Citation Nr: 20021696 Decision Date: 03/26/20 Archive Date: 03/26/20 DOCKET NO. 18-12 142 DATE: March 26, 2020 ORDER Entitlement to service connection for bilateral hearing loss is granted. FINDING OF FACT The evidence of record reflects that the Veteran does have bilateral hearing loss for VA purposes. CONCLUSION OF LAW The criteria for establishing entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. § 1110 (West 2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.385 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Army from January 1971 to October 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that in order to perfect his appeal, the Veteran submitted a Notice of Disagreement form, which the Regional Office (RO) accepted in lieu of a VA Form 9. Thus, the Board finds the RO’s acceptance of the NOD gives the Board jurisdiction over the claim and is properly before the Board at this time. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a link between the claimed in-service disease or injury and the present disability. Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013). Service connection may be granted for any disease initially diagnosed after service when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). For veterans with 90 days or more of active service during a war period or after December 31, 1946, certain chronic diseases, including organic diseases of the nervous system such as sensorineural hearing loss, 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. §§ 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. VA considers high frequency sensorineural hearing loss to be an organic disease of the nervous system. See Fountain v. McDonald, 27 Vet. App. 258, 264 (2015) (“By internal agency materials, the Secretary has made clear that sensorineural hearing loss is considered subject to § 3.309(a) as an ‘[o]rganic disease[] of the nervous system.’“); 38 C.F.R. § 3.309 (a) (2017) (“Chronic diseases.... Other organic diseases of the nervous system.”). Pursuant to 38 C.F.R. § 3.303 (b), where a chronic disease such as sensorineural hearing loss is shown as such in service, subsequent manifestations of the same chronic disease are generally service connected. If a chronic disease is noted in service but chronicity in service is not adequately supported, a showing of continuity of symptomatology after separation is required. For the 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 500, 1000, 2000, 3000, 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 (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 (2018). An examination for hearing impairment for VA purposes must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test (Maryland CNC) and a pure tone audiometry test. 38 C.F.R. § 4.85 (a). Factual Background The Veteran’s service treatment records (STRs) contain an audiometric test results taken on entrance to the United States Army in January 1971. The audiogram showed pure tone thresholds, in decibels, as follows: 500 1000 2000 3000 4000 RIGHT 0 0 0 5 LEFT 0 0 0 5 See January 1971 STR Report of Medical Examination. The Veteran underwent a separation examination which included a Rudmose Audiogram in October 1972. The results from the audiogram are contained in the Veteran’s STRs and establish there was no threshold shift in the Veteran’s hearing. See October 1972 STR Rudmose Audiogram. The Veteran’s separation examination notes his military occupation specialty (MOS) was as a clerk typist. See October 1972 STR Report of Medical Examination. In April 2006, the Veteran’s VA treatment records note that the Veteran had hearing limitations. See April 2006 St. James VA Clinic Primary Care Nursing Note. In May 2017, the Veteran reported sometimes having hearing loss. See May 2017 St. James VA Clinic CBOC Annual Visit. In December 2017, the Veteran underwent his first and only VA examination for hearing loss and tinnitus. Here, the Veteran’s examination showed pure tone thresholds, in decibels, as follows: Hz 500 1000 2000 3000 4000 6000 8000 Avg Hz RIGHT 10 15 20 30 35 25 20 25 LEFT 15 15 20 30 35 35 35 25 See December 2017 VA Hearing Loss and Tinnitus Disability Benefits Questionnaire (DBQ). As to the Veteran’s bilateral hearing loss, the VA examiner determined that the Veteran suffered from sensorineural hearing loss (in frequency range of 500-4000 Hz) in both ears, but his bilateral hearing loss was not at least as likely as not caused by or a result of military service. See id. The VA examiner rationalized his opinion based on the Veteran’s entrance examination and his MOS in service which had a low probability of hazardous noise exposure. Further, the VA examiner determined there was insufficient history of military noise exposure to conclude that the Veteran’s current hearing loss could be attributed only to military noise exposure and not the normal progression of hearing loss. See id. 1. Bilateral Hearing Loss The Veteran contends that his bilateral hearing loss is related to his in-service noise exposure. The Board concludes that the Veteran has a current diagnosis of bilateral hearing loss that is attributable to his service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), 3.385. Specifically, the Veteran underwent a VA examination for hearing loss in December 2017, which includes a diagnosis of bilateral hearing loss for VA purposes. See December 2017 VA Hearing Loss and Tinnitus DBQ. Based on this examination, VA granted the Veteran entitlement to service connection for tinnitus due to noise exposure during service. See January 2018 Rating Decision. Importantly, the VA examiner determined that the Veteran’s service-connected tinnitus was a symptom of his bilateral hearing loss. Given that this is now a favorable finding, it is logical to find that the Veteran’s bilateral hearing loss should also be service connected where all three elements of service connection have been met. Therefore, giving the Veteran the benefit of the doubt, the Board concludes that service connection for bilateral hearing loss is warranted. YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Glaeser, 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.