Citation Nr: 18152513 Decision Date: 11/27/18 Archive Date: 11/23/18 DOCKET NO. 16-31 514 DATE: November 27, 2018 ORDER Entitlement to service connection for bilateral hearing loss is denied. FINDING OF FACT The Veteran’s hearing loss is not related to an in-service injury, event, or disease; it was not manifest within one year from service separation; and continuity of symptomatology has not been shown. CONCLUSION OF LAW The criteria to establish service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1991 to August 1994. The Veteran appeals a September 2014 rating decision by the Agency of Original Jurisdiction (AOJ) denying entitlement to service connection for bilateral hearing loss. Service Connection Entitlement to service connection for bilateral hearing loss A Veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1110. Generally, to establish a right to compensation for a present disability, a Veteran 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 Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). Under 38 C.F.R. § 3.303(b), claims for chronic diseases enumerated in 38 C.F.R. § 3.309(a) benefit from a relaxed evidentiary standard. See Walker v. Shinseki, 708 F.3d 1331, 1339 (Fed. Cir. 2013). Bilateral hearing loss has been interpreted as such a disease. To show a chronic disease in service, the record must contain a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331, 1339 (Fed. Cir. 2013). The Veteran contends that he went to see a clinician for ear pain towards the end of his period of service. See April 2014 Correspondence. He further contends that at the time of separation, he would have been put on medical hold for hearing tests, but he refused so that he would not miss his school’s start date. Id. Additionally, he alleges he made complaints about his ear pain during service, but a mistake in its documentation was made. See March 2015 Correspondence. The Veteran also cites to various sections of the Noise and Military Service: Implications for Hearing Loss and Tinnitus report (NMSR) stating the unreliability of audio tests due to difference in military locality, notice of hearing loss being delayed, and hazards of noise due to the military environment. Id. The first Shedden element is met. The Veteran has hearing loss for VA purposes. See August 2014 VA examination report. The second Shedden element is also met. The Veteran worked in high-risk noise exposed areas during active service to include close proximity to the flight line without hearing protection. See March 2015 and June 2016 Correspondence. As such, the crux of this case centers on whether the Veteran’s bilateral hearing loss is attributable to service. For the following reasons, the Board finds that the third Shedden element has not been met. The August 2014 VA examiner provided a negative nexus opinion. See August 2014 VA Examination. The clinician stated that based on the Institute of Medicine report, prolonged delay in the onset of noise induced hearing loss was unlikely. The examiner also stated there was an insufficient scientific basis to conclude that permanent hearing loss directly attributable to noise exposure will develop long after such noise exposure. Additionally, the examiner noted that the Veteran had no significant shift in hearing levels greater than normal measurement during military service and that there was no record of complaint or treatment of hearing loss in the service records. Id. The Board finds the August 2014 VA examiner’s opinion to be persuasive. The Veteran’s service treatment records (STR) show insignificant threshold shifts from the time of entry to separation. See July 1990 and May 1994 STR. Also, the Veteran indicated on service separation that he did not then have, nor had he ever had, ear trouble or hearing loss. See May 1994 STR. Although the Veteran contends complaints of ear pain were made during service, but not documented, the record is still insufficient to establish chronicity in-service due to lack of in-service symptoms or diagnosis and the Veteran’s own statements on service separation that he did not have ear trouble or hearing problems at that time or prior. The Board recognizes that the absence of a hearing disability during service is not always fatal to a service connection claim for hearing loss. See Ledford v. Derwinski, 3 Vet. App. 87 (1992). However, while an incomplete audiological separation examination cannot be held against such claim, here the Veteran’s separation examination affirmatively shows that his hearing acuity underwent no significant change during service and was normal at separation. Id. at 89 The weight of the evidence shows that the Veteran entered service with normal hearing, was exposed to loud noises during service, and separated from service with normal hearing. Though he now asserts that there was a difference in his hearing at separation, contemporaneous objective audiometric data is of greater value in showing that the Veteran did not have any in-service hearing loss. The only evidence supporting the Veteran’s claim that his current hearing loss was caused by service, is his own lay assertions. Though a lay person may speak to etiology in some limited circumstances in which nexus is obvious merely through observation, such as sustaining a fall leading to a broken leg, a layperson cannot provide evidence as to more complex medical questions such as associating the delayed onset of hearing loss with noise exposure several decades prior. (Continued on the next page)   The preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application, and the claim must be denied. 38 U.S.C § 5107(b) (2012); 38 C.F.R. § 3.102 (2017). DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Zheng, Associate Counsel