Citation Nr: 18150771 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 16-44 800 DATE: November 15, 2018 ORDER Entitlement to service connection for bilateral hearing loss is granted. FINDING OF FACT Bilateral hearing loss was incurred during periods of active duty for training (ACDUTRA). CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss are met. 38 U.S.C. §§ 1110, 1131; 1153m 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1986 to January 1987. The Veteran also had subsequent periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) as a member of the Air Force Reserve until his retirement in January 2014. This matter is on appeal from an April 2015 rating decision. Service Connection The Veteran is seeking service connection for bilateral hearing loss. The Veteran reported that his hearing loss was incurred in and/or aggravated during periods of ACDUTRA and INACDUTRA while serving in the Air Force Reserves. Specifically, the Veteran contends that he sustained hearing loss as a result of his time spent at the shooting range for M-16 training. The Veteran asserts that sometime after the event, he visited the 433rd Airlift Wing medical bay where a doctor referred him to an audiologist at Kelly Airforce Base in Texas. After testing, the audiologist also confirmed the hearing loss. The Veteran added that prior to qualifying for the M-16, he never had hearing problems. Service connection may only be granted for disability resulting from disease or injury incurred or aggravated while performing ACDUTRA, or an injury incurred or aggravated while performing inactive duty for training INACDUTRA. 38 U.S.C. §§ 101 (24), 106, 1110; 38 C.F.R. §§ 3.6, 3.303, 3.304. ACDUTRA includes full time duty performed by members of the National Guard of any state or the reservists. 38 C.F.R. § 3.6 (c). INACDUTRA includes duty other than full time duty performed by a member of the Reserves or the National Guard of any state. 38 C.F.R. § 3.6 (d). The Veteran’s service treatment records during active service revealed no complaints or notes relating to hearing loss. Moreover, the Veteran himself has reported that his hearing problems began during periods of ACDUCTRA. As such, there is no evidence to show that the Veteran’s hearing loss was incurred during his initial period of active service. However, a December 1999 service record showed that the Veteran presented for his periodic service physical examination and he was diagnosed with mild, low frequency bilateral hearing loss. Moreover, service personnel records show that the Veteran did participate in M-16 Firearms qualification training in May 1996 as reported by the Veteran. Moreover, the AOJ has conceded in-service noise exposure and awarded service connection for tinnitus based on such exposure. The Veteran was afforded a VA examination in April 2015, which showed puretone thresholds as follows: HERTZ 1000 2000 3000 4000 RIGHT 55 65 60 65 LEFT 60 65 65 70 Speech audiometry revealed speech recognition of 44 percent in the right ear and 48 percent in the left ear. The puretone threshold average was 61 decibels in the right ear and 65 decibels in the left ear. The examiner diagnosed sensorineural hearing loss in both ears. However, the examiner indicated that because there was no entrance or exit testing in the record, he was unable to opine hearing loss and nexus to military noise exposure without resorting to mere speculation. Importantly, at the examination, the Veteran also reported the onset of tinnitus about 15 years prior. The examiner found that the Veteran’s tinnitus was as least as likely as not a result of military noise exposure. The April 2015 VA examination shows that the Veteran meets the requirements of 38 C.F.R. § 3.385 for current hearing loss in both ears. Moreover, the Board finds that Veteran’s statements concerning noise exposure during periods of ACDUTRA are credible and supported by the Veteran’s service personnel records. As such they are consistent with the circumstances of his service and establish an in-service injury. 38 U.S.C. § 1154(a). Thus, as there is a current hearing loss disability and evidence of extensive noise exposure during periods of ACDUTRA, the Board must determine whether the Veteran’s current disability is related to such noise exposure. Based on the medical evidence of record and when resolving the benefit of the doubt in favor of the Veteran, the Board finds that the Veteran’s hearing loss was incurred during periods of ACDUTRA. Although the April 2015 VA examiner found that an opinion could not be rendered without resorting to speculation, the examiner did not appear to consider the Veteran’s statements concerning the onset of his hearing loss during ACDUTRA or address the conceded excessive in-service noise exposure. As such, the Board finds this opinion inadequate. See Jones v. Shinseki, 23 Vet. App. 382, 389 (2010). Moreover, importantly, the evidence of extensive noise exposure during such periods and the Veteran’s statements weighs the evidence in favor of a finding that the current hearing loss is related to those exposures. The Board also finds it significant that a December 1999 service record diagnosed mild hearing loss. Moreover, importantly, the April 2015 VA examiner found that the Veteran’s tinnitus was due to noise exposure during ACDUTRA and service connection was awarded for the Veteran’s tinnitus. At the examination, the Veteran also reported the onset of tinnitus to be about the time that he was diagnosed with hearing loss in 1999. Although hearing loss and tinnitus are separate disabilities, medical treatises indicate that the cause of tinnitus can usually be determined by finding the cause of the associated hearing loss. See, e.g., Harrison’s Principles of Internal Medicine 178 (Anthony S. Fauci et al. eds., 14th ed. 1998).   Accordingly, resolving the benefit of the doubt in favor of the Veteran, service connection is warranted for bilateral hearing loss. In reaching this conclusion, the evidence is at least in equipoise, and the benefit of the doubt doctrine has been applied where appropriate. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). J.N. MOATS Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N.Yeh, Associate Counsel