Citation Nr: 18154984 Decision Date: 12/04/18 Archive Date: 12/03/18 DOCKET NO. 16-38 191 DATE: December 4, 2018 ORDER Entitlement to service connection for bilateral hearing loss is denied. FINDING OF FACT The preponderance of the evidence indicates that the Veteran’s bilateral hearing loss was not caused or incurred in active service. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the Navy on active duty from October 1981 to October 1984. The Veteran contends that his current bilateral hearing loss is attributable to his exposure to loud noise during service, as he was never regularly exposed to loud noise before or after service. His service personnel records confirm that on active duty, the Veteran worked on the flight line on the U.S.S. Nimitz, a naval aircraft carrier, where he supported the aviation mission. He argues that the Navy’s provision of frequent hearing tests suggests that the Navy was concerned about the sailors’ possible hearing loss due to noise exposure. He notes that most of the sailors he worked with suffered hearing loss. The Veteran claims that the audiologist examiner’s 2015 opinion is flawed and not entitled to evidentiary weight because the examiner did not address the significance of the small shifts in hearing thresholds indicated in the audiogram results from when he was in service. Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a link between the claimed in-service disease or injury and the present disability. Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013). Alternatively, service connection may be established under 38 C.F.R. § 3.303(b) by (1) evidence of (a) the existence of a chronic disease in service or during an applicable presumption period under 38 C.F.R. § 3.307, and (b) present manifestations of the same chronic disease, or (2) when a chronic disease is not present during service, evidence of continuity of symptomatology. Certain chronic diseases listed in 38 C.F.R. § 3.309(a), including sensorineural hearing loss, may be presumed to have been incurred during service if manifested to a compensable degree within one year of separation from active service. 38 U.S.C. §§ 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. For these diseases, subsequent manifestations of the same chronic disease at any later date, however remote, are presumed to be service connected unless the manifestations are clearly attributable to intercurrent causes. 38 C.F.R. § 3.303(b). To show that a chronic disease arose in service, the Veteran must have experienced 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, or where an in-service diagnosis of chronicity may be legitimately questioned, the disease may be deemed chronic if a claimant shows continuity of symptoms after discharge, or if all evidence establishes that the disease was incurred in service. 38 C.F.R. §§ 3.303(b), 3.303 (d). For hearing loss claims in which the hearing disability initially manifests more than one year after service, a claimant may establish direct service connection based on evidence showing that the current hearing loss is causally related to injury or disease suffered in service,” even where audiometric testing during service and at separation does not establish a hearing loss disability under 38 C.F.R. § 3.385. Hensley v. West, 5 Vet. App. 155, 164 (1994). For the purposes of applying the laws administered by VA, impaired hearing is considered to be a disability when: 1) the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; 2) when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or 3) when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. Hensley provides that the threshold for normal hearing is between 0 and 20 decibels and that higher thresholds show some degree of hearing loss. Hensley at 157. When all the evidence is assembled, the VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. A medical opinion is adequate where it is based upon consideration of the veteran’s prior medical history and examinations, it describes the disability, if any, in sufficient detail so that the Board’s evaluation of the claimed disability will be a fully informed one, and it supports all conclusions with analyses that the Board can consider and weigh against contrary opinions. Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (2007). Upon review of all the evidence of record, the Board finds that the Veteran does not have a service related bilateral hearing loss. The Veteran’s service treatment records contain audiogram results taken on five dates during his active duty service. The examiners at that time assessed normal bilateral hearing, although the threshold level findings in both ears varied from test to test, and most increased slightly over the period. In December 2015, a VA examiner reviewed the Veteran’s service treatment records, his records of treatment at the Veterans Affairs Medical Center in Shreveport and Texarkana, and his service personnel records. The VA examiner recorded the Veteran’s hearing pure tone thresholds in decibels as follows: Frequency Right Ear Left Ear 1000 Hz 60 60 2000 Hz 65 65 3000 Hz 70 80 4000 Hz 85 80 Speech audiometry revealed speech recognition ability of 48 percent in the right ear and of 44 percent in the left ear. Tympanometry findings were normal for the right ear and abnormal for the left ear. The examiner considered the Veteran’s history of having had no noise exposure prior to and after military service, and exposure to flight deck noise in his work as an aviation ordinance man. The Veteran told her that his ears started ringing during service, and that the condition has persisted throughout his life. At that at the time, he had difficulty hearing conversations. As a preliminary matter, the Board acknowledges that the VA’s December 2015 auditory testing results and the examiner’s assessment establish that the Veteran has a current hearing loss disability under the VA standards, and that the weight of the medical and lay evidence proves that the Veteran was exposed to acoustic trauma in service because he worked in a very loud environment on the flight line of the U.S.S. Nimitz. Therefore, the only issue on appeal is whether the Veteran’s in service traumatic acoustic injury is also causally related to the Veteran’s current hearing loss. This is a case of delayed onset hearing loss. It is not one in which the Veteran is entitled to a presumption of service connection for hearing loss under 38 C.F.R. § 3.303(b) because there is no evidence in the record that he experienced a ratable hearing loss in service or within one year from his separation from service. Nor is there evidence that there is service connection based upon continuity of symptomatology pursuant to 38 C.F.R. § 3.303(a). The record does not suggest, nor does the Veteran otherwise contend, that he has complained of or been treated for hearing loss at any time prior to 2015. Therefore, for the Veteran’s hearing loss to be service connected, a direct service connection must be established. The Veteran’s argument that the 2015 examiner did not consider his hearing shifts in service is simply not correct, as it was explicitly addressed in the rationale for the opinion provided. The Board finds that the VA medical examiner’s opinion regarding hearing loss is probative, as it was rendered after a review of the Veteran’s claims file and personnel records and is supported by a sufficient rationale that was informed by the examiner’s medical expertise. The examiner’s opinion is also consistent with the evidence of record. In addition, the Veteran has not provided information as to when or to what extent his hearing loss initially manifested. The hearing loss disability was apparently first confirmed by the VA in the December 2015 VA examination, nearly thirty years following his separation from active service. While the Veteran might sincerely believe his hearing loss is due to in service noise exposure, as a layperson, he has not shown that he possesses the necessary clinical expertise to comment on complicated medical issues such as the nature and etiology of sensorineural hearing loss. See 38 C.F.R. § 3.159(a)(1). Therefore, he is not competent to provide an opinion concerning the etiology of his current hearing loss. As the only competent medical opinion of record failed to link the Veteran’s current bilateral hearing loss to service, the evidence preponderates against the claim for service connection. The evidence in this case is not so evenly balanced that the Board should apply the benefit of the doubt rule as required by law and VA regulations. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Zizzi