92 Decision Citation: BVA 92-28716 Y92 BOARD OF VETERANS' APPEALS WASHINGTON, D.C. 20420 DOCKET NO. 91-47 613 ) DATE ) ) ) THE ISSUES 1. Entitlement to service connection for a left ear hearing loss and tinnitus. 2. Entitlement to secondary service connection for vertigo. 3. Entitlement to an increased (compensable) rating for right ear hearing loss. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD R. T. Jones, Associate Counsel INTRODUCTION The veteran served on active duty from March 1969 to September 1972. This matter comes to the Board of Veterans' Appeals (Board), in part, from a March 1990 decision by the Department of Veterans Affairs (VA) Regional Office (RO), San Diego, California, which denied service connection for bilateral hearing loss. After the veteran timely perfected his appeal, the RO granted service connection for right ear hearing loss and continued the denial of service connection for left ear hearing loss in March 1991. Service connection for tinnitus was denied by the RO in March 1991. In May 1991 the RO denied service connection for vertigo. A statement of the case on the issue of service connection for tinnitus and an increased rating for right ear hearing loss was issued to the veteran in May 1991. The veteran filed a substantive appeal with respect to the issues of service connection for tinnitus and an increased rating for right ear hearing loss in June 1991, and filed a notice of disagreement with denial of service connection for vertigo in June 1991. A supplemental statement of the case, denying all of the benefits sought on appeal, was issued to the veteran in July 1991. The veteran filed a substantive appeal with respect to the issue of service connection for vertigo in October 1991. The case was received and docketed at the Board in November 1991. In March 1992 the veteran's representative, the Disabled American Veterans, filed written argument in support of the claim. The issues of an increased rating for hearing loss and service connection for vertigo will be addressed in the remand portion of this decision. DECISION OF THE BOARD In accordance with 38 U.S.C.A. § 7104 (West 1992), following review and consideration of all the evidence in the veteran's claims file, and for the following reasons and bases, it is the decision of the Board that the evidence supports the veteran's claim for service connection for left ear hearing loss and tinnitus. CONTENTIONS OF APPELLANT ON APPEAL The appellant contends, in essence, that he has tinnitus and left ear hearing loss from the exposure to loud noises during service. FINDINGS OF FACT 1. The veteran's current left ear hearing loss had its onset during service. 2. Tinnitus is associated with his service-connected sensorineural hearing loss. CONCLUSIONS OF LAW 1. Left ear hearing loss was incurred in active service. 38 U.S.C.A. §§ 1110, 5107(b). 2. Tinnitus is proximately due to or the result of his service-connected sensorineural hearing loss. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.310(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The veteran's claims are well grounded within the meaning of 38 U.S.C. § 5107(a). That is, he has presented claims which are not inherently implausible. We are satisfied that all relevant facts have been properly developed with regard to the issues on appeal. No further assistance to the veteran is required to comply with the duty to assist the veteran. Id. Pursuant to 38 U.S.C.A. § 1110, service connection may be granted for a disability incurred in or aggravated during the veteran's period of military service. Also, service connection may be granted for disability which is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). The veteran asserts that his left ear hearing was damaged by loud noises while on active duty, and his report of service separation (DD Form 214) shows that he served in the field artillery. The pre-induction examination in March 1969 showed hearing thresholds of 15, 5, 0, and 20 decibels, at 500, 1000, 2000, and 4000 hertz, respectively, in the left ear. The service medical records show no notation of any left ear hearing loss, and the September 1972 service separation examination showed decibel thresholds of 20, 25, 25, and 25 at 500, 1000, 2000 and 4000 hertz, respectively, in the left ear. There was no complaint or finding relative to a left ear hearing loss prior to a visit to a VA outpatient clinic in December 1989 when the veteran complained of tinnitus and hearing loss. On VA audiological evaluation in January 1990, the veteran reported a history of a military noise exposure and/or acoustic trauma with a gradual onset and progression of a hearing loss. There was a notation that he had had degenerative hearing loss for one year and tinnitus for eight years. Examination showed bilateral sensorineural hearing loss. Pertinent medical literature defines hearing loss at thresholds approaching 25 decibels; the 26 to 40 decibel range is considered "mild" hearing loss. VA Physician's Guide for Disability Evaluation Examinations, 3-11 (1985). Thus, the veteran's hearing was substantially normal at induction and was essentially mildly impaired at separation. The Court of Veterans Appeals has held that where a veteran had normal hearing at entrance, some hearing loss at separation, and currently has a hearing loss meeting the criteria in 38 C.F.R.§ 3.385, service connection may be granted. Ledford v. Derwinski, No. 91-903 (U.S. Vet. App. Aug. 7, 1992). The veteran currently meets the criteria for service connection for hearing loss in 38 C.F.R. § 3.385, and given the nature of the veteran's service in the field artillery and the onset of hearing loss in his other ear during service, there is at least an approximate balance of the evidence concerning the service origin of left ear hearing loss. We therefor conclude that service connection for left ear hearing loss is warranted. 38 U.S.C.A. § 5107(A). Tinnitus was not shown during service or for many years thereafter. However, both tinnitus and sensorineural hearing loss are associated with cochlear damage, and service connection may be granted for disability which is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). In these cases the benefit of the doubt is given to the veteran, as we are unable to dissociate the tinnitus from the service-connected sensorineural hearing loss. Thus, there is a reasonable basis for a grant of service connection for tinnitus. 38 U.S.C.A. § 5107(b), 38 C.F.R. § 3.310(a). ORDER Service connection for tinnitus and left ear hearing loss is granted. REMAND In light of the grant of service connection for left ear hearing loss, further rating action is required to evaluate the veteran's service-connected bilateral hearing loss. In addition, the veteran claims his vertigo is due to his service-connected hearing loss. Accordingly the case is remanded for the following: 1. The RO should rate the veteran's service-connected, bilateral hearing loss, and he should be furnished a supplemental statement of the case reflecting the rating action taken. 2. The RO should arrange for the veteran to be medically evaluated by an appropri- ate specialist to determine if he now has vertigo. The examiner should provide an opinion as to the etiology of any vertigo found. The claims folder should be made available to the examiner for review prior to the examination. Thereafter, if the decision on either issue is adverse to the veteran, a supplemental statement of the case should be provided the veteran and his representative. After the veteran is given a reasonable opportunity to respond, the case should be returned to the Board. BOARD OF VETERANS' APPEALS WASHINGTON, D.C. 20420 * (MEMBER TEMPORARILY ABSENT) L. W. TOBIN J. F. GOUGH (CONTINUED ON NEXT PAGE) *38 U.S.C.A. § 7102(a)(2)(A) (West 1991) permits a Board of Veterans' Appeals Section, upon direction of the Chairman of the Board, to proceed with the transaction of business without awaiting assignment of an additional Member to the Section when the Section is composed of fewer than three Members due to absence of a Member, vacancy on the Board or inability of the Member assigned to the Section to serve on the panel. The Chairman has directed that the Section proceed with the transaction of business, including the issuance of decisions, without awaiting the assignment of a third Member. 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. 57 Fed. Reg. 4126 (1992) (to be codified as 38 C.F.R. § 20.1100(b)).