Citation Nr: 18157569 Decision Date: 12/12/18 Archive Date: 12/12/18 DOCKET NO. 17-04 027 DATE: December 12, 2018 ORDER Entitlement to service-connection for bilateral hearing loss is granted. FINDING OF FACT There is at least an approximate balance of positive and negative evidence as to whether the Veteran’s hearing loss is related to his active service. CONCLUSION OF LAW Resolving reasonable doubt in favor of the Veteran, 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). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in active duty service from January 1969 to January 1971. This matter is on appeal from a February 2014 rating decision for bilateral hearing loss. No hearing was requested. Service connection is granted on a direct basis when there is competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Service connection for chronic diseases listed in 38 U.S.C. sections 1101 (3) and 38 C.F.R. § 3.309(a), such as bilateral sensorineural hearing loss, may be established on a presumptive basis if the chronic disease was shown as chronic in service; manifested to a compensable degree within a presumptive period, usually one year, after separation from service; or was noted in service with continuity of symptomatology since service. 38 U.S.C. §§ 1112, 1113; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); 38 C.F.R. §§ 3.303 (b), 3.307, 3.309(a). When evaluating the evidence and rendering a decision on the merits, the Board is required to assess the credibility and probative value of proffered evidence in the context of the record as a whole. See Evans v. West, 12 Vet. App. 22, 26 (1998). When a claimant seeks benefits and the evidence is in relative equipoise, the claimant prevails. 38 U.S.C. § 5107(b); See Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 C.F.R. § 3.102. The preponderance of the evidence must be against the claim for benefits to be denied. See Alemany v. Brown, 9 Vet. App. 518 (1996). The Veteran contends that his condition was caused by his active duty service. He asserts that his duties working with tanks as a tank commander affected his hearing and resulted in his condition. The Veteran’s DD 214 form lists his occupation as an armor crewman. The Board has also conceded noise exposure based upon the Veteran’s military occupation. An June 2013 VA Initial Outpatient Visit assessed the Veteran with hearing loss based his history of present illness. The report noted this hearing loss began with the Veteran’s duties as tank commander in active service, and this condition was progressive over time. An August 2013 VA OPC Audiology Consultation noted the Veteran experienced significant hazardous noise exposure while serving in active service, and found the Veteran with moderate to mild sensorineural hearing loss in his right ear, and mild sensorineural hearing loss in his left ear. The Veteran was provided hearing aids in February 2014 and a June 2015 VA Nurse report notes the Veteran is hard of hearing and requires hearing aids to hear. A June 2014 statement from the Veteran’s private doctor reports the Veteran recalls hearing impairment soon after separation from service. The service treatment records do not show any complaints or treatment for hearing loss or tinnitus. However, the Board finds the Veteran is competent to report that he experienced symptoms of hearing loss during this period. His statements are credible and entitled to probative weight, as they are internally consistent and consistent with other evidence of record, which shows that these symptoms combined with his duties and experiences in service were attributable to the Veteran’s current bilateral sensorineural hearing loss and tinnitus. The February 2014 VA examiner provided a negative etiology opinion. However, this opinion appears based only upon the lack of reported puretone values in the examination and the Veteran’s enlistment and separation examination audiogram results, which the VA examiner found no significant threshold change throughout service. The VA examiner was unable to report any puretone threshold values, stating: “Despite repeated attempts and reinstruction, the pure-tone test results were not reliable and are not suitable for rating purposes in this examiner’s opinion, and are therefore not being reported.” However, the VA examiner would opine that the threshold values were inconsistent with an August 2013 VA OP audiogram, even though the examiner did not report any values. The August 2013 VA audio examination did obtain puretone threshold values and indicated the results indicated moderate to mild hearing loss for both left and right ears; However, this examination did not use the Maryland CNC speech discrimination test and as such, the August 2013 and February 2014 examinations are inadequate for Board purposes. Furthermore, the absence of in-service evidence of a hearing disability during service (i.e., one meeting the requirements of 38 C.F.R. § 3.385) is not always fatal to a service connection claim. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Evidence of a current hearing loss disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting the regulatory requirements for hearing loss disability for VA purposes, and a medically sound basis upon which to attribute the post-service findings to the injury in service (as opposed to intercurrent causes). See Hensley v. Brown, 5 Vet. App. 155, 159 (1993). The Board finds there is sufficient evidence to support a link between the Veteran’s diagnoses of hearing loss and his acoustic trauma in service, despite the examiner’s findings. In light of the Veteran’s acoustic trauma in service, the current diagnosis of hearing loss, and the Veteran’s credible statements reporting continuity of symptoms since service, the Board finds the evidence is at least in equipoise. As such, the benefit of the doubt is resolved in the Veteran’s favor and service connection for hearing loss is warranted. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Yang, Law Clerk