Citation Nr: 18159715 Decision Date: 12/19/18 Archive Date: 12/19/18 DOCKET NO. 14-09 006 DATE: December 19, 2018 ORDER Entitlement to service connection for sensorineural hearing loss in the left ear is granted. FINDING OF FACT The Veteran’s current level of hearing loss in her left ear is etiologically related to her active duty service. CONCLUSION OF LAW The criteria for entitlement to service connection for sensorineural hearing loss in the left ear have been met. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1154(b) (2012); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1980 to February 1983. Entitlement to service connection for sensorineural hearing loss in the left ear Service connection will be granted if the Veteran has a disability resulting from personal injury or disease incurred in the line of duty, or for aggravation of a preexisting injury or disease incurred in the line of duty during active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish service connection, the evidence 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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). A valid service connection claim requires competent evidence of a current disability. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). However, the presence of a disability at any time during the claim process – or relatively close thereto – can justify a grant of service connection, even where such disability has become asymptomatic. McClain v. Nicholson, 21 Vet. App. 319 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). Service connection for certain chronic disorders, including sensorineural hearing loss, may be presumed where demonstrated to a compensable degree within 1 year following separation from qualifying service. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. In Fountain v. McDonald, 27 Vet. App. 258 (2015), the Court determined that tinnitus is an “organic disease of the nervous system” subject to presumptive service connection where there is evidence of acoustic trauma and nerve damage. For an enumerated “chronic disease” such as hearing loss shown in service (or within a presumptive period under § 3.307), subsequent manifestations of the same chronic disease at any later date, however remote, are service-connected, unless clearly attributable to intercurrent causes. See Groves v. Peake, 524 F.3d 1306, 1309 (2008). For the purpose of applying the laws administered by VA, impaired hearing is considered to be a disability when the auditory threshold at any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores utilizing the Maryland CNC Tests are less than 94 percent. 38 C.F.R. § 3.385. Normal puretone thresholds during service do not necessarily preclude service connection. See 38 C.F.R. § 3.303(d); Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Whenever there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the Veteran. 38 U.S.C. § 5107(b). In her November 1979 entrance report of medical history, the Veteran reported hearing loss in her left ear, and the February 1980 entrance medical examination contains audiometric results that reflect left ear hearing loss per VA standards of 38 C.F.R. § 3.385. While in service, she was treated for pain and bleeding after her left ear was injured. See October and December 1981 Service Treatment Records. The Board notes that the Veteran declined to undergo a medical examination at separation from service. The Board also notes that she is service-connected for residuals of ruptured tympanic membrane of the left ear, currently rated as noncompensable. The Veteran has provided statements that her left ear hearing loss was aggravated during service, as she became deaf in the left ear after basic training, and was struck in the left ear during an in-service assault. See February 2013 and April 2010 Veteran Statements. VA has conceded that she was assaulted during service, and she is competent to report experiencing symptoms of hearing loss. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). A March 2013 VA audiometric examination reflects mixed left ear hearing loss, and the left ear puretone threshold readings reflect worse hearing than the February 1980 audiometric results. The examiner determined that the left ear hearing loss was not etiologically related to service, and the left tympanic membrane “apparently self-resolved.” The examiner did not provide a rationale regarding whether the Veteran’s in-service injuries aggravated her left ear hearing loss. By contrast, a September 2018 expert opinion determined that her in-service assault likely aggravated her left ear hearing loss. The expert further determined that her service-connected residuals of ruptured tympanic membrane could also have injured her middle ear ossicles, and likely aggravated the left ear hearing loss beyond the normal progression of the disorder. Based on the September 2018 expert opinion and the Veteran’s statements regarding an increase in symptoms during service, entitlement to service connection for hearing loss of the left ear is warranted. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Howell, Associate Counsel