Citation Nr: 0300474 Decision Date: 01/09/03 Archive Date: 01/28/03 DOCKET NO. 98-17 801 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Columbia, South Carolina THE ISSUE Entitlement to service connection for loss of bilateral acoustic reflexes, also claimed as audio dyslexia. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Christopher J. Gearin, Counsel INTRODUCTION The veteran had over 20 years of active military service, and she retired from service in March 1997. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 1997 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Columbia, South Carolina, which, in pertinent part, denied the above claim. The Board remanded this case in March 2000 for further development, and it has returned for appellate review. FINDINGS OF FACT The veteran's loss of bilateral acoustic reflexes, also claimed as audio dyslexia, had its onset in service. CONCLUSION OF LAW Loss of bilateral acoustic reflexes, also claimed as audio dyslexia, was incurred during active service. 38 U.S.C.A. §§ 1110, 1131 (West 1991 & Supp. 2002); 38 C.F.R. § 3.303 (2002). REASONS AND BASES FOR FINDINGS AND CONCLUSION I. Veterans Claims Assistance Act of 2000 Through correspondence, the rating decision, the statement of the case and the supplemental statement of the case, the veteran has been informed of the evidence necessary to substantiate her claim. Pertinent identified medical and other records have been obtained, and VA examinations have been provided. The Board finds that the notice and duty to assist provisions of the law have been satisfied. 38 U.S.C.A. §§ 5103, 5103A (West 1991 & Supp. 2002); 38 C.F.R. § 3.159 (2002). II. Service Connection Entitlement to service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active duty. 38 U.S.C.A. § 1110. Additionally, service connection may be granted for any disease initially diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). The veteran claims that she has a disability manifested by loss of acoustic reflexes which results in inability to process sound properly. She claims this is like an audio dyslexia. Based on a thorough review of the record, the Board finds that the evidence favors the veteran's claim for service connection for loss of acoustic reflexes, claimed as audio dyslexia. The service medical records revealed that the veteran complained of difficulty "making out tones," although it is not known whether this was merely a symptom of her hearing loss. Her service medical records show that acoustic reflexes were absent in both ears during some examinations, and auditory brain evoked responses conducted in 1995 and 1996 were abnormal. The Board adopts the findings made by a VA examiner in a June 2001 report and January 2002 addendum. Although at the beginning of the June 2001 report, the examiner wrote that the claims file was not available, he later noted in the report that he had reviewed the claims file. The examiner assessed by history that the veteran had objectively abnormal brain stemming evoke response tests that had been repeated. The VA examiner's concern was whether the veteran had central auditory processing disorder. The veteran provided the examiner with several articles and provided a history that might be consistent with the need for evaluation of these tests. The examiner diagnosed the veteran with possible central auditory processing disorder as evidenced by abnormal audiometric scores and abnormal auditory brainstem response scores with a normal magnetic resonance imaging scan. In the January 2002 addendum, The VA examiner from June 2001 noted that the veteran had abnormal auditory function evidenced by audiograms and evoked response testing results, which were abnormal on several occasions. Additionally, magnetic resonance imaging scans were done some years before. The veteran's symptoms highly suggest a central auditory processing disorder. The examiner noted that the disorder was directly associated with the abnormal studies of the VIII nerve function. These findings, symptoms, and deficits of disabilities seemed highly likely to be caused during the veteran's active service experience. The examiner added that high frequency hearing loss is also part of this condition. The Board finds this June 2001 VA examination report and January 2002 addendum compelling. The examiner thoroughly discussed the veteran's medical condition and explained the reasons for the opinion. The Board has considered the other evidence of record, but finds that it lacks probative weight in comparison to the June 2001 VA examination report and January 2002 addendum. According to an August 2002 VA medical report, another examiner reached the opposite conclusion. The August 2002 VA examiner provided the following opinion. The acoustic reflex testing of the veteran was as to be expected for her hearing levels. Here acoustic reflexes were present where her hearing levels would allow the reflexes to be measured, and they were absent where hearing levels would obliterate the response. Acoustic reflex testing was never reviewed alone, but always in conjunction with the diagnostic battery. Absence of an acoustic reflex is not a separate disability and is not related to the veteran's military service. In addition, a central auditory processing disorder (CAPD) is not a developed problem. Difficulties with processing auditory information would have been present throughout the veteran's life. The veteran's description of difficulty with speech clarity is, in the examiner's opinion, related to her sloping high-frequency sensorineural hearing loss and loss of consonant discrimination. The examiner noted that a magnetic resonance imaging or autoimmune studies were indicated. The Board finds this August 2002 VA examination lacks probative weight because it was not based on a review of the veteran's claims file. In the Board's opinion the evidence supportive of the claim is at least in equipoise with that against the claim. Accordingly, the Board concludes that the veteran's loss of bilateral acoustic reflexes, also claimed as audio dyslexia, is warranted. ORDER Service connection for loss of bilateral acoustic reflexes, also claimed as audio dyslexia, is granted. BETTINA S. CALLAWAY Member, Board of Veterans' Appeals IMPORTANT NOTICE: We have attached a VA Form 4597 that tells you what steps you can take if you disagree with our decision. We are in the process of updating the form to reflect changes in the law effective on December 27, 2001. See the Veterans Education and Benefits Expansion Act of 2001, Pub. L. No. 107-103, 115 Stat. 976 (2001). In the meanwhile, please note these important corrections to the advice in the form: ? These changes apply to the section entitled "Appeal to the United States Court of Appeals for Veterans Claims." (1) A "Notice of Disagreement filed on or after November 18, 1988" is no longer required to appeal to the Court. (2) You are no longer required to file a copy of your Notice of Appeal with VA's General Counsel. ? In the section entitled "Representation before VA," filing a "Notice of Disagreement with respect to the claim on or after November 18, 1988" is no longer a condition for an attorney-at-law or a VA accredited agent to charge you a fee for representing you.