13-02 949, 13-02 949

Veteran served multiple active-duty periods including deployments to southwest Asia and Bosnia; claimed tinnitus in March 2011 and reported hearing/noise exposure during service as a helicopter crew chief and MP.
Service treatment records do not document tinnitus; a September 2010 post-deployment questionnaire indicates denial of ringing in the ears.
VA audiology exam (June 2011) diagnosed current tinnitus, noted in-service acoustic trauma, but opined nexus to service was speculative due to inconsistent onset reports and normal hearing thresholds.
Veteran testified at a June 2013 Board hearing he first noticed tinnitus in 2005 in Bosnia and maintained continuity to present; Board found him credible.
Board concluded evidence was in equipoise, resolved reasonable doubt in Veteran’s favor, granted service connection for tinnitus; separate claim for congenital coronary bridging was remanded for further cardiology development (obtain flight stress tests and clarify whether condition worsened during service).

Issue	Plaintiff's Argument	Defendant's Argument	Held
Service connection for tinnitus	Veteran: tinnitus began in Bosnia (2005) from in-service noise and has continued; credible lay testimony establishes nexus	VA: 2011 examiner said nexus speculative due to inconsistent onset, denial in 2010 questionnaire, and normal audiometric thresholds	Granted — Board found Veteran’s credible lay testimony sufficient to establish nexus and resolved reasonable doubt in his favor
Service connection for bridging of LAD artery with systolic/diastolic collapse	Veteran: heart condition related to or aggravated by service (claimed worsening during service)	VA: Cardiologist opined congenital condition pre-existed service; insufficient records (stress tests) to determine progression during service	Remanded — obtain flight physical stress tests and return to cardiologist for an adequate opinion on in-service worsening

Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (competent lay testimony can establish service connection)
Holton v. Shinseki, 557 F.3d 1362 (Fed. Cir. 2009) (elements required to establish service connection)
Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) (continuity of symptomatology requirement when chronicity in service not established)
Stegall v. West, 11 Vet. App. 268 (Vet. App. 1998) (VA must comply with Board remand directives)
Reonal v. Brown, 5 Vet. App. 458 (Vet. App. 1993) (medical opinion based on inaccurate factual premise is not probative)
Barr v. Nicholson, 21 Vet. App. 303 (Vet. App. 2007) (VA must ensure examination/opinion is adequate when it procures one)