Citation Nr: A25052844 Decision Date: 06/16/25 Archive Date: 06/16/25 DOCKET NO. 220823-270765 DATE: June 16, 2025 ORDER Entitlement to service connection for tinnitus is granted. REMANDED Entitlement to service connection for traumatic brain injury (TBI) is remanded. Entitlement to service connection for bilateral hearing loss (BHL) is remanded. FINDING OF FACT The competing evidence is in approximate balance as to whether the Veteran's current tinnitus is the result of his active service. CONCLUSION OF LAW The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the U.S. Army from March 1983 to March 1986, from April 2002 to May 2003, from October 2005 to August 2006, and from June 2016 to January 2017. These matters come before the Board of Veterans' Appeals (Board) on appeal from an August 2022 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO), an agency of original jurisdiction (AOJ). The Veteran filed an August 2022 VA Form 10182, Decision Review Request: Board Appeal, and selected the Evidence Submission docket. Accordingly, the evidentiary record before the Board consists of the evidence of record at the time of the decision on appeal and any evidence submitted with or within 90 days following the VA Form 10182. 38?C.F.R. §?20.303. 1. Entitlement to service connection for tinnitus is granted. The Veteran contends he suffers from tinnitus as a result of his military service. Specifically, he contends that he was routinely exposed to hazardous noise, such as gunfire and demolitions during combat and combat training while serving in the U.S. Army Special Forces. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service.?38 U.S.C. §§ 1131, 5107;?38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi,?381 F.3d 1163, 1166-67?(Fed. Cir. 2004).? A lay person is competent to describe his symptoms of ringing in the ears throughout the years. Charles v. Principi,?16 Vet. App. 370, 374-75?(2002). If a Veteran reports ringing in their ears, a diagnosis of?tinnitus?is generally applied without further examination. In addition, since the diagnosis of?tinnitus?is so heavily reliant upon lay statements, the etiology of the disorder is similarly reliant upon them. The date that a veteran reports that the?tinnitus?symptoms started is generally accepted as the date that the disorder began. Thus, while service connection for?tinnitus?requires a medical diagnosis of?tinnitus?and a medical nexus relating the diagnosis to military service, lay testimony plays an unusually important role in these determinations and can even be competent and sufficient to establish a diagnosis and medical etiology of a condition. Davidson v. Shinseki,?581 F.3d 1313?(Fed. Cir. 2009). The Board's primary role in adjudicating a?tinnitus?claim is to assess the credibility of lay statements. Buchanan v. Nicholson,?451 F.3d 1331?(Fed. Cir. 2006).? In considering the instant matter, the Board acknowledges at the outset that the AOJ did not provide the Veteran with a VA examination in developing his supplemental claim. As for the merits of the claim, because the AOJ did not obtain a contemporaneous VA examination, the only evidence of record regarding the first element of service connection is included in lay statements of record, as well as a June 2010 VA examination obtained during adjudication of the Veteran's prior service connection claim for tinnitus and hearing loss. However, since the June 2010 VA examination was conducted, the Veteran had additional periods of service. As such, the June 2010 VA examination is inadequate for the purposes of evaluating the Veteran's current disability caused by his service as it predates his most recent service. Turning to the lay testimony of record, the Board notes that the Veteran reports experiencing tinnitus. The Veteran submitted an additional lay statement from his wife, who reports observing the Veteran experiencing symptoms of tinnitus. The Board finds both the Veteran and his wife competent to report symptoms of such a condition and finds their reports credible. Resolving all reasonable doubt in his favor on this issue, the Board finds the Veteran has a current tinnitus condition and concludes that the first element of service connection has been met. As for the second element, the AOJ conceded that "qualifying event, injury, or disease had its onset during [the Veteran's] service" based on noise exposure from his military occupational specialty as an SF Senior Sargent, which has a high probability to exposure to hazardous noise. Given the Veteran's extensive combat and service experience of record, the Board agrees. Similarly, the competing evidence is in approximate balance regarding whether the Veteran's?tinnitus?is related to his noise exposure in service. Thus, the Board resolves reasonable doubt in favor of the Veteran. Service connection for tinnitus is granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough,?21 F.4th 776, 780 (Fed. Cir. 2021).? REASONS FOR REMAND 1. Entitlement to service connection for a TBI is remanded. 2. Entitlement to service connection for BHL is remanded. The Veteran is seeking to establish service connection for a TBI and BHL. He contends he suffered many TBI injuries over the course of his service, which include at least 60 breaches, multiple fragmentary grenades, claymore mines he detonated, explosive materials used for destroying vehicles, and a March 2006 ambush where his vehicle was hit by an IED. He further contends to suffer from BHL from his time of service and specifically claims that his hearing loss worsened following his previous June 2010 VA examination that showed no diagnosis of hearing loss. See July 2022 lay statement. A medical examination is adequate "where it is based upon consideration of the veteran's prior medical history and examinations and also describes the disability... in sufficient detail so that the Board's 'evaluation of the claimed disability will be a fully informed one.' Stefl v. Nicholson, 21?Vet. App.?120, 123 (2007). An opinion must communicate to the Board "that a medical expert has applied valid medical analysis to [a case's facts]... to reach [his or her] conclusions." Nieves-Rodriguez v. Peake, 22?Vet. App.?295, 301 (2008).?An opinion's probative value derives from "the factually accurate, fully articulated, sound reasoning for the conclusion." Id.?at 304.?Without these qualities, a medical opinion is "insufficient to allow the Board to make an informed decision" as to appropriate weight and is inadequate. Stefl, 21 Vet. App. at 124-25. The Veteran was afforded June 2010 VA examinations for his TBI and BHL claims. In the June 2010 BHL VA examination, the examiner determined it was less likely than not that his TBI was related to service because "he was protected from the blast of IED explosions and did not lose consciousness" and his headaches "did not occur in proximity to the time of injury and are brought about by occupational stress." This rationale is blatantly inadequate and fails to consider the totality of the Veteran's in-service injuries. Additionally, the Veteran had additional periods of service following this examination, which have not been evaluated by a medical professional. Similarly, the Veteran's purported BHL has not been evaluated since his most recent period of service, where he credibly asserted that his hearing worsened. For these reasons, new examinations must be obtained on remand. The matters are REMANDED for the following action: 1. Schedule the Veteran for VA examinations to determine the nature and etiology for his claimed TBI and BHL. The examiner must review the claims file, including a copy of this remand. The examiner is asked to provide a response to the following: (a). Is the Veteran's claimed TBI at least as likely as not related to his service? (b). Is the Veteran's claimed BHL at least as likely as not related to his service? In forming their opinion, the examiner should address the Veteran's contentions regarding the onset and continuity of his TBI and BHL, as well as the service treatment records and July 2022 lay statements of record documenting the extent of the Veteran's in-service injuries. The examiner is advised that a negative opinion cannot be based solely on the absence of treatment in service. In providing the requested opinions, consider the Veteran's description of the in-service injuries and symptoms as well as post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of the current disability, this should be noted. Stated another way, do the Veteran's reports about the symptoms align with how the currently diagnosed disabilities are known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Finkelstein, Benjamin A. 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.