Citation Nr: 18152147 Decision Date: 11/21/18 Archive Date: 11/21/18 DOCKET NO. 17-03 859 DATE: November 21, 2018 ORDER Service connection for bilateral hearing loss is granted. FINDING OF FACT 1. The Veteran was exposed to acoustic trauma during his time in service. 2. The evidence linking a current hearing loss disability to such acoustic trauma is evenly balanced both for and against the claim. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss have been met. The Veteran’s hearing loss was incurred in active service. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the Army National Guard of California from July 1955 to January 1959. During his time in the National Guard, the Veteran served in the 149th Antiaircraft Artillery. He then served in the U.S. Army from February 1959 to February 1962 as a Combat Engineer. The Veteran contends that his current hearing loss was caused by his exposure to the loud noises produced by artillery fire and explosives in the National Guard, as well as exposure to explosive charges and large tractors and other heavy equipment while building roads in Alaska. At times during his service in Alaska, the Veteran was exposed to the “humongous roar” of the tractors inside of hangars. He reported he was never provided any kind of ear protection during his time in the National Guard or the Army. Here, the Veteran’s pre-induction examination included a “whisper test” to evaluate his hearing. The Veteran scored 15/15 on the test and reported no prior history of ear problems and no current symptoms of hearing loss or associated problems with the ears. In addition, he reported that his hearing loss did not begin until around 1960-62. When the Veteran was discharged from the Army in 1962, he reported dizziness, but no ear problems. However, audiometer testing of the right ear showed a 15 decibel (dB) loss at the puretone threshold of 500 Hertz (Hz), a 10-dB loss at 1000 Hz, a -5-dB loss at 2000 Hz, -5 dB loss at 4000 Hz, and a 16-dB loss at 5000 Hz. In the right ear, decibel loss at the puretone threshold of 500 Hz was 10, with 5-dB loss at 1000 Hz, a -5-dB loss at 2000 Hz, a -5-dB loss at 4000 Hz, and a 5-dB loss at 5000 Hz. Regarding current hearing loss, VA examination findings from March 2018 show the right ear with 42 percent speech discrimination. Decibel (dB) loss at the puretone threshold of 500 Hertz (Hz) was 60 with a 65-dB loss at 1000 Hz, a 65-dB loss at 2000 Hz, an 80-dB loss at 3000 Hz, and a 100-dB loss at 4000 Hz. The average decibel loss was 77.5 in the right ear. The left ear showed a speech discrimination of 58 percent. Decibel loss at the puretone threshold of 500 Hz was 55 with a 60-dB loss at 1000 Hz, a 70-dB loss at 2000 Hz, an 80-dB loss at 3000 Hz, and a 95-dB loss at 4000 Hz. The average decibel loss was 76.25 in the left ear. The Veteran maintains that service connection is warranted for bilateral hearing loss. In general, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). To establish entitlement to direct service connection for the claimed disability, there must be: (1) medical evidence of 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 or link between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004), citing Hansen v. Principi, 16 Vet. App. 110, 111 (2002). For the purpose of applying the laws administered by VA, impaired hearing is considered 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 above frequencies are 26 decibels or higher; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. The United States Court of Appeals for Veterans Claims (Court) has held that the threshold for normal hearing is from 0 to 20 decibels, and that higher threshold levels indicate some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). It is noteworthy that the lack of any evidence showing the Veteran exhibited hearing loss consistent with the regulatory threshold requirements for hearing disability during service (38 C.F.R. § 3.385), is not fatal to his claim. The laws and regulations do not require in-service complaints of, or treatment for, hearing loss in order to establish service connection. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Instead, where there is no evidence of the appellant’s hearing disability until many years after separation from service, “[i]f evidence should sufficiently demonstrate a medical relationship between the appellant’s in-service exposure to loud noise and his current disability, it would follow that the appellant incurred an injury in service.” Hensley v. Brown, 5 Vet. App. 155, 160 (1993). In response to the current claim a VA audiological examination was conducted in March 2018. As discussed above, the pure tone thresholds in the right ear at 500, 1000, 2000, 3,000, and 4000 Hz were 60, 65, 65, 80, and 100 decibels, respectively. In the left ear, pure tone thresholds were 55, 60, 70, 80, and 95 decibels. The speech recognition score was 42 percent in the right ear and 58 percent in the left ear. The examiner diagnosed the Veteran with sensorineural hearing loss in each ear. The VA audiologist determined that military service did not at least as likely as not cause the Veteran’s bilateral hearing loss, pointing out that the Veteran did not have a hearing loss when he was discharged from the military and that his current hearing loss was more than likely due to post-military factors such as hearing loss from aging, not military noise exposure. Regarding element (1), current disability, as discussed above, post-service VA examinations show significant bilateral hearing loss. Regarding element (2), in-service incurrence, as discussed above, the Veteran reported being exposed to loud explosions, weaponry, and machinery. The Veteran competent to describe and report his inservice noise exposure. In addition, the VA examiner acknowledged the Veteran’s primary specialty of combat engineer has a high probability of hazardous noise exposure. The examiner further acknowledged the Veteran’s reports of noise exposure, including, firing weapons such as machine guns, carbines, and other heavy weapons, as well as exposure to dynamite explosions. Therefore, the requirements of element (2) are satisfied. Regarding element (3), causal relationship, the Board notes that there are medical opinions both for and against the Veteran’s claims. Here, the record contains a March 2018 VA medical opinion which is against the claim, attributing the Veteran’s hearing loss to old age. However, the record also contains multiple supportive opinions from the Veteran’s treating Audiologist, Dr. I. For example, in February 2017, Dr. I opined that the Veteran’s history of military noise exposure without hearing protection “must be considered a major factor in the type and degree of hearing loss [the Veteran] has suffered.” Dr. I went on to opine it was “as least as likely as not that the disability had its onset in service and is causally related to his current disability.” Dr. I’s other opinions and letters offer nearly identical accounts of the Veteran’s history of noise exposure and hearing loss and the etiology of that hearing loss. In all of these opinions and letters, Dr. I attributed the Veteran’s hearing loss to military noise exposure, not old age. As the record contains evidence weighing both in favor of and against the Veteran’s claim, the Board finds that the evidence regarding the third element, causal relationship, is at least in relative equipoise. Resolving reasonable doubt in the Veteran’s favor, the Board finds that the third element is satisfied. As all three elements have been satisfied, the Board finds that service connection for bilateral hearing loss is warranted. MATTHEW TENNER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Vassallo