Citation Nr: 18145534 Decision Date: 10/29/18 Archive Date: 10/29/18 DOCKET NO. 16-16 452 DATE: October 29, 2018 ORDER Entitlement to service connection for hearing loss is denied. FINDING OF FACT The Veteran’s hearing loss is not etiologically related to service. CONCLUSION OF LAW The criteria for service connection for hearing loss have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION This case comes before the Board on appeal from a March 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran served active duty in the U.S. Army from December 1968 to July 1970. 1. Entitlement to service connection for hearing loss Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110. Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may also be established for a current disability on the basis of a presumption that certain chronic diseases, to include hearing loss, manifested to a compensable degree within a certain time following service. U.S.C. §§ 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. For hearing loss, the disease must have manifested to a degree of 10 percent or more within one year of separation from service. 38 C.F.R §3.307(a)(3). Service connection for recognized chronic diseases can also be established through continuity of symptomatology. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); 38 C.F.R. §§ 3.303(b), 3.309. For chronic diseases shown as such in service or within the applicable presumptive period, subsequent manifestations of the same chronic disease at any later date are service-connected unless attributable to an incurrent cause. 38 C.F.R. § 3.303(b). For a chronic disease to be considered to have been “shown in service,” there must be a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings. Id. When the condition noted in-service or within the presumptive period is not the chronic disease, a showing of continuity of symptomatology after discharge is required. Id. For purposes of applying 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, 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. At the outset, the Board notes that the Veteran has a current diagnosis of bilateral hearing loss that meets the criteria of 38 C.F.R. § 3.385. As such, the first element of service connection is met. The Board also concedes that the Veteran was exposed to some degree of noise during active service, noting that his MOS was Field Artillery, which is rated a “high probability” of noise exposure. What remains for consideration is whether the Veteran’s current hearing loss is related to his in-service noise exposure. The Veteran had an in-service audiological evaluation during service in both December 1968 and July 1970, at which time auditory thresholds were recorded. However, because it is unclear whether such thresholds were recorded using American Standards Association (ASA) units or International Standards Organization-American National Standards Institute (ISO-ANSI) units, the Board will consider the recorded metrics under both standards, relying on the unit measurements most favorable to the Veteran’s appeal. As it relates to VA examinations and VA records, audiological reports were routinely converted from ISO-ANSI results to ASA units until the end of 1975 because the regulatory standard for evaluating hearing loss was not changed to required ISO-ANSI units until September 9, 1975. In light of the above, and where necessary to facilitate data comparison for VA purposes in the decision below, including under C.F.R. § 3.385, audiometric data originally recorded using ASA standards will be converted to ISO-ANSI standards by adding between 5 and 15 decibels to the recorded data. Even under the conversion between ASA and ISO-ANSI, the Veteran’s relevant entrance and exit audiological examinations revealed no hearing loss for VA compensation purposes under either standard. 38 C.F.R. § 3.385. Additionally, his service treatment records are silent as to any complaints of hearing loss. Post-service records reveal that the Veteran notably had maintained that his hearing was “normal” and denied any hearing loss through 2007, over 35 years after leaving service. At an August 2007 audiology consult, an evaluation revealed normal hearing sensitivity with mild to severe high frequency sensorineural hearing loss. However, he was not yet considered a candidate for hearing aids. According to a December 2014 medical report, the Veteran stated he is unsure of the initial onset of his hearing loss. The Veteran also reported tinnitus and dizziness (vertigo), which he stated as having onset during service in Vietnam. The ongoing symptoms of tinnitus and vertigo, which predated the symptoms of hearing loss, caused doctors to consider retrocochlear pathology. Doctors have since found no middle ear deformities or inflammation. The Veteran underwent a Disability Benefits Questionnaire (DBQ) examination in March 2015. The VA examiner at that time opined that his hearing loss was less likely than not due to the Veteran’s service. This opinion was based upon the fact that the Veteran’s entrance and exit exams were normal, and that the Veteran subsequently spent 40 years working in a factory with required hearing protection. The examiner also noted there had been no permanent positive threshold shift in either ear at the relevant frequencies from service entrance to service separation. The Board finds that the VA examiner’s March 2015 opinions are adequate. The examiner personally examined the Veteran, considered the service records, medical history, and post-service occupation of the Veteran, and provided thorough supporting rationales for the conclusions reached. Barr v. Nicholson, 21 Vet. App. 303 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The Board finds that the VA examiner’s opinions are competent, credible, and persuasive and assigns them high probative weight. The Board finds that the evidence of record does not support a finding that the Veteran’s current diagnosis of bilateral hearing loss manifested or otherwise originated during his period of service, within one year of discharge from service, or is otherwise related to his military service. Regarding direct service connection, the Board finds the Veteran’s bilateral hearing loss does not meet the standards for direct service connection as the preponderance of the evidence supports a finding that there is no medical nexus between active service and the current disability. Although the records show that the Veteran has a current diagnosis of bilateral hearing loss, the service treatment records are silent for any complaints, symptoms, or diagnosis of sensorineural hearing loss during his active service. Further, there is no competent evidence of record to suggest that the Veteran’s hearing loss is related to service. As for presumptive service connection based on chronic disease, the Board finds the preponderance of the evidence does not support a finding that the Veteran’s bilateral hearing loss, a chronic disease, manifested to a compensable level in the first post-service year. 38 C.F.R. § 3.309(a). Based on the records, the Veteran’s bilateral hearing loss was first documented in 2007, more than forty years after his service. In fact, while he consistently reported dizziness (vertigo) and tinnitus and attributed them to his service, he denied experiencing hearing loss until 2007. As there is no evidence of manifestation within the first post-service year, service connection for bilateral hearing loss based on the presumption in favor of chronic disease is not warranted in this case. 38 C.F.R. §§ 3.303(b), 3.307, 3.309. In regard to presumptive service connection based on continuity of symptomatology, the Board finds the preponderance of the evidence does not show that the Veteran experienced signs and symptoms of bilateral hearing loss on a continuous basis. For instance, service treatment records show no occurrence of symptoms or signs associated with hearing loss. In fact, while he continuously complained of symptoms of tinnitus and vertigo, the Veteran himself denied hearing loss until 2007, which is over 35 years after service. As the records do not show a continuity of symptomatology, the Veteran’s bilateral hearing loss cannot be presumptively service connected. In conclusion, although the Veteran has established a current disability and in-service incurrence, the preponderance of the evidence establishes that his hearing loss was not manifested during service or for many years thereafter, and is not otherwise related to his active service. Since the preponderance of the evidence is against the claim, the benefit of the doubt rule is not applicable. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 55-57 (1990); 38 C.F.R. § 3.102. For these reasons, the claim is denied. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Stuedemann, Associate Counsel