Citation Nr: 18155136 Decision Date: 12/03/18 Archive Date: 12/03/18 DOCKET NO. 17-41 396 DATE: December 3, 2018 ORDER Entitlement to service connection for bilateral hearing loss is denied. Entitlement to service connection for tinnitus is granted. FINDINGS OF FACT 1. The Veteran’s current bilateral hearing loss is not etiologically related to his military service. 2. Resolving all doubt in the Veteran’s favor, tinnitus is etiologically related to his period of active service. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 5103, 5103A, 5107; 38 C.F.R. § 3.102, 3.159, 3.303, 3.307, 3.309, 3.385. 2. The criteria for entitlement to service connection for tinnitus are met. 38 U.S.C. §§ 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1960 to May 1964. 1. Entitlement to service connection for bilateral hearing loss The Veteran contends that his bilateral hearing loss is a result of exposure to loud noise in service. Establishing service connection requires (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). For the purposes of applying the laws administered by VA, impaired hearing only will be considered to be an actual ratable 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 these frequencies 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. In March 2015 the Veteran underwent a VA audiological examination in conjunction with this claim. Puretone thresholds in the left and right ear reveal that the Veteran currently has bilateral hearing loss for VA purposes. See March 2015 VA examination. Thus, the first element of service connection has been met. For the purpose of this appeal, noise exposure in service is conceded and therefore the second element of service connection has been met. The Veteran’s specialty title as a Field Artillery Cannoneer is highly probable for hazardous noise exposure. See DD214 Notwithstanding the conceded in-service noise exposure, the third element, a causal connection between the military noise exposure and the Veteran’s present hearing loss must be established. Therefore, the question becomes whether the Veteran’s current hearing loss is at least as likely as not caused by that in-service exposure to noise. As noted above, the Veteran was afforded a VA examination in March 2015. The VA examiner opined that the Veteran’s hearing loss was not at least as likely as not caused by or the result of an event in military. The examiner expressed that upon review of the Veteran’s enlistment and separation audio examinations, hearing was assessed at 15/15 bilaterally, with no defects regarding hearing noted. In addition, the examiner noted that the Veteran’s service treatment records were silent for hearing loss. The examiner expressed that in a nursing note dated in October 2014, the Veteran indicated that his hearing loss began 8 to 9 years earlier. In a December 2017 addendum opinion, the examiner expressed that although the Veteran’s DD214 showed the Veteran’s military occupational specialty (MOS) as field artillery, the Veteran’s records have no complaint, diagnosis, or treatment for hearing loss until over 45 years after his active duty service. The examiner expressed that in a VA intake examination dated in November 2009, about 45 years after service, it was documented that it was the Veteran’s initial visit to get established for hearing aids. Based on a review of all the evidence of record, the Board finds that the preponderance of evidence is against a finding that the Veteran’s bilateral hearing loss is etiologically related to the Veteran’s in-service noise exposure. Regarding entitlement to service connection on a direct basis, the Board finds the December 2017 VA addendum medical opinion to be the most probative evidence of record as to whether the Veteran’s current bilateral hearing loss is related to his active service. The examiner’s rationale is thorough and it took into consideration the entire record, including the Veteran’s service treatment records and VA treatment records. The Board acknowledges that the Veteran was exposed to loud noise in service, and has considered his lay statements attributing his current bilateral hearing loss to his in-service noise exposure. While it is common knowledge that exposure to loud noise can cause hearing loss, the first medical evidence of record reflecting the Veteran’s symptoms of hearing problems is dated more than 40 years after his separation from service. Moreover, in a nursing note dated in October 2014, the Veteran indicated that his hearing loss began 8 to 9 years earlier. In addition, the Veteran’s entrance and separation examinations showed normal hearing. Furthermore, the Veteran’s bilateral hearing loss was not shown to have been manifested in the first post-service year, and therefore the chronic disease presumptive provisions of 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307, 3.309 do not apply. The Board acknowledges the Veteran’s contention that his bilateral hearing loss was caused by his conceded in-service noise exposure. However, the Veteran’s statements regarding the cause of his bilateral hearing loss are lay statements that purport to provide a nexus opinion between his service and his condition, and the Board finds the Veteran’s statements are not competent for this purpose. In the instant case the question of whether the Veteran’s bilateral hearing loss was caused by in-service noise exposure is something that cannot be determined by mere observation. Nor is this question simple, as it requires clinical testing and training to make the appropriate interpretations and conclusions about what the testing demonstrates in conjunction with the symptoms reported. The Board finds the Veteran is competent to describe noise exposure both in and out of service as well as his hearing symptoms. However, the causation of the hearing loss requires a medical expert’s opinion and objective medical findings. As such, the Board finds that the Veteran’s statements as to the etiology of his bilateral hearing loss are not competent evidence as to a nexus. In summary, the competent medical evidence of record weighs against a finding that a nexus exists between the Veteran’s bilateral hearing loss disability and his active military service. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. As the preponderance of the evidence is against the Veteran’s claim, that doctrine does not apply, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 2. Entitlement to service connection for tinnitus The Veteran, as a layperson, is competent to report on matters observed or within his personal knowledge. Therefore, the Veteran is competent to attest to the date of onset of his tinnitus symptoms, i.e., ringing in the ears. Moreover, tinnitus-or, ringing in the ears-is the type of disability that may be established on the basis of lay evidence as it is subjective in nature. See Charles v. Principi, 16 Vet. App. 370 (2002). (Continued on the next page)   The Veteran contends that his bilateral tinnitus is related to his military service. The Veteran maintains that his tinnitus is due to high noise exposure. The Veteran’s specialty title was that of a Field Artillery Cannoneer which is consistent with acoustic trauma. See DD214. Although the December 2017 VA examiner opined that the Veteran’s tinnitus was less likely than not caused by or a result of military noise exposure, the Board finds the Veteran’s statements as to the onset of his tinnitus in service to be competent and credible. Therefore, resolving reasonable doubt in the Veteran’s favor, service connection for tinnitus is established. See 38 U.S.C. § 5107, 38 C.F.R. § 3.102. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M.D.