Citation Nr: 20021070 Decision Date: 03/24/20 Archive Date: 03/24/20 DOCKET NO. 17-39 990 DATE: March 24, 2020 ORDER Entitlement to service connection for bilateral hearing loss is granted. Entitlement to service connection for tinnitus is granted. FINDINGS OF FACT 1. The Veteran’s current bilateral hearing loss is related to his active service. 2. The Veteran’s current tinnitus is related to his active service. CONCLUSIONS OF LAW 1. Bilateral hearing loss was incurred in active service. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385. 2. Tinnitus was incurred in active service. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1967 to February 1970. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2016 rating decision. In November 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript has been associated with the record. In December 2019, the Veteran submitted additional evidence, including a private medical opinion, for which there is an automatic waiver of initial consideration by the agency of original jurisdiction (AOJ). Law and Analysis Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty in the active military, naval, or air service. 38 U.S.C. §§ 1110, 1131. That an injury or disease occurred in service is not enough; there must be chronic disability resulting from that injury or disease. Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). For the showing of 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. Sensorineural hearing loss is an organic disease of the nervous system and is considered to be 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; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258, 271 (2015) In addition, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including hearing loss and tinnitus as organic diseases of the nervous system, are presumed to have been incurred in service if they manifested to a compensable degree within one year of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309. In considering the evidence of record under the laws and regulations, the Board concludes that the Veteran is entitled to service connection for bilateral hearing loss and tinnitus. The Veteran has contended that he has current hearing loss and tinnitus as a result of in-service noise exposure. In particular, he has asserted that he was exposed to hazardous noise from small arms fire and explosions during basic training and combat simulations. The Veteran’s service personnel records also show that his military occupational specialty (MOS) was a field radio repairman, which has a moderate probability for exposure to acoustic trauma. The Veteran is competent to report noise exposure in service, and his service personnel records confirm his military occupational specialty. As such, his reported noise exposure is consistent with the circumstances of his military service, and there is no reason to doubt the credibility of such statements. Therefore, the Board finds the Veteran’s reports of noise exposure to be competent and credible. In addition, the evidence shows that the Veteran has bilateral hearing loss as defined by 38 C.F.R. § 3.385, and he has been diagnosed as having tinnitus. Thus, the remaining question is whether those disorders are related to his military service. In this regard, there is both favorable and unfavorable evidence. The Veteran’s service treatment records are negative for any complaints, treatment, or diagnoses of hearing loss and tinnitus. An April 1967 enlistment examination found his ears and drums to be normal, and his hearing was within normal limits, regardless of whether the American Standards Association (ASA) standard or International Standards Organization - American National Standards Institute (ISO-ANSI) standard is applied. The Veteran also denied having a history of ear trouble or hearing loss at that time The claims file does not contain a separation examination report, and the Veteran testified during the November 2019 hearing that his hearing was not evaluated at the time of his separation. However, in a February 1970 report of medical history, the Veteran denied having any ear problems or hearing loss. The Veteran was later afforded a VA examination in June 2016. The examiner noted that the Veteran’s hearing was normal during his enlistment examination and was not tested at time of his separation in 1970; however, she also observed that the Veteran denied having a medical history of hearing loss at that time. The examiner also noted the Veteran’s MOS of field radio repairman and that he was not a combat veteran. He reported noise from radio equipment and during basic training, including obstacle course noise, without hearing protection. He also reported post-service occupational and recreational noise exposure; however, he indicated that he used hearing protection. The examiner opined that the Veteran’s bilateral hearing loss was less likely than not caused by or the result of noise exposure in military service, explaining that he was not engaged in combat and had many years of post-service occupational and recreational noise exposure. The examiner also opined that his tinnitus was less likely than not related to military noise exposure, explaining that there were no complaints of hearing loss at discharge and that the Veteran had many years of occupational and recreational noise to attribute to the current tinnitus. In a December 2019 private medical opinion, J.O. (initials used to protect privacy) stated that she was a doctor of audiology with decades of experience. She noted the Veteran’s reported history of military noise exposure, and she indicated that tinnitus and hearing loss can occur as a result of even one traumatic noise exposure. In this regard, J.O. explained that even a single exposure may be sufficient to cause damage to the inner ear hair cells causing a permanent or temporary threshold shift in hearing as well as tinnitus. She stated that, after listening to the Veteran’s description of in-service noise exposure, she believes that he is impaired from such noise exposure. She also acknowledged his reports of occupational noise exposure, but observed that he wore hearing protection devices and that the noise levels were much lower than during military service. J.O. concluded that, based on the reported history, the findings of her evaluation, and a review of the case history, the Veteran is as likely as not to have sustained hearing loss due to his military service. The unfavorable evidence consists of the service treatment records, which are negative for any complaints, treatment or diagnosis of hearing loss or tinnitus, and the June 2016 VA examination report, which concluded that the Veteran’s hearing loss and tinnitus can be attributed to extensive post-service noise exposure. The favorable evidence consists of J.O.’s positive nexus opinion and the Veteran’s November 2019 hearing testimony. The Board finds the June 2016 VA examination report has limited probative value because the examiner relied, in part, on the fact that the Veteran did not engage in combat and had many years of occupational and recreational noise exposure. However, as noted above, the Veteran’s MOS of field radio repairman has a moderate probability of noise exposure. The VA examiner also did not have the opportunity to consider the Veteran’s November 2019 hearing testimony. On the other hand, J.O. based her opinion on the Veteran’s reported history and the pertinent facts, and she provided thorough rationale for her conclusion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (most of the probative value of a medical opinion comes from its reasoning). Based on the evidence of record, the Board concludes that service connection for bilateral hearing loss and tinnitus is warranted. J.W. ZISSIMOS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D.S. Chilcote, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.