Citation Nr: 18157755
Decision Date: 12/14/18	Archive Date: 12/13/18

DOCKET NO. 16-63 406
DATE:	December 14, 2018



ORDER
Entitlement to service connection for bilateral hearing loss is granted.
FINDING OF FACT
The evidence is in equipoise as to whether bilateral hearing loss is related to in-service noise exposure.
CONCLUSION OF LAW
The criteria for service connection for bilateral hearing loss are met.  38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a).

REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty with the United States Army from May 1972 to April 1974.
This matter is before the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).
Service Connection for Bilateral Hearing Loss
The Veteran and his representative generally contend the Veteran is entitled to service connection for bilateral hearing loss due to in-service noise exposure.  
Service connection may be granted for disability resulting from disease or injury incurred or aggravated during active military service.  38 U.S.C. § 1110.  Generally, service connection requires (1) the existence of a present disability, (2) in-service incurrence or aggravation of an injury or disease, 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 (Fed. Cir. 2004).  
The Board acknowledges that sensorineural hearing loss is a chronic disease entitled to presumptive service connection in certain circumstances.  38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309.  However, as service connection is being granted based on a direct theory of entitlement, these provisions will not be further discussed.
The December 2015 and September 2016 VA audiological examinations indicate the Veteran has a current disability of hearing loss.



Impaired hearing is considered a disability for VA purposes when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels (dB) or greater or where the auditory thresholds for at least three of these frequencies are 26 dB or greater or when the Maryland CNC speech recognition scores are less than 94 percent.  38 C.F.R. § 3.385.
The December 2015 examination reveals the following puretone thresholds, in decibels and Maryland CNC Test scores:

	HERTZ	CNC
	500	1000	2000	3000	4000	%
RIGHT	40	45	60	60	60	84
LEFT	25	30	45	55	60	88

Based on the Veteran having auditory thresholds above 40 dB at one frequency bilaterally and thresholds of above 26 dB at three or more frequencies bilaterally, the evidence supports the Veteran has a current bilateral hearing loss disability.  The Veteran’s speech recognition scores of less than 94 percent bilaterally also meets the requirement for hearing loss bilaterally.  





The September 2016 VA examination reveals the following puretone thresholds, in decibels and Maryland CNC Test scores:

	HERTZ	CNC
	500	1000	2000	3000	4000	%
RIGHT	45	45	60	70	65	88
LEFT	25	30	45	55	55	92

Based on the Veteran having auditory thresholds above 40 dB at one frequency bilaterally and thresholds of above 26 dB at three or more frequencies bilaterally, the evidence supports the Veteran has a current bilateral hearing loss disability.  The Veteran’s speech recognition scores of less than 94 percent bilaterally also meets the requirement for hearing loss bilaterally.  
The evidence of record also indicates the Veteran had in-service noise exposure.  The Veteran’s DD-214 reflects that the Veteran was a track vehicle repairer during service, which poses a highly probable exposure to acoustic trauma.  In addition, the Veteran was awarded sharpshooter badges during service.  
As to whether the Veteran’s hearing loss is related to service, there are conflicting medical opinions.  A private audiologist, I.K., Ph.D., opined in July 2016 that it is more than likely that the Veteran’s hearing loss is due to his military experience.  Dr. I.K. reasoned that the Veteran presented with significant noise induced hearing loss bilaterally and the hearing loss was due to working with tank engines in service. 
The Board acknowledges that following the December 2015 VA examination, the examiner opined that the Veteran’s hearing loss was less likely than not incurred in or caused by the Veteran’s service.  The examiner reasoned the audiograms conducted during service show normal hearing bilaterally and no significant shift in hearing between the entrance and exit examinations.  Further, the examiner noted that the research does not support delayed onset hearing loss.    
The Board places equal weight of probative value on the July 2016 private opinion and the December 2015 VA opinion as they both contain adequate rationale for the conclusions reached and are based on a review of the Veteran’s history.  Therefore, as the record contains medical opinions both for and against the Veteran’s claim, the Board finds that the evidence of record is in equipoise as to whether there is a nexus between the Veteran’s current bilateral hearing loss and military service.  In such cases, all reasonable doubt is resolved in favor of the Veteran.  As such, service connection for hearing loss is granted.  38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990).
 
M. SORISIO
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	N. Breitbach, Associate Counsel