Citation Nr: 18145848 Decision Date: 10/30/18 Archive Date: 10/30/18 DOCKET NO. 16-49 041 DATE: October 30, 2018 ORDER Entitlement to service connection for bilateral hearing loss is granted. FINDING OF FACT The Veteran’s hearing loss began during active service. 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. §§ 3.303, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1960 to October 1967. A hearing was not requested. 1. Entitlement to service connection for bilateral hearing loss Service connection will be presumed for certain chronic diseases, including bilateral hearing loss, if manifest to a compensable degree within one year after discharge from service. See 38 C.F.R. §§ 3.307, 3.309. Because there is no indication that the Veteran’s hearing loss was manifested within one year of service, service connection is not available on a presumptive basis. Service connection can still be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service, even if the disability was initially diagnosed after 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) 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). Service connection may be granted for any disease initially diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Alternatively, service connection may be established by (a) evidence of (i) the existence of a chronic disease in service or during an applicable presumption period under 38 C.F.R. § 3.307 and (ii) present manifestations of the same chronic disease, or (b) when a chronic disease is not present during service, evidence of continuity of symptomatology. 38 C.F.R. § 3.303(b). However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed in 38 C.F.R. § 3.309(a) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 hertz (Hz) is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies at 500, 1000, 2000, 3000, or 4000 Hz 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. Even if disabling loss is not demonstrated at separation, a veteran may establish service connection for a current hearing disability by submitting evidence that a current disability is causally related to service. See Hensley v. Brown, 5 Vet. App. 155, 160 (1993). The Veteran’s April 2015 VA examination provides for a diagnosis of hearing loss. Pure tone thresholds, in decibels, are as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 20 25 40 55 70 LEFT 25 25 50 70 90 Speech recognition ability using the Maryland CNC test is 94 percent in the right ear and 94 percent in the left ear. The Veteran’s pure tone threshold values support a current diagnosis of bilateral hearing loss under 38 C.F.R. § 3.385. The Veteran is entitled to service connection for bilateral hearing loss on the basis of continuity of symptomatology. During the April 2015 VA audiological examiner, the Veteran stated that his hearing became worse during his period of service between January 1960 and October 1967. Consistent with this, the Veteran’s service treatment records contain the following audiometric data for the right ear: RIGHT EAR Air Conduction in Decibels 500 Hz 1000 Hz 2000 Hz 3000 Hz 4000 Hz 1/8/1964 -10 -10 -10 – -10 1/11/1966 15 10 10 15 50 8/9/1967 -10 -10 -10 -10 -10 3/4/1972 0 5 5 20 15 For the left ear, pure tone thresholds are as follows: LEFT EAR Air Conduction in Decibels 500 Hz 1000 Hz 2000 Hz 3000 Hz 4000 Hz 1/8/1964 -10 -10 -10 – -10 1/11/1966 15 10 15 20 30 8/9/1967 -10 -10 -10 -10 -10 3/4/1972 5 0 10 5 10 This evidence corroborates the Veteran’s testimony that his hearing became worse during service and in-service noise exposure is conceded. Giving the Veteran the reasonable doubt regarding the January 1966 audiogram, the evidence supports the existence reduced hearing in both ears relative to January 1964. However, even discounting the January 1966 audiogram, the evidence nevertheless indicates decreased hearing after the Veteran left service in October 1967, based on the increase in pure tone thresholds between August 1967 and March 1972. Hearing loss is one of the chronic diseases under 38 C.F.R. § 3.307(a) for which service connection is available on the basis of continuity of symptomatology. Therefore, based on the Veteran’s competent, credible evidence of in-service noise exposure, lay and medical evidence suggesting in-service hearing loss, and continuity of symptomatology, service connection for bilateral hearing loss is warranted under 38 C.F.R. § 3.303(b). In reaching these conclusions, the Board has considered the April 2015 VA medical opinion, which concludes that the Veteran’s bilateral hearing loss is less likely than not related to service. This conclusion is based in part on the fact that the Veteran “did not have a significant threshold shift beyond normal variability while in service.” However, this opinion in no way disputes entitlement to service connection on the basis of continuity of symptomatology. Moreover, the Veteran reports no significant post-service occupational/recreational noise exposure. The Board will therefore give the Veteran the benefit of the doubt, and find that service connection for bilateral hearing loss is warranted. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Cannon, Associate Counsel