Citation Nr: 18150949 Decision Date: 11/16/18 Archive Date: 11/16/18 DOCKET NO. 15-09 518 DATE: November 16, 2018 ORDER Entitlement to service connection for bilateral hearing loss is denied. FINDING OF FACT The evidence is against a finding that the Veteran’s hearing loss was caused by military service. CONCLUSION OF LAW The criteria for establishing service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1968 to January 1970. This matter comes before the Board of Veterans’ Appeals (Board) from an October 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). Neither the Veteran nor his representative has raised any issues with the duty to notify or duty to assist. Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an 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, the so-called “nexus” requirement. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). VA has established certain rules and presumptions for chronic diseases, such as sensorineural hearing loss. See 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a); Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). With chronic diseases shown as such in service so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless attributable to intercurrent causes. 38 C.F.R. § 3.303(b). If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. § 3.303(b). In addition, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, chronic diseases are presumed to have been incurred in service if they manifested to a compensable degree within one year of separation from service. 38 C.F.R. §§ 3.307(a)(3), 3.309(a). It is the Board’s responsibility to evaluate the entire record on appeal. 38 U.S.C. § 7104(a). When there is an approximate balance in the evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Veteran asserts that he currently has bilateral hearing loss that is related to noise exposure during active service. For the reasons that follow, the Board finds that service connection is not warranted. For the purpose of applying the laws administered by VA, impaired hearing will be considered a disability when the auditory threshold for any of the frequencies of 500, 1000, 2000, 3000, and 4000 Hertz is 40 decibels or greater; the auditory thresholds for at least three of these frequencies are 26 decibels or greater; or speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. As an initial matter, the Veteran was afforded a VA audiological examination in October 2014. Results of both puretone audiometry and speech recognition testing revealed hearing loss for VA purposes under 38 C.F.R. § 3.385. Thus, the remaining question is whether his current hearing loss disability is related to service. Service treatment records (STRs) show no complaints of acoustic trauma or hearing difficulties, and his hearing was normal upon both entrance and separation. The record is negative for evidence of a hearing loss disability until a May 2009 VA treatment record noting the Veteran’s complaint of decreased hearing. As hearing loss is not shown to have been present during service or in the first year after separation of service, and continuity of symptomatology leading to a diagnosis of hearing loss is not shown, in-service incurrence of hearing loss cannot be presumed. See 38 C.F.R. §§ 3.307, 3.309(a). To the extent the Veteran asserts a continuity of symptomatology beginning during service, the Board finds these statements to lack credibility as they are in direct conflict with the Veteran’s report of medical history at separation from service where he denied hearing loss. The Board finds the report of medical history at separation from service to be more reliable than more recent assertions as it was done contemporaneous to service and for the purpose of identifying disability at that time. The Veteran presented for a VA examination in October 2014, at which time he was interviewed by the examiner who also reviewed the pertinent medical history and performed an examination. The examiner opined that the Veteran’s bilateral hearing loss was not at least as likely as not (50 percent probability or greater) caused by or the result of his military service. The examiner explained that the damage from noise exposure occurs at the time of the exposure, which can cause either only a temporary hearing threshold shift or immediate and permanent hearing loss, and a normal audiogram subsequent to the noise exposure would verify whether the hearing recovered without a permanent threshold shift. As the examiner noted, the Veteran’s STRs showed no indication of any auditory threshold shift during service. The Board finds this opinion highly probative as it was made by a medical professional with consideration of the specific facts in this case and after examination of the Veteran. There is no medical opinion or competent and credible evidence in significant conflict with the VA medical opinion. The Board acknowledges the October 2018 statement provided by the Veteran’s representative essentially arguing the claim should be granted based on the results of research findings, specifically Adding Insult to Injury: Cochlear Nerve Degeneration after “Temporary” Noise-Induced Hearing Loss, The Journal of Neuroscience, November 11, 2009: 29(45): 14077-14085 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2812055/. The Board finds that reliance on this study is misplaced. The study essentially found that while there may be normal (hearing) threshold sensitivity after noise exposure there can still be ongoing and dramatic neural degeneration in noise-exposed ears. The study suggests that reversibility of noise-induced threshold shifts mask underlying neuropathology that likely has profound long-term consequences on auditory processing. Some examples of consequences given in the study include difficulties hearing in noisy environments, tinnitus, and intolerance of moderately intense stimuli. The study does not suggest that threshold shifts occur years after noise exposure. VA measures hearing loss based in part on hearing threshold sensitivity. 38 C.F.R. §§ 3.385, 4.85. Accordingly, even with consideration of the information pointed out by the Veteran’s representative, the evidence of record is adequate and preponderates against a grant of service connection in this case. The Board has considered the Veteran’s statements, to include his assertions that his current hearing loss is related to noise exposure during his military service. Although the Veteran’s military occupational specialty as a Storage Specialist may not necessarily “concede” acoustic trauma in service, he has consistently maintained that he was exposed to loud vehicle noise while in service. However, while the Veteran is competent to report (1) symptoms observable to a layperson, e.g., decreased hearing ability; (2) a diagnosis that is later confirmed by clinical findings; or (3) a contemporary diagnosis, he is not competent to independently opine as to the specific etiology of a condition as these are medically complex issues. See Davidson v. Shinseki, 581 F.3d 1313 (2009). Thus, his lay assertions do not constitute evidence upon which service connection can be granted. In any event, the Board ultimately assigns greater probative weight to the medical evidence of record, to include the opinion rendered by a trained medical professional based on appropriate diagnostic testing and reasonably drawn conclusions with supportive rationale. For the above reasons, the preponderance of the evidence is against the claim and service connection for bilateral hearing loss is denied. Nathan Kroes Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Scarduzio, Associate Counsel