Citation Nr: 18154906 Decision Date: 12/04/18 Archive Date: 11/30/18 DOCKET NO. 16-50 961 DATE: December 4, 2018 ORDER Entitlement to service connection for bilateral sensorineural hearing loss is denied. FINDING OF FACT The Veteran’s current bilateral sensorineural hearing loss did not begin in service or within one year of service and is not etiologically related to his military service. CONCLUSION OF LAW The criteria for service connection for hearing loss have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably in the United States Air Force from July 1967 to May 1971. This case comes to the Board of Veterans’ Appeals (the Board) on appeal from an August 2015 rating decision by the Department of Veteran’s Affairs (VA) regional office (RO). 1. Entitlement to service connection for bilateral sensorineural hearing loss. Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110. Generally, the evidence 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. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). An alternative method of establishing the second and third Shedden elements for disabilities identified as chronic diseases in 38 C.F.R. § 3.309(a) is through a demonstration of continuity of symptomatology. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Sensorineural hearing loss is considered a qualifying organic disease of the nervous system within the definition of 38 C.F.R. § 3.309(a). For purposes of applying the laws administered by VA, impaired hearing will be considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz 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 Board notes that the Veteran has a current diagnosis of sensorineural hearing loss in both ears under the above metrics. Shedden element one is thus met. The Board also finds that the Veteran was likely exposed to acoustic trauma while in service. Shedden element two is thus also met. What is for consideration is whether this current hearing loss is etiologically related to the Veteran’s military service. During a January 2015 hearing aid evaluation, the examiner noted the Veteran had never previously worn hearing aids. The examiner stated that the Veteran reported having difficulty understanding in group settings and distinguishing background noise. It was found that the Veteran had normal to mild hearing loss bilaterally at frequencies up to 2000Hz; beyond that frequency, the Veteran’s hearing in the right ear was found to be moderate to severe, while the left ear was rated as profound hearing loss. A June 2015 Compensation and Pension (C&P) Examination found that the Veteran has hearing loss bilaterally. However, the audiologist opined that this hearing loss is less likely than not etiologically related to the Veteran’s service. To support this, the audiologist noted that the Veteran’s enlistment and separation examinations both showed hearing well within what is considered normal limits. The examiner acknowledged that the Veteran’s service entry and separation audiograms reflected a threshold shift of approximately 10 decibels but noted that such finding was within normal limits bilaterally and does not represent hearing loss for diagnostic purposes. The Veteran left military service over 45 years ago. Until 2015, there is no record of treatment for or complaints of hearing loss. Thus, the Board concludes that, while the Veteran has diagnosed bilateral sensorineural hearing loss, which is a qualifying chronic disease under 38 C.F.R. § 3.309(a), the condition did not manifest to a compensable degree in service or within a presumptive period. 38 C.F.R. §§ 3.307, 3.309(a). Service connection under a theory of continuity of symptomatology is likewise not available under these circumstances. 38 C.F.R. § 3.303(b). Regarding service connection on a direct basis, the Board finds that the most probative evidence—the June 2015 C&P examination—does not support a finding that the Veteran’s currently diagnosed bilateral sensorineural hearing loss is related to acoustic trauma experienced while in service. The Veteran has not provided any competent evidence to the contrary. Consequently, the Board concludes the third element of service connection is not met under Shedden. While the Veteran believes his hearing loss is related to his active service, he is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it requires specialized medical education and testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. In summary, the preponderance of the probative evidence is against finding that the Veteran’s bilateral hearing loss is etiologically related to his period of active service. As the weight of the evidence is against the Veteran’s claim, the benefit-of-the-doubt doctrine does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Service connection for bilateral sensorineural hearing loss is therefore denied. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Stuedemann, Associate Counsel