Citation Nr: 20042367 Decision Date: 06/23/20 Archive Date: 06/23/20 DOCKET NO. 16-29 273 DATE: June 23, 2020 ORDER Service connection for bilateral hearing loss is denied. FINDINGS OF FACT 1. The Veteran served on active duty from October 1972 to August 1974. 2. Bilateral hearing loss was not shown in service, was not shown to a compensable degree within one year of service, symptoms not continuous since service, and hearing loss is not causally or etiologically related to service. CONCLUSION OF LAW Bilateral hearing loss was not incurred in service and is not presumed to have been incurred in service. 38 U.S.C. §§ 1110, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.307, 3.309 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSION Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) 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 in or aggravated by service. See 38 C.F.R. §§ 3.303 (a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a presumptive basis for diseases listed in § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307. Hearing loss is recognized by VA as a “chronic disease” under 38 C.F.R. § 3.309(a), such that the presumptive provisions of 38 C.F.R. §§ 3.303(b), 3.307, and 3.309 apply. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258 (2015). For VA purposes, impaired hearing will be considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz (Hz) is 40 decibels (dB) or greater, the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, and 4000 Hz are 26 dB or greater, or speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. Additionally, the Court has held that “the threshold for normal hearing is from 0 to 20 dBs, and higher threshold levels indicate some degree of hearing loss.” See Hensley v. Brown, 5 Vet. App. 155, 157 (1993). First, the Veteran was diagnosed with bilateral hearing loss that meets the VA regulatory criteria at 38 C.F.R. § 3.385 in a June 2014 VA examination. Accordingly, the first element of service connection has been met. As to an in-service incurrence, the service treatment records (STRs) do not reflect complaints of, treatment for, or a diagnosis of hearing loss despite his statements regarding exposure to acoustic trauma from firearms, equipment, grenades, bombs, tanks, trucks, boats, and airplanes. Normal hearing was recorded at induction and separation. As a result, the second element of direct service connection has not been met. To the extent that the Veteran asserts a nexus between his in-service duties and current hearing loss, a medical evidence does not support the appeal. There are three medical nexus opinions of record and all weigh against the claim. In June 2014, a VA examiner opined that the Veteran’s hearing loss was not at least as likely as not caused by or a result of service. She explained that the Veteran did not have hearing loss in his right ear for VA purposes. An addendum medical opinion was obtained from the June 2014 VA examiner, who acknowledged the Veteran’s speech recognition scores reflected hearing loss for VA purposes in both ears. The examiner opined that it was still less than likely hearing loss was related to service, as hearing sensitivity was normal during service. In a February 2015 medical opinion, the clinician opined that the Veteran’s hearing loss was not caused by or a result of service. The clinician reasoned that the Veteran’s separation audiogram revealed no hearing loss. Most recently, a December 2019 VA examiner concluded that it was less likely than not that hearing loss was caused by or a result of service despite reported noise exposure from service in military (firearms, equipment, grenades, bombs, tanks, trucks, boats, and airplanes). The examiner reported that there was a decrease noted at 500 Hz at separation and normal hearing from 1000 to 8000 Hz. She explained that the decrease noted at 500 Hz was not a significant finding for noise exposure and not thought to be significant for rating purposes. Further, the examiner noted that typically, hearing loss associated with noise exposure would demonstrate changes in hearing thresholds at or just after noise exposure and that there were no significant changes noted during service and the Veteran’s complaints of decrease in hearing did not begin until 1977, three years following separation. Taken in combination, the Board affords significant probative value to these opinions, which consider the Veteran’s in-service noise exposure, in-service audiograms, and the onset and nature of the disorder against pertinent medical literature. There is no indication that the examiners were not fully aware of the Veteran’s past medical history or misstated any relevant fact. As to presumptive service connection, hearing loss was not shown in service. It is significant that hearing loss was not shown at the time of service separation. Therefore, the medical evidence does not support presumptive service connection on a “chronic disease or injury shown in service” basis. Next, the medical evidence does not support presumptive service connected based on continuity of symptomatology since service. Specifically, the Veteran was discharged in 1974 and complaints of hearing loss did not begin until 1977, at the earliest. Thus, the medical evidence does not support service connection on a “continuity of symptomatology” basis. Similarly, the disorder did not manifest itself to a degree of 10 percent or more within one year from the date of separation of service. As noted, the Veteran separated from service in 1974 but did not note symptoms until 1977 at the earliest. This evidence does not support presumptive service connection on a “manifest within one-year from separation” basis. Therefore, presumptive service connection on any basis is not supported by the medical evidence. The Board has considered the Veteran’s lay statements that hearing loss was caused by service. He is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses. However, he is not competent to offer an opinion as to the etiology of his current disorder due to the medical complexity of the matter involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claim for service connection and there is no doubt to be otherwise resolved. As such, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board’s consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Grzeczkowicz 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.