 1968. The evidence shows that tinnitus developed 47 years after service and BLHL developed 43 years after service based on his own reports to the VA. As such, the evidence does not support service connection on a "continuity of symptomatology" basis. Further, in light of the same evidence, tinnitus and BLHL did not develop to a degree of 10 percent or more within one year from the date of separation of service. Thus, the evidence does not support presumptive service connection on a "manifest within one-year from separation" basis. Therefore, the medical evidence does not support presumptive service connection on any basis. The Board has considered the Veteran's lay statements that tinnitus and BLHL were caused by service. While he is competent to report symptoms as this requires only personal knowledge as it comes through the senses, he is not competent to offer an opinion as to the etiology of the current disorders due to the medical complexity of the matter involved. Such competent evidence concerning the nature and extent of the Veteran's tinnitus and BLHL has been provided by the medical personnel who examined him during the current appeal, and who rendered pertinent opinions in conjunction with the evaluations. Those findings (as provided in the examination reports and other clinical evidence) directly address the criteria under which these disorders are evaluated. The VA medical professionals explained their reasoning based on an accurate characterization of the evidence. Therefore, the Board attaches greater probative weight to the clinical findings than to the lay statements regarding etiology. In sum, after a careful review of the record, the evidence weighs persuasively against the claims for service connection and there is no doubt to be resolved. As such, the appeals are denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). Michael Lane Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. J. Ferguson, 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.