BVA9501817 DOCKET NO. 93-10 761 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to service connection for tinnitus. 2. Entitlement to service connection for an acquired psychiatric disorder. 3. Whether new and material evidence has been submitted to reopen a claim for entitlement to service connection for a dermatological disorder. 4. Entitlement to service connection for a cardiovascular disorder. 5. Entitlement to an increased (compensable) evaluation for chronic otitis media, left ear, with postoperative residuals, perforated tympanic membrane. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Alice A. Booher, Counsel INTRODUCTION The veteran had active service from January 1961 to September 1966. This appeal was taken from the rating action by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida, in August 1992. CONTENTIONS OF APPELLANT ON APPEAL In essence, it is maintained by and on behalf of the appellant that as a result of ongoing left ear problems in service, he developed tinnitus. It is averred that at the present time, the tinnitus is persistent and annoying. Service connection should be awarded. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is in favor of the veteran's claim for service connection for tinnitus. FINDINGS OF FACT 1. The veteran has service connection for defective hearing, and chronic otitis media, left ear, with postoperative residuals of tympanic membrane perforation. 2. Within months of his separation from service, the veteran complained of left ear tinnitus; his complaints have been consistent for many years. 3. The veteran's left ear tinnitus is consistent with and reasonably attributable to the same events which caused his service-connected defective hearing, left ear. CONCLUSION OF LAW Left ear tinnitus was incurred in service. 38 U.S.C.A. § 1110, 1131, 5107 (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Board finds that the facts relevant to the issue relating to service connection for tinnitus have been properly and adequately developed and that the statutory obligation of the VA to assist the veteran in the development of his claim in that regard has been satisfied pursuant to 38 U.S.C.A. § 5107. The veteran is service-connected for defective hearing, left ear. Service connection is to be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131 (West 1991). This requires a finding that there is a current disability which has a definite relationship with an injury or disease or some other manifestation of the disability during service. Rabideau v. Derwinski, 2 Vet.App. 141, 143 (1992) and Cuevas v. Principi, 3 Vet.App. 542, 548 (1992). However, it need not be shown that the disorder was present or diagnosed during service but only that there is a nexus between the current condition and military service, even if first diagnosed after service, on the basis of all the evidence, including pertinent service medical records. This can be shown by establishing that the disability resulted from personal injury or disease suffered in the line of duty. 38 C.F.R. § 3.303(d) (1993); Godfrey v. Derwinski, 2 Vet.App. 352, 356 (1992). The veteran's service medical records are silent for complaints of tinnitus; however, he did receive ongoing treatment for left ear problems, including draining, and a perforation was noted in the tympanic membrane. On the VA examination immediately after separation from service in 1967, intermittent tinnitus in the left ear was reported. In his VA Form 1-9 of May 1967, primarily relating to other problems, the veteran reiterated that he had ongoing ringing in his ears. He underwent a tympanoplasty on the left ear in 1973, and on a VA examination in 1976, tinnitus was not specifically noted. However, on VA examination in 1985, he again complained of a constant noise in the ears. An increased in his tinnitus over the past two years was noted on VA outpatient records in 1991. During the VA examination in 1992, when specialized audiometric testing was undertaken, the veteran reported bilateral constant tinnitus; his tinnitus had been matched by the examiner to the 3,000-4,000 Hertz hearing loss of approximately 75-95 decibels as reported by the veteran, The examiner concluded that the onset of the tinnitus had occurred in 1965 when the veteran was working with radar and developed ear infections. While the veteran has bilateral tinnitus, a review of the service medical records reflects that his hearing problems during service were limited to the left ear, and his left ear is the only ear for which service connection for defective hearing is in effect. The Board finds that there is a reasonable basis for finding that the veteran's left ear tinnitus is the result of the same events in service which caused the service-connected left ear defective hearing, and therefore, service connection is in order. 38 U.S.C.A. § 1110, 1131. ORDER Service connection for left ear tinnitus is granted. REMAND The veteran has alleged that as a result of persistent tinnitus, he has developed a psychiatric disorder. A review of the claims folder reveals that he has not been afforded a VA psychiatric examination in this regard. He has indicated that symptoms of his hearing loss, tinnitus and ear infections have increased to an intolerable level; that the ear ringing had makes sleep impossible and renders him unable to work, and had also resulted in serious nervousness. Depression has developed to the point where he has been suicidal, although medication had helped. It is averred by the veteran that his duties in service resulted in exposure to radioactive substances and radio frequency waves and microwaves, causing heart and skin disorders. He alleges treatment for these disorders by the VA. Based on the evidence of record, the Board finds that the case must be REMANDED for additional development as follows: 1. The veteran's service records, including DD Form 1141 are to be obtained and associated with the claims folder. 2. The veteran's complete VA outpatient records (including but not limited to the Mental Hygiene Clinic) since December 1991 should be acquired and associated with the claims folder. 3. The veteran should be given VA psychiatry, cardiology and dermatology examinations, to determine the nature and extent, duration, diagnoses and etiology of current disabilities. All necessary laboratory and other testing should be conducted. The VA psychiatric examination is to address the question of whether the claimed psychiatric disorder is causally or etiologically related to the service- connected left ear disorders. The claims folder and all evidence obtained pursuant to this REMAND must be made available to the examiners prior to their evaluation of the veteran 's case. Thereafter the case should be reviewed by the RO with regard to all service connection issues, including all evidence and all pertinent regulations. If the decision remains unsatisfactory, a Supplemental Statement of the Case should be issued on all issues, and the veteran and his representative should be afforded the opportunity to respond. The case should then be returned to the Board for further appellate review. The veteran need do nothing further until so notified. RENÉE M. PELLETIER Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. (CONTINUED ON NEXT PAGE) Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1993).