Citation Nr: 18131258
Decision Date: 08/31/18	Archive Date: 08/31/18

DOCKET NO. 14-25 954
DATE:	August 31, 2018
Entitlement to service connection for bilateral hearing loss is granted.
The probative and competent evidence of record is in equipoise as to whether the Veteran’s bilateral hearing loss disability was incurred in or related to military service.
Affording the appellant the benefit of the doubt, the criteria for service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.385.
The Veteran served on active duty from March 1970 to March 1972. The Veteran died during the pendency of the appeal and the appellant, his surviving spouse, has been substituted. 
Entitlement to service connection for bilateral hearing loss
The appellant asserts that the Veteran’s bilateral hearing loss was proximately due to his active service. 
The Board concludes that during his lifetime, the Veteran had a diagnosis of hearing loss that is related to his service. Service connection is granted. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363 (Fed. Cir. 2009); Hensley v. Brown, 5 Vet. App. 155 (1993); 38 C.F.R. §§ 3.303(a), 3.385. 
The Veteran’s service treatment records (STRs) include a report documenting the Veteran’s January 1970 entrance examination which included an audiologic examination. After converting the results provided in the American Standards Association (ASA) units to the International Standards Organization-American National Standards Institute (ISO-ANSI) units, which is the current standard used by the regulations for rating purposes, the audiological examination, pure tone thresholds, in decibels were as follows:
 	500	1000	2000	3000	4000
RIGHT	30	25	20	---	15
LEFT	30	20	20	---	20

The Veteran’s STRs are silent for any complaints of hearing loss or hearing difficulty.
The Veteran had a separation examination in March 1972 which included an audiological examination. The Veteran completed a Report of Medical History Form, in which the Veteran denied having trouble hearing. The audiological examination, pure tone thresholds, in decibels, was as follows:
 	500	1000	2000	3000	4000
RIGHT	15	15	15	---	15
LEFT	15	15	15	---	15

In April 2012, the Veteran submitted a written statement that right after he was discharged from military service he took a job that required him to take a hearing test which is how he learned he had significant hearing loss in his left ear. The Veteran further stated that he does not have documentation of this because it occurred over 40 years ago and he cannot recall the doctor’s name or address. The Veteran also submitted a written statement from his spouse, where she states that she has known the Veteran since 1970 and that she has to talk loudly and repeat herself frequently when speaking to him.
In July 2012 the Veteran was given a VA examination which yielded results that meet the criteria for a hearing loss disability for VA compensation purposes. The Veteran reported to the examiner that he was deployed to Vietnam with the primary duties of removing and disposing of ammunition from the field. The Veteran reported that he was exposed to explosives and gunfire without hearing protection. The Veteran denied recreational noise exposure, and reported using hearing protection in his employment at a corrugated box manufacturing facility. 
However, the July 2012 examiner offered a negative nexus opinion noting that the Veteran’s hearing thresholds at enlistment were within normal limits bilaterally and that there was no significant change in these thresholds noted between enlistment and separation. At separation the thresholds remained within normal limits bilaterally. The examiner further noted that the Veteran marked “No” to “hearing loss” and “Ear, Nose and Throat (ENT) trouble” on his Report of Medical History form at discharge. The Examiner added additional remarks of 
Today’s finding suggest possible retrocochlear involvement on the left. Asymmetric pure tone thresholds and significantly poorer word understanding on the left. Additionally, pt. reported bilateral tinnitus, left greater than right and new episodes of dizziness. Neurology consult was already placed by GMC, it is also recommended that ENT consult be considered by GMC to rule out retrocochlear pathology.
In August 2012, VA medical records reflect that the Veteran met with his general medical provider who noted the Veteran’s left ear hearing loss and scheduled a neurology consult and MRI to rule a retrocochlear etiology with his hearing loss and dizziness. The records further show in January 2013, the MRI results were reviewed with the Veteran. Although, the MRI showed that the Veteran had findings of the brain, neurological symptoms such as dizziness and chronic hearing loss are “atypical” for symptoms of multiple sclerosis. After this MRI interpretation, records show that the Veteran’s diagnosis was confirmed to be a progressive demyelinating disease, which shifted the focus of his treatment from his hearing loss as his health rapidly deteriorated. 
After a review of the evidence, the Board finds the competent and credible evidence is in equipoise regarding whether the Veteran incurred hearing loss during service. The negative opinion by the July 2012 examiner was based upon the Veteran’s hearing threshold being within normal limits at separation. However, the Board notes that the Veteran’s audiological examination results documented at separation are oddly all the same value of 15 decibels for all tested frequencies. However, this is not the case for the Veteran’s audiological examination during his entrance examination. In fact, according to the Veteran’s entrance and separation examination reports, his hearing improved after military service, despite the Veteran’s statements of engaging in combat related activities and exposure to explosives without hearing protection during his time in service.
Thus, the Board places little probative value on the audiological examination results recorded at separation as they likely do not accurately reflect that the Veteran’s hearing acuity at separation. Therefore, the Board finds the Veteran’s lay-testimony experiencing hazardous noise exposure during service and being told at an employment audiological examination that he has hearing loss immediately after service, to be credible despite, the lack of treatment records documenting in-service hearing loss.
In summary, the competent and credible evidence is in equipoise regarding whether the Veteran incurred hearing loss during service and has had hearing loss symptoms since then. The medical evidence within the records shows that the Veteran has been diagnosed with bilateral hearing loss that is a disability for VA compensation purposes. 
(Continued on the next page)
The benefit of the doubt is resolved in the Veteran’s favor; service connection for bilateral hearing loss must be granted. Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.
M.E. Larkin
Veterans Law Judge
Board of Veterans’ Appeals

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