Citation Nr: 18159625 Decision Date: 12/19/18 Archive Date: 12/19/18 DOCKET NO. 15-31 079 DATE: December 19, 2018 ORDER Service connection for bilateral hearing loss is granted. Service connection for tinnitus is granted. FINDINGS OF FACT 1. The Veteran has bilateral hearing loss that is likely due to noise exposure during service. 2. The Veteran has tinnitus that is likely due to noise exposure during service. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss have been met. 38 U.S.C. § 1110 (2012); 38 C.F.R. §§ 3.303, 3.385 (2018). 2. The criteria for service connection for tinnitus have been met. 38 U.S.C. § 1110 (2012); 38 C.F.R. §§ 3.303, 3.385 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from October 1968 to September 1972. This matter comes before the Board of Veterans’ Appeals (Board) from a May 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office. The Veteran provided testimony before the undersigned Veterans Law Judge via videoconference equipment in December 2018. This decision is being made under the “one-touch” program. A transcript of the hearing will be associated with the claims file at a later time. Service Connection Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an 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 or aggravated during service, the so-called “nexus” requirement. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). A disability that is proximately due to, the result of, or aggravated by a service-connected disease or injury shall be service connected. 38 C.F.R. § 3.310. Service connection for certain diseases, including organic diseases of the nervous system, such as sensorineural hearing loss and tinnitus, may also be established on a presumptive basis by showing that the disease manifested to a compensable degree within one year from the date of separation from service. 38 C.F.R. §§ 3.307(a)(3), 3.309(a). In determining whether service connection is warranted for a disability, 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 the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant. 1. Bilateral Hearing Loss The Veteran contends that his bilateral hearing loss is related to noise exposure during service. For purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies of 500, 1000, 2000, 3000, or 4000 Hertz (Hz) is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies of 500, 1000, 2000, 3000, or 4000 Hz 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. The threshold for normal hearing is from 0 to 20 decibels, and higher threshold levels indicate some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). The medical evidence of record demonstrates that the Veteran has a current bilateral hearing loss disability for VA purposes, as defined in 38 C.F.R. § 3.385. Specifically, the May 2015 VA examination report shows that the Veteran has an auditory threshold of 50 decibels at 4000 Hz in the right ear and 75 decibels at 4000 Hz in the left ear. Therefore, he has a hearing loss disability for VA compensation purposes. With respect to an in-service injury or disease, the Veteran has reported exposure to noise during service. In February 2018, the Veteran indicated that he was exposed to noise during flight training and while serving in combat as an attack helicopter pilot. As part of his duties, he was exposed to noise from high-pitch turbine engines, 20 mm cannon fire, gun fire, and rockets, as well as noise from other aircraft. The Veteran is competent to report his experiences during service. The Veteran’s reports of exposure to noise from helicopter engines and other combat noises are credible because they are consistent with the circumstances of his service, to include as reflected by the Sharpshooter Marksmanship Badges and occupational specialty noted as pilot shown on his DD Form 214. See 38 U.S.C. § 1154(a). Accordingly, the Board finds that the Veteran incurred an in-service injury consisting of acoustic trauma. Regarding the relationship between his current hearing loss and service, the Board notes that service treatment records include the June 1968 enlistment examination report, which shows that the auditory threshold was 0 decibels at 500, 1000, 2000, and 4000 Hz for both ears. Testing was not conducted at 3000 Hz. See also Flight Examinations of September 1968 and 1969. In January 1971, all auditory thresholds were 0 decibels for both ears at all frequencies except for the left ear at 4000 Hz, which was 25 decibels. In February 1972, all auditory thresholds were 5 decibels for both ears at all frequencies except for the left ear at 4000 Hz, which had improved to 20 decibels. The September 1972 separation examination shows that the auditory thresholds of the right ear were 5 decibels at 500, 1000, 2000, and 4000 Hz. The auditory thresholds of the left ear were 5 decibels at 500, 1000, and 2000 Hz. At 4000 Hz, the auditory threshold was 10 decibels. Testing was not conducted at 3000 Hz for either ear. The Board acknowledges that while the Veteran did not have a hearing loss disability for VA purposes during service, test results show some worsening of hearing acuity between entrance and separation from service. The Board also acknowledges the Veteran’s argument that his hearing significantly worsened during service at the higher frequencies, such as 6000 and 8000 Hz, an assertion which is supported by the records. See statement, February 2018. However, these frequencies are not used when determining whether he has a hearing loss disability for VA purposes. The Board also considered the opinion from the May 2015 VA examiner, which indicates that the Veteran’s bilateral hearing loss was less likely than not related to noise exposure during service. The examiner found that the entrance and separation examinations showed normal hearing, bilaterally, and that there was insufficient research to determine whether permanent noise-induced hearing loss could develop after the cessation of that noise exposure. In an August 2014 opinion from the Veteran’s private provider, Dr. K.A., he indicated that the Veteran served as a helicopter pilot during service and that the occupation is associated with significant noise exposure. No other noise exposure was documented. Dr. K.A. stated that the Veteran had bilateral severe sensorineural hearing loss, which presented as a classic case of noise induced hearing loss. In March 2016, Dr. K.A. stated that the Veteran had bilateral high-frequency hearing loss most likely associated with exposure to noise and that there is a likely association with exposure to noise while working as a pilot. Regarding these opinions, the Board finds that they are in relative equipoise as the VA examiner provided a negative opinion with supporting rationale and Dr. K.A. provided a positive opinion with supporting rationale. As noted above, when the evidence is in equipoise, the Veteran gets the benefit of the doubt. Based on the service treatment records showing some worsening of hearing acuity during service, the Veteran’s lay statements and testimony, and the opinion reports from Dr. K.A. indicating that the Veteran’s hearing loss was due to noise exposure during service, the Board finds that the Veteran should be given the benefit of the doubt that his current bilateral hearing loss is most likely due to acoustic trauma experienced during service. 38 U.S.C. §§ 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Therefore, service connection for bilateral hearing loss is granted. 2. Tinnitus The Veteran seeks service connection for tinnitus. In this case, treatment records confirm a current diagnosis of tinnitus. With respect to an in-service injury or disease, the service treatment records are absent for any complaint of or treatment for tinnitus during active service. However, as noted above, the Veteran had acoustic trauma during service. Regarding a nexus between tinnitus and the in-service acoustic trauma and/or bilateral hearing loss, in August 2014, Dr. K.A. indicated that the Veteran has constant tinnitus that is related to his high frequency hearing loss, bilaterally. He noted that high frequency hearing loss is the most common cause of tinnitus. In a March 2016 opinion, Dr. K.A. indicated that he reviewed the Veteran’s treatment records since service and stated that it was at least as likely as not that the Veteran’s tinnitus was associated with noise exposure while serving as a pilot during service. He stated that the most commonly associated risk factor for tinnitus is noise exposure and that tinnitus is likely related to noise exposure while serving as a pilot. Since the evidence shows a current diagnosis of tinnitus, the in-service injury of acoustic trauma, and a nexus between them, service connection for tinnitus is granted. See supra 38 U.S.C. §§ 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). L. CHU Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Amanda G. Alderman