Citation Nr: 18143203 Decision Date: 10/18/18 Archive Date: 10/18/18 DOCKET NO. 16-29 150 DATE: October 18, 2018 ORDER Entitlement to service connection for right ear hearing loss is denied. REMANDED Entitlement to an initial evaluation in excess of 30 percent for posttraumatic stress disorder (PTSD) is remanded. FINDING OF FACT The medical evidence of record does not reflect a nexus between the Veteran’s current right ear hearing loss disability and military service, to include any in-service noise exposure. CONCLUSION OF LAW The criteria for establishing service connection for right ear hearing loss have not been met. 38 U.S.C. §§ 1131, 1154, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty with the United States Army from February 1968 to February 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a hearing in April 2017. Entitlement to service connection for right ear 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; 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 current disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also 38 C.F.R. § 3.303, Hickson v. West, 12 Vet. App. 247, 252-53 (1999). Service connection may be granted for any disease initially diagnosed after service, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Certain chronic diseases, including hearing loss, may be presumed to have been incurred in or aggravated by service if they manifest to a compensable degree within one year of discharge from service, even though there is no evidence of such disease during service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309(a). For purposes of the laws administered by VA, impaired hearing will be considered 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. The failure to meet these criteria at the time of a Veteran’s separation from active service is not necessarily a bar to service connection for hearing loss disability. A claimant “may nevertheless establish service connection for a current hearing loss disability by submitting evidence that the current disability is related to service.” Hensley, 5 Vet. App. at 160. The Veteran’s military occupational specialty is listed as combat engineer, which is considered a specialty with highly probable exposure to noise and acoustic trauma. He reported noise exposure to artillery, trucks, heavy equipment, firearms, helicopters, and aircraft. He also reported post-military noise exposure as a mechanic. The Veteran underwent hearing tests in conjunction with his induction and separation examinations. At both of these examinations, the Veteran’s hearing was measured to be well within normal limits; in fact, his hearing test at separation returned slightly better results than at his induction examination. The Veteran’s wife testified that the first time she and the Veteran suspected he had hearing loss was in approximately July 2014, when they first had the Veteran’s hearing checked with a VA audiologist. The Veteran’s VA treatment records show that his right ear was noted to have moderate to moderately severe sensorineural hearing loss at the 2000 to 5000 Hertz thresholds. He was noted to be a candidate for hearing aids, which he received in May 2015. In September 2014, the Veteran attended a VA audiological examination, which revealed the following audiometric results: 500 Hz 1000 Hz 2000 Hz 3000 Hz 4000 Hz Speech Discrimination RIGHT 5 25 40 50 60 94% LEFT 5 10 20 25 35 100% These results constitute right ear hearing loss for VA purposes, as the auditory threshold of several frequencies exceeds 40 decibels in the right ear. The examiner opined that the right ear hearing loss was less likely than not caused by military noise exposure. The examiner explained that the Veteran’s hearing was measured on entrance to and separation from the military, and there were no significant positive threshold shifts between those two examinations. The examiner noted that, given these results, there was no evidence of permanent noise injury beginning during service. After careful review of the available evidence, the Board finds that service connection for bilateral hearing loss is not warranted in this case. Although the Veteran is competent, as a lay person, to report symptoms of his hearing loss, he is not competent to provide an opinion on a complex medical question such as the cause of hearing loss. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007) (except in limited circumstances, a layperson is not competent to provide evidence of diagnoses). Therefore, his assertion that the in-service noise exposure caused his current hearing loss is not probative, leaving the VA examination as the only competent opinion in the record. The Board finds that the VA examination is probative, as it relies on medical evidence of record and addresses the significance of the Veteran’s normal induction and separation hearing tests. There is no competent evidence of a link between any in-service noise exposure and the current hearing loss disability. Accordingly, service connection for right ear hearing loss is not warranted. REASONS FOR REMAND Entitlement to an initial evaluation in excess of 30 percent for PTSD is remanded. The Veteran and his wife testified at the April 2017 Board hearing that the symptoms of his service-connected PTSD have worsened since the last VA examination in September 2014. Therefore, a new VA examination is necessary to determine the current severity of the Veteran’s PTSD. See Palczewski v. Nicholson, 21 Vet. App. 174, 181-82 (2007); Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). The matter is REMANDED for the following action: Schedule the Veteran for an examination with an appropriate clinician to determine the current severity of the Veteran’s service-connected PTSD. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Josey, Associate Counsel