Citation Nr: 18152178
Decision Date: 11/21/18	Archive Date: 11/21/18

DOCKET NO. 18-40 754
DATE:	November 21, 2018
ORDER
Entitlement to service connection for right ear hearing loss is granted.
FINDING OF FACT
The Veteran’s pre-existing right ear hearing loss was aggravated by acoustic trauma experienced during active service.
CONCLUSION OF LAW
The criteria for service connection for right ear hearing loss have been met.  38 U.S.C.§§ 1131, 1153, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.306 (2018).
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served in the U.S. Navy on active duty from March 1980 to March 1983.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision by the Columbia, South Carolina, Regional Office (RO) of the United States Department of Veterans Affairs (VA).
Analysis
Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service.  See 38 U.S.C. § 1131; 38 C.F.R. § 3.303.  “To establish a right to compensation for a present disability, a veteran 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”—the so-called “nexus” requirement.”  Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). 
There is no dispute as to the Veteran’s diagnosis of right ear hearing loss or to his exposure to acoustic trauma during active service.  The remaining question involves the “nexus requirement.”  Right ear hearing loss was noted at the Veteran’s examination for entry onto active duty, and a January 2016 VA examiner opined that this pre-existing condition was not permanently aggravated beyond the natural progression by in-service noise exposure.  She reasoned, based on VA policy, that a 10-decibel shift at one frequency over service was not significant and therefore did not represent a change.
However, the Board finds that the upward shift in puretone thresholds shown over the course of service is in this particular case is significant.  The Veteran has been service-connected for noise-induced left ear hearing loss and tinnitus, giving greater significance to the shift in the right ear beyond typical statistics.  
As there has been a worsening in hearing, VA is bound to presume such aggravation is due to service, unless VA can clearly and unmistakably show that such is instead due to the natural progression of the condition.  38 U.S.C. § 1153; 38 C.F.R. § 3.306.  Given the awards of service connection with regard to the left ear and tinnitus, and the absence of affirmative evidence of natural progression, the presumption of not rebutted.
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Service connection for right ear hearing loss is warranted.
 
WILLIAM H. DONNELLY
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	L.J. Bakke, Counsel