Citation Nr: 18132267
Decision Date: 09/06/18	Archive Date: 09/06/18

DOCKET NO. 15-42 349
DATE:	September 6, 2018
Entitlement to service connection for bilateral hearing loss is granted.
Resolving reasonable doubt in the Veteran’s favor, his bilateral hearing loss is at least as likely as not related to his military service.
The criteria for entitlement to service connection for bilateral hearing loss are met.  38 U.S.C. §§ 1110, 1112, 1113, 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(a). 
The Veteran served on active duty from December 1968 to May 1970.  This matter comes before the Board on appeal from January 2014 and November 2014 Regional Office (RO) rating decisions.  In January 2017, the Veteran testified at a hearing before the undersigned Veterans Law Judge.
Entitlement to service connection for bilateral hearing loss is granted.
The Veteran contends that he has a current bilateral hearing loss disability that is related to in-service noise exposure.  
Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a).
To establish a right to compensation for a present disability, a veteran must show (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, or nexus, between the present disability and the disease or injury incurred or aggravated during service.  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).
Service connection for impaired hearing shall only be established when hearing status as determined by audiometric testing meets specified puretone and speech recognition criteria.  Audiometric testing measures threshold hearing levels (in decibels) over a range of frequencies (in Hertz).  Hensley v. Brown, 5 Vet. App. 155, 158 (1993).
For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent.  38 C.F.R. § 3.385.
There is no dispute that the Veteran has a current hearing loss disability for VA purposes.  (See October 2013 VA examination report.)  Nor is there a dispute that the Veteran was exposed to loud noise during service.  He testified at his Board hearing that he “worked in the motor pool … on great big generators.”  (See Board hearing transcript, page 5.)  His reports of in-service noise exposure are corroborated by his DD Form 214, which reflects that he was a mechanic during service.
The Veteran’s service treatment records list the following audiometry readings on his February 1970 separation examination:
 	500	1000	2000	3000	4000
RIGHT	0 	0	0	X	20
LEFT	 0	5	0	X	0
 A February 1969 service treatment record reflects that the Veteran was treated for otitis media, left viral.  He was subsequently granted service connection for this disability.  
The claims folder contains medical records that were added to the claims file in July 1974.  One such record includes a July 1974 audiogram that lists the following findings: 
 	500	1000	2000	3000	4000
RIGHT	 25	20	20	X	35
LEFT	 20	25	25	X	25
Speech audiometry revealed speech recognition ability of 100 percent in the right ear and of 100 percent in the left ear.  An undated medical record that was submitted at that time diagnoses defective hearing bilaterally.  It notes that the Veteran reported that he has difficulty hearing and has some ringing in his ears off and on.  (He was subsequently granted service connection for tinnitus.)  He reported that “[h]e first noticed this trouble following completion of basic training in February 1969.  He feels that his hearing has been getting worse.”  
There are two etiology opinions of record.  The first of these appears in the October 2013 VA examination report.  The VA examiner found that the Veteran’s hearing loss is not at least as likely as not caused by or a result of an event in military service.  The rationale was that the separation audiogram showed hearing within normal limits from 250 to 8000 Hertz bilaterally.  The examiner noted that there is no scientific basis for the existence of delayed onset hearing loss due to acoustic trauma.  The examiner based this opinion on review of the record and interview and testing of the Veteran.  Military noise exposure from weapons training, generators, trucks, and jeeps was noted.  Vocational noise exposure from working at a beef plant was noted, as was recreational noise exposure from motorcycles and power tools.
A February 2015 opinion from a private audiologist notes that the Veteran was in service in the late 1960s, “where he experienced a persistent ear infection, regular exposure to hazardous noises, and repeated instances of tinnitus and hearing loss subsequent to loud noise exposure.”  He reported experiencing constant hearing loss and tinnitus since discharge.  The audiologist noted that the Veteran has no history of occupational or recreational noise exposure without hearing protection, and he has no family history of otologic dysfunction or disease.  He noted that the only complicating medical condition is diabetes, but that the Veteran’s hearing loss predated his diabetes.  He noted that the Veteran was diagnosed with hearing loss and tinnitus in 1973 after struggling with it for several years.  In light of the above, and based on review of the Veteran’s service treatment records and interview, examination, and testing, the audiologist opined that the Veteran’s “hearing loss and tinnitus are more likely than not the result of noise exposure during military service.”
The Board finds that both of these opinions are probative, as they are based on review of the record and interview and examination of the Veteran.  Both examiners provide rationales for their opinions, and both possess the necessary education, training, or experience to provide competent medical evidence under 38 C.F.R. § 3.159 (a)(1).  See Cox v. Nicholson, 20 Vet. App. 563 (2007).  The Board notes that both of these opinions are supported by the record.  In particular, the Board notes that a progression in the Veteran’s hearing loss is reflected between his separation examination and the audiogram that was conducted four years later.  
The Board therefore will resolve reasonable doubt in the Veteran’s favor and find that entitlement to service connection for bilateral hearing loss is warranted.
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Elizabeth Jalley, Counsel 

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