Citation Nr: 20023076 Decision Date: 04/02/20 Archive Date: 04/02/20 DOCKET NO. 17-46 593 DATE: April 2, 2020 ORDER Entitlement to service connection for bilateral sensorineural hearing loss disability is granted. Entitlement to service connection for tinnitus is granted. FINDINGS OF FACT 1. The Veteran’s bilateral sensorineural hearing loss disability is attributable to service. 2. The Veteran’s tinnitus is attributable to service. CONCLUSIONS OF LAW 1. Bilateral sensorineural hearing loss was incurred in service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 2. Tinnitus was incurred in service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1965 to August 1970. In November 2019, the Veteran testified before the undersigned Veterans Law Judge at a Board of Veterans’ Appeals (Board) videoconference hearing in St. Louis, Missouri. A transcript of the proceeding is of record. 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, 1131; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). 1. Entitlement to service connection for bilateral sensorineural hearing loss disability Upon review of the evidence of record, the Board resolves doubt in favor of the Veteran and finds service connection for bilateral sensorineural hearing loss disability is warranted. A review of the Veteran’s service treatment records reveals a bilateral decrease in hearing acuity from the time of entrance to the time of separation from service. However, the Veteran did not have a hearing loss disability for VA purposes. 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 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. In April 2016, the Veteran attended a VA hearing loss and tinnitus examination. Similar to his testimony and other statements, the Veteran reported in-service noise exposure while working on the flight line and as a pilot, and that after service “he worked as a system safety engineer as a civilian and wore double hearing protection in situations with loud equipment.” Upon examination, the Veteran was found to have bilateral sensorineural hearing loss for VA purposes. With regard to the right ear, the examiner found there was not a significant decline in hearing sensitivity between entrance and separation from service. The examiner stated the Veteran’s military occupational specialty (MOS) “likely exposed him to excessive noise but the there is no evidence to indicate that this had a negative impact on hearing. It is this examiner’s opinion that the veteran’s hearing was less likely than not adversely affected by acoustic trauma during military service.” With regard to his left ear, the VA examination report asked the examiner, “is the Veteran’s left ear hearing loss at least as likely as not (50% probability or greater) caused by or a result of an event in military service?” See VA examination report, page 4 (emphasis added). The examiner stated “No”, because hearing evaluations at entrance and separation from service reveal hearing within normal limits. However, the examiner went on to find that there was a significant threshold shift in service and stated, “the veteran’s MOS of Flight is classified by the DOD [Department of Defense] as having a high probability of hazardous noise exposure and it is this examiner’s opinion that this veteran was exposed to hazardous noise while in the military and it is at least as likely as not that it did cause a worsening of hearing thresholds in the veteran’s left ear.” After his hearing, the Veteran submitted a November 2019 hearing evaluation by a private clinician. The clinician opined the Veteran’s current bilateral hearing loss is at least as likely as not caused by or the result of military noise exposure. In support of this, the examiner noted the Veteran’s MOS and bilateral significant threshold shifts between entrance and separation from service. See document received November 18, 2019, page 6 (significant threshold shifts seen at 500Hz and 6000Hz in right ear and 500Hz and 3000Hz in left ear). The evidence of record contains well supported yet conflicting opinions with regard to the etiology of the Veteran’s hearing loss, and the Board finds this evidence to be in relative equipoise. The doubt created by this relative equipoise is resolved in favor of the Veteran. Therefore, service connection for bilateral sensorineural hearing loss is warranted. 2. Entitlement to service connection for tinnitus Upon review of the evidence of record, the Board finds the Veteran’s tinnitus is a symptom of his herein service connected bilateral sensorineural hearing loss disability. In a January 2016 statement that accompanied his claim, the Veteran stated he first noticed tinnitus 15 to 20 years prior, but dismissed it as a slight nuisance. He reported it worsened with time. “Tinnitus is now a constant irritation in my life.” During his November 2019 hearing, the Veteran testified he didn’t remember if tinnitus began in service. “I lost much of my memories from being in the service. And before that, most of them.” See hearing transcript, page 6. During the April 2016 VA examination, the Veteran reported constant bilateral tinnitus that began 10 years prior to the examination. The examiner opined the Veteran’s tinnitus was less likely than not due to military noise exposure. In support of this, the examiner noted tinnitus began 10 years prior. “Even if his hearing loss began due to military noise exposure, it is more likely than not that if tinnitus was a symptom of that hearing loss, the onset would have been much sooner than reported. The etiology of the tinnitus is unknown.” See April 2016 VA examination report, pages 5-6. However, the examiner did not address the Veteran’s January 2016 statement that tinnitus began as far back as 20 years prior. During his private hearing evaluation in November 2019, the Veteran reported tinnitus began in service. A review of the record reveals conflicting statements by the Veteran and his representative about the onset of the Veteran’s tinnitus, including whether it began in service or decades later. The November 2019 private clinician was not aware of the Veteran’s prior reports of tinnitus having a post-service onset. However, the clinician did not explicitly rely on the date of onset as the rationale for opinions provide. Instead the clinician relied on the Veteran’s history of noise exposure and threshold shifts seen in service to opine tinnitus was caused by in-service noise exposure. Additionally, the clinician opined the Veteran’s tinnitus is at least as likely as not a symptom associated with the Veteran’s hearing loss. See document received November 18, 2019, page 4. Both clinicians have provided conflicting opinions, that are imperfectly supported. Nevertheless, the Board finds the evidence to be in relative equipoise as to the Veteran’s tinnitus being due to in-service noise exposure. Accordingly, the Board resolves doubt in favor of the Veteran and finds his tinnitus was incurred in service. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Gregory T. Shannon 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.