Citation Nr: 18141642 Decision Date: 10/11/18 Archive Date: 10/11/18 DOCKET NO. 16-31 864 DATE: October 11, 2018 ORDER Service connection for bilateral hearing loss is granted. FINDING OF FACT The Veteran’s current bilateral hearing loss for VA purposes is at least as likely as not causally related to his exposure to noise while serving in the Army. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303(a), 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United Stated Army from December 1966 to November 1969 and October 1977 to October 1978. This matter comes before the Board on appeal from a Rating Decision issued by the Agency of Original Jurisdiction (AOJ) in August 2014. The Veteran filed a Notice of Disagreement in September 2014. A Statement of the Case was issued in December 2015. The Veteran filed a substantive appeal to the Board of Veterans’ Appeals in February 2016. Service connection for bilateral hearing loss Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); 38 C.F.R. § 3.303. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, then the issue will be resolved in favor of the Veteran. 38 U.S.C. § 5107; see Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). First, establishing service connection requires competent evidence of a current disability. The Veteran had a private examination done by audiologist H.G. in July 2015 that included a Maryland CNC test and a puretone threshold test which revealed sensorineural hearing loss in both ears. The Veteran also underwent a VA examination in July 2014 that included a Maryland CNC test and a puretone threshold test which revealed sensorineural hearing loss in both ears. These two examinations are sufficient for the Board to find a current diagnosis of bilateral hearing loss. 38 C.F.R. § 3.385. Second, establishing service connection requires medical or lay evidence of in-service incurrence or aggravation of a disease or injury. The Veteran explains that he was exposed to many loud noises while serving in a mechanized infantry unit in the Army, in particular during his time in Germany in 1967 through 1969. The Veteran states that his post had armored units, an artillery unit, and his infantry unit; they often conducted field exercises together that would put the Veteran in close proximity to vehicles, weaponry, and in some cases, jet planes. The Veteran states that he was exposed to intense noise from firearms, grenades, mines, artillery, large vehicle engines, tank tracks, etc. The Veteran is competent to report as to his whereabouts and experiences. The Veteran’s statements are also credible because the events he reported are consistent with his military personnel record which indicates that he was in Germany and was assigned to an infantry unit. 38 U.S.C. § 1154(a). The Veteran’s competent and credible statements are sufficient for the Board to find that the claimed in-service event(s) occurred. Finally, establishing service connection requires medical evidence of a nexus between the claimed in-service disease or injury and the present disability. On this element, the evidence of record is somewhat unclear because two medical examiners came to different conclusions. The Veteran saw audiologist H.G. in July 2015 who concluded that he did have sensorineural hearing loss and that his hearing loss was more likely than not causally connected to his military service. Dr. H.G. stated that the Veteran reported experiencing tinnitus that started shortly after he left the military, and noted that tinnitus is typically a symptom of structural damage to the inner ear. Thus, she reasoned that since it is likely that the Veteran had structural damage to his ears shortly after exiting the military, his hearing loss was most likely caused by his military service. However, the Veteran previously had underwent a VA examination in July 2014 where the VA examiner came to the opposite conclusion. The VA examiner relied in large part on an Institute of Medicine (IOM) report (Noise and Military Service, September 2005) and opined that prolonged delay in the onset of noise-induced hearing loss would be unlikely. However, that report is somewhat inconclusive, as the researchers have stipulated that there is not much evidence on delayed onset hearing loss and that longitudinal studies would be needed to better understand the mechanisms and processes involved in recovery from noise exposure. The VA examiner also noted that the was no significant shift in hearing levels during service. Both medical examiners can be presumed competent to offer medical diagnoses and opinions by virtue of their education, training, and experience. 38 C.F.R. § 3.159(a)(1). Both examination reports are entitled to some weight since both examiners crafted their reports based on examining the Veteran, asking about his medical history and reviewing his service treatment records, and conducting audiological tests. As the Board finds these opinions are entitled to the same weight, there is an approximate balance of positive and negative evidence on the material issue of nexus; therefore, the benefit of the doubt goes in favor of the Veteran on the issue. 38 C.F.R. § 3.102. In short, service connection for bilateral hearing loss is granted because competent and credible evidence establish all service connection elements. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Macchiaroli, Law Clerk