Citation Nr: 18142712 Decision Date: 10/17/18 Archive Date: 10/16/18 DOCKET NO. 16-32 470 DATE: October 17, 2018 ORDER Service connection for right ear hearing loss is granted. Service connection for tinnitus is granted. REMANDED Service connection for left ear hearing loss is remanded. FINDINGS OF FACT 1. The Veteran’s right ear hearing loss is linked to noise exposure during active service. 2. The Veteran’s tinnitus is secondary to his hearing loss disability. CONCLUSIONS OF LAW 1. The criteria for service connection for right ear hearing loss have been met. 38 U.S.C. §§ 1110, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.385 (2017). 2. The criteria for service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.102, 3.310 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1970 to June 1991. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). 1. Service connection for right ear hearing loss is established. Law Service connection will generally be awarded when a veteran has a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). To establish service connection on a direct basis, the evidence must show (1) a current disability; (2) incurrence or aggravation of a disease or injury in service; and (3) a link or nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Hickson v. West, 12 Vet. App. 247, 252 (1999). A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. When the evidence supports the claim, or is in relative equipoise, the claim will be granted. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). Analysis The August 2013 VA examination report shows audiometric testing results that satisfy VA’s criteria for a hearing loss disability in the right ear. See 38 C.F.R. § 3.385 (defining a hearing loss disability for VA compensation purposes). The Veteran has provided credible testimony of in-service noise exposure from duties aboard an aircraft carrier, and as a Systems Organizational Maintenance Technician, with daily proximity to the flight line. See May 2014 Notice of Disagreement; August 2013 VA Examination Report; Service Personnel Records. The Veteran’s DD 214’s also show that he initially served as an Aviation Structural Mechanic (AMSC), a military occupational specialty that has a high probability of involving noise exposure. See Department of Defense’s Duty MOS Noise Exposure Listing; Veterans Benefits Administration Manual, M21-1 III.iv.4.B.3.c. (providing that in-service noise exposure may be established based on an MOS’s probability of involving noise exposure, as set forth in the listing provided by DOD). Thus, there is probative evidence of significant in-service noise exposure consistent with the circumstances of the Veteran’s service. The balance of the evidence supports a link between the Veteran’s right ear hearing loss disability and his in-service noise exposure. In an April 2014 private treatment record, a physician stated that a “substantial contribution of noise exposure” to the Veteran’s hearing loss “is likely.” The Veteran has denied post-service noise exposure. See August 2013 VA Examination Report. In the August 2013 VA examination report, the VA examiner opined that the Veteran’s hearing loss was less likely than not related to active service. The Board finds the evidence to be in relative equipoise on this issue, and resolves reasonable doubt in favor of the Veteran. See Gilbert, 1 Vet. App. at 55; 38 C.F.R. § 3.102. Accordingly, service connection for right ear hearing loss is established. 2. Service connection for tinnitus is established. Service connection may be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disease or injury. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for aggravation of a disease or injury by a service-connected disability. Id. In the April 2014 private treatment record, the Veteran’s treating physician stated that the Veteran had tinnitus secondary to his sensorineural hearing loss. The August 2013 VA examiner found against a relationship to service, but did not opine on whether the Veteran’s tinnitus may be secondary to his hearing loss. As service connection for right ear hearing loss has been established, the criteria for service connection for tinnitus as secondary to hearing loss are satisfied. See 38 C.F.R. § 3.310. REASONS FOR REMAND Service connection for left ear hearing loss is remanded. A new VA examination is warranted to assess whether the Veteran now has a current left ear loss disability. The testing results recorded in the August 2013 VA examination report do not satisfy VA’s criteria for a hearing loss disability. See 38 C.F.R. § 3.385; Hensley v. Brown, 5 Vet. App. 155, 157 (1993). While an April 2014 private audiogram does show a left ear loss disability, a private treatment record dated a few days later reflects that the Veteran had cerumen impaction of the left ear, which was removed at that time. It is thus impossible to determine whether the increased left ear hearing loss recorded in the April 2014 audiogram was sensorineural in nature, or instead caused by cerumen impaction. An August 2016 audiogram from the Walter Reed National Military Medical Center is also of record, and appears to show significantly improved left ear hearing. However, it is extremely difficult to read due to poor resolution of the copy. Thus, the Board will not base a decision on that record. The matter is REMANDED for the following action: Arrange for a new VA audiological examination to help determine whether the Veteran has a left ear hearing loss disability. If so, service connection should be established based on the Board’s decision regarding the right ear. P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Rutkin, Counsel