Citation Nr: 18154099 Decision Date: 11/29/18 Archive Date: 11/29/18 DOCKET NO. 13-33 849A DATE: November 29, 2018 ORDER Entitlement to service connection for bilateral hearing loss is granted. Entitlement to service connection for tinnitus is granted. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran’s favor, his bilateral hearing loss is at least as likely as not related to in-service exposure to acoustic trauma. 2. Resolving reasonable doubt in the Veteran’s favor, his tinnitus is at least as likely as not related to in-service exposure to acoustic trauma. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bilateral hearing loss are met. 38 U.S.C. §§ 1110, 1112, 1113, 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.307, 3.309(a). 2. The criteria for entitlement to service connection for tinnitus loss are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty service from November 1985 to February 1986 with additional periods of service in the U.S. Army National Guard from 1986 to 1990. He testified before the undersigned Veterans Law Judge a Board videoconference hearing in April 2016. The Board remanded this case for additional development in October 2016. The case is now returned for appellate review. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. 1. Entitlement to service connection for bilateral hearing loss 2. Entitlement to service connection for tinnitus The Veteran contends that his bilateral hearing loss and tinnitus were the result of his exposure to an exploding grenade during his basic training. Since that incident, the Veteran reported experiencing ringing in his ears and diminished hearing. See April 2016 Board hearing transcript. The Board concludes that the Veteran has a current diagnosis of bilateral hearing loss and tinnitus related to in-service exposure to acoustic trauma. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). For VA purposes, impaired hearing will not be considered to be a disability unless the auditory threshold in any of the frequencies of 500, 1,000, 2,000, 3,000, or 4,000 Hertz (Hz) is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies of 500, 1,000, 2,000, 3,000, or 4,000 Hz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. The service treatment records note that the Veteran’s hearing was normal at entry into service in March 1985. The Veteran complained of decreased hearing associated with an ear infection during his active duty service. After service, a March 2017 private treatment record notes that the Veteran related progression in hearing loss and tinnitus since his military service noise exposure. He stated that he had trouble understanding speech, and that his ear felt full at times. The Veteran was assessed as having tinnitus and bilateral sensorineural hearing loss. The audiological assessment further noted that the hearing loss and tinnitus were service-related. VA examinations were provided in August 2010 and March 2017, and an addendum opinion was provided in June 2018. On all examinations, it was noted that the Veteran had a hearing loss and tinnitus disability but that an opinion as to whether these disabilities were related to military service could not be provided without resort to speculation, because an exit examination was not provided. The Veteran’s exposure to acoustic trauma in service is conceded, in that a grenade explosion during basic training is consistent with the circumstances of his service and his personnel records that note he was an infantryman. See 38 U.S.C. § 1154(a). His statement concerning post-service noise exposure also are competent and presumed credible in that he worked as a truck driver as a civilian and was only exposed to truck engine noise. The Veteran also is competent to state that he has experienced hearing loss and tinnitus, as these are found to be capable of lay observation. The United States Court of Appeals for Veterans Claims (Court) has held that, when a condition may be diagnosed by its unique and readily identifiable features, the presence of the disorder is not a determination “medical in nature” and is capable of lay observation. Charles v. Principi, 16 Vet. App. 370, 374-375 (2002); see also Washington v. Nicholson, 19 Vet. App. 362, 368 (2005); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). As the Veteran has exposure to acoustic trauma in service and post-service complaints of hearing loss and tinnitus, the determinative issue is whether there is any relationship between the inservice events and the current disabilities. As noted, a private medical assessment notes that the Veteran’s hearing loss and tinnitus were service-related, based on the Veteran’s statements regarding exposure to acoustic trauma in service from a hand grenade exploding, and his post-service complaints of experiencing tinnitus and hearing loss since service. While the Veteran underwent two VA examinations and had several VA medical opinions requested, the examiners consistently reported that a medical opinion on the etiology of the Veteran’s hearing loss and tinnitus could not be provided without resort to speculation, because there was no exit examination provided. In comparing and weighing the evidence, the private opinion was based on examination of the Veteran, noted the Veteran’s competent complaints, and included a clear opinion. The VA audiologists did not seem to place any weight on the Veteran’s competent statements regarding experiencing hearing loss and tinnitus in service and thereafter, and did not provide any explanation as to why a medical opinion could not be provided on the etiology of the Veteran’s hearing loss and tinnitus without an exit examination report demonstrating a threshold shift. (Continued on the next page)   As the evidence is in relative equipoise, all doubt is resolved in the Veteran’s favor that a nexus exists between the Veteran’s bilateral hearing loss and tinnitus and his exposure to acoustic trauma in service. Accordingly, service connection for both disabilities is in order. S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Sarah B. Richmond