Citation Nr: 18158391 Decision Date: 12/14/18 Archive Date: 12/14/18 DOCKET NO. 16-58 660 DATE: December 14, 2018 ORDER Service connection for hearing loss is denied. FINDINGS OF FACT 1. The Veteran had active service from August 1960 to July 1962 2. Hearing loss was not shown in service, was not present to a compensable degree within one year of separation from active service, and was not causally or etiologically related to service. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss have not been met. REASONS AND BASES FOR FINDINGS AND CONCLUSION As an initial matter, this matter was previously before the Board in September 2017, at which time the case was remanded for additional development. The case has now been returned to the Board for further adjudicative action. Additionally, in connection with this appeal the Veteran testified at an April 2017 hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the record. Service Connection Service connection may be granted on a direct basis as a result of disease or injury incurred in service when the following conditions are met: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). For the showing of a chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. As an organic disease of the nervous system, sensorineural hearing loss is considered a chronic disease for VA compensation purposes. If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. § 3.303 (b), 3.309(a); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) For veterans who served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including organic diseases of the nervous system (sensorineural hearing loss), are presumed to have been incurred in service if they manifested to a compensable degree within one year from the date of separation from service. 38 U.S.C. §§ 1101 , 1112, 1113, 1137 (2012); 38 C.F.R. §§ 3.307, 3.309 (2017). When all the evidence is assembled, 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. For VA purposes, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000 or 4000 Hertz (Hz) is 40 decibels (dB) or greater, the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000 or 4000 Hz are 26 dB or greater, or speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. Additionally, “the threshold for normal hearing is from 0 to 20 dBs [decibels] and higher threshold levels indicate some degree of hearing loss.” Hensley v. Brown, 5 Vet. App. 155 (1993). As an initial matter, hearing loss has been diagnosed. Specifically, a February 2018 VA examination diagnosed bilateral sensorineural hearing loss. Therefore, a current disorder has been shown and the first element of service connection has been met. Next, the Veteran was exposed to loud noise while in service. He described working in a trailer around machinery constantly for 1 year repairing damaged helicopters. He stated that he was not provided with hearing protection and that each day after leaving the trailer, his ears would ring for an hour. He further asserted noise exposure from handling his M-1 rifle. Based on this evidence, in-service noise exposure is established. However, the Veteran’s service treatment records do not document any complaints, diagnosis, or treatment for hearing loss. In fact, the Veteran indicated in his July 1962 separation examination that he did not have ear trouble. Additionally, in an associated medical examination, his ears were found to be clinically normal. Following his separation from service, the record does not establish that the Veteran sought treatment for hearing loss, and there is no evidence of hearing loss within one year of his separation from military service. Indeed, he did not complain of hearing trouble until 2006, more than 40 years after separation from service. Accordingly, the medical evidence does not support the claim for service connection on a presumptive basis. The remaining question is whether his current hearing loss is otherwise related to his military service, including his noise exposure therein. In this regard, in medical treatment notes between January and June 2006, the Veteran reported experiencing fairly gradual loss of hearing in his right ear over the previous 7-8 months. He stated that his hearing loss occurred in October 2005 and that he had a viral infection at the same time. He further stated that he first noted the hearing loss when talking on the phone. Clinicians diagnosed hearing loss that was conductive in origin. In a subsequent October 2013 VA examination, the Veteran reported bilateral hearing loss and tinnitus due to acoustic trauma in active service. He explained that he was a machinist and a machine shop worker in the Army and that he was exposed to machinery noise and sounds from gunfire. He stated that he was not provided with hearing protection. He related that after separation, he worked in a vending company for 5 years and was a truck driver for 30 years, during which he was exposed to diesel motors. He finally stated that he was exposed recreationally to lawn mower noise. He noted that he could not remember the circumstances or date of onset of his hearing loss, but that he had trouble hearing everything as a result of his hearing loss. The examiner diagnosed bilateral sensorineural hearing loss and recurrent tinnitus and opined that the Veteran’s hearing loss was less likely than not caused by or a result of military service. The examiner noted that the Veteran had a significant history of occupational and recreational noise exposure over a period of years and that frequency-specific tests were unavailable at the time of his separation from service. In an April 2017 hearing before the undersigned Veteran’s Law Judge, the Veteran testified that while in service he worked in a machine shop repairing damaged helicopters for 6 to 7 hours per day for 1 year. He testified that he did not first experience hearing problems while in service, but that he first had a hearing problem in 2002 and 2003. He noted that after separation, he did not work in a noisy environment and had no exposure to loud noises recreationally. He stated that he believed that his current hearing loss stemmed from his in-service machine shop work. In a May 2017 VA examination, the Veteran reported that he was a machinist in-service and was awarded an expert M-1 badge for his proficiency with an M-1 rifle. He stated that while in-service, he was exposed to noisy machines. The examiner diagnosed bilateral sensorineural hearing loss that he opined was less likely than not caused by or a result of an event in military service. The examiner explained that noise-induced hearing loss is typically symmetrical and that asymmetrical hearing loss requires a specific triggering event. The examiner noted that the Veteran reported that his hearing changed slowly over time and did not report an event that triggered his asymmetrical hearing loss. The examiner further observed that the Veteran reported working in a factory near noise and driving a truck for 30 years and found that his factory work and truck driving were noisy occupations which could be contributing factors to his hearing loss. In a February 2018 VA examination, the Veteran described exposure to machinery working in a box-like space making airplane and helicopter parts without the use of hearing protection. He stated that prior to service, he worked at a medical center and was exposed to lathes, drills, and saws, and that after service he drove a semi-truck for 30 years. Recreationally, he reported using lawn equipment for home maintenance, intermittently going hunting, and using a pontoon boat. The examiner diagnosed bilateral sensorineural hearing loss and opined that it was less likely than not caused by or a result of an event in military service. The examiner noted that the Veteran reported that his hearing difficulties began gradually in 2005 and 2006 and that the hearing in his right ear has been poor since that time. The examiner found that he reported no etiology for asymmetric hearing loss. While the examiner could not rule out a significant loss of hearing during active service, the examiner stated that right-sided asymmetric hearing was not consistent with his reported noise history, as noise from machinery and other occupational noise exposure would be expected to affect both ears in a similar fashion. The Board has considered multiple lay statements and testimony submitted by the Veteran regarding the etiology of his current hearing loss. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. Layno v. Brown, 6 Vet. App. 465, 469 (1994). However, he is not competent to offer an opinion as to the etiology of his current disorder due to the medical complexity of the matters involved. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Woehlaert v. Nicholson, 21 Vet. App. 456, 462. Such competent evidence has been provided by the medical personnel who have examined the Veteran during the current appeal and by service records obtained and associated with the claims file. Here, the Board attaches greater probative weight to the examination reports and clinical findings than to his statements. Based on the record before the Board, the evidence does not reach the level of equipoise. 38 U.S.C. § 5107(a). In this regard, the Veteran’s assertions of decreased hearing since service do not establish that his hearing loss rose to the level of a “disability” for purposes of VA compensation, or to a ratable level of disability within one year of separation from service. Accordingly, the preponderance of the evidence is against the claim for service connection and there is no doubt to be otherwise resolved. As service connection is not warranted, the appeal is denied. (Continued on the next page)   Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). ANTHONY C. SCIRE, JR. Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Spigelman, Associate Counsel