Citation Nr: 18154541 Decision Date: 12/03/18 Archive Date: 11/30/18 DOCKET NO. 16-51 131 DATE: December 3, 2018 ORDER Entitlement to service to service connection for bilateral hearing loss is granted. FINDING OF FACT The evidence of record is at least in equipoise whether the Veteran’s diagnosed hearing loss resulted from his military service. CONCLUSION OF LAW Resolving reasonable doubt in favor of the Veteran, the criteria for entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102 3.303, 3.385, 4.85. REASONS AND BASES FOR FINDING AND CONCLUSION Entitlement to service to service connection for bilateral hearing loss is granted. The Veteran served from June 1968 to June 1970, including nine months in Vietnam, where he saw combat as an infantryman and was decorated with the Silver Star, the Bronze Star and other combat-related awards. He represents that he was exposed to significant acoustic trauma in the form of gunfire, grenade blasts and artillery fire, all without hearing protection. On the basis of his combat experience, acoustic trauma is conceded. The Veteran applied for service connection for hearing loss in April 2014. He underwent a VA hearing test in May 2014, the results of which showed bilateral sensorineural hearing loss. Based, however, on the results of acoustic testing administered to the Veteran at pre-induction in November 1967 and again at separation in May 1970, the VA hearing examiner opined that the Veteran’s hearing loss was less likely as not related to his service. Relying on this opinion, in April 2015 a Department of Veterans Affairs (VA) regional office (RO) denied the claim, and the Veteran appealed. As explained below, the Board finds that the evidence of record is in relative equipoise as to whether the Veteran’s hearing loss resulted from his service, and on that basis grants service connection. The May 2014 VA examiner’s opinion was that as there was no permanent positive threshold shift in hearing acuity greater than normal measurement variability at any frequency between 500 and 6000 Hertz (Hz) for either ear between the two in-service tests, it was therefore less likely than not that the Veteran’s current hearing loss resulted from his military service. In her rationale for this conclusion, she explained that the Veteran’s testing on separation showed no change in hearing from his entrance examination, beyond “normal variability/progression,” and therefore there was “no hearing damage during service, with hearing thresholds within the normal range at separation from the service.” She noted that hearing loss did not exist in either ear prior to service. She provided a short bibliography of articles supporting the proposition that although research is not completely definitive, it is generally unlikely that hearing loss will appear many years after acoustic trauma has stopped, i.e., after separation from service. She did not discuss that proposition as it applied to the Veteran’s specific case; her negative opinion was based primarily on the fact that the Veteran’s hearing was normal at separation from service. The Board notes that when assessing the probative value of a medical opinion, the thoroughness and detail of the opinion must be considered. Prejean v. West, 13 Vet. App. 444, 448-49 (2000). An adequate rationale must be provided for any medical opinion rendered; a conclusory, contradictory or incomplete analysis is not adequate. Stefl v. Nicholson, 21 Vet. App. 120 (2007). In light of the above, the Board finds the examiner’s opinion inadequate. Moreover, applicable VA regulations do not preclude service connection for a current hearing loss disability even where hearing is within normal limits on audiometric testing at separation from service. When audiometric test results at a Veteran’s separation from service do not meet the regulatory requirements for establishing a disability at that time, he or she may nevertheless establish service connection for a current hearing disability by submitting evidence that the current disability is causally related to service. Hensley v. Brown, 5 Vet. App. 155, 159-60 (1993). Here, the Veteran reported exposure to small arms fire, grenade explosions, artillery, and rocket launchers without ear protection. He characterized the noise level as “very extreme.” He stated that he noticed diminished hearing upon return from Vietnam. The Veteran’s spouse stated that he had significant hearing loss when they first met in 1973; she specified that he could not hear higher pitch ranges and usually did not hear her if he had his back to her when she spoke to him. The Board notes that the Veteran is competent to provide lay evidence of his symptomatology, to the extent his symptoms are directly observable by him and do not require specialized medical or other training to describe. 38 C.F.R. § 3.159(a)(2); see Layno v. Brown, 6 Vet. App. 465, 467-69 (1994). The Veteran’s spouse is similarly competent to provide lay evidence of her direct observations. Id. The Board finds credible the Veteran’s representations about his exposure to extreme levels of noise because they are consistent with combat. The Board notes that it has no reason to doubt the Veteran’s representations about the onset of his symptoms because they are subjective and thus observable to himself, and because his spouse provides an account of specific ways in which the Veteran demonstrated hearing loss when they met in 1973, relatively soon after the Veteran’s 1970 discharge. The Board likewise has no reason to doubt the Veteran’s spouse, or the specific details of her description. The Board notes that at the May 2014 examination, the Veteran reported post-military exposure to some occupational noise through work in oil fields and recreational use of a wood saw; however, there is no detail regarding the timing or character of these exposures, and the Board is satisfied that the Veteran’s and his spouse’s lay evidence of hearing loss soon after return from Vietnam and separation sufficiently indicates a service-based origin of his hearing loss. In light of the above, the Board finds that the evidence of record is at least in equipoise regarding whether the Veteran’s hearing loss was incurred in or resulted from his service. Accordingly, resolving reasonable doubt in favor of the Veteran, the Board finds that service connection for bilateral hearing loss is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD David S. Katz, Associate Counsel