Citation Nr: 21001730 Decision Date: 01/11/21 Archive Date: 01/11/21 DOCKET NO. 17-31 764 DATE: January 11, 2021 ORDER Entitlement to service connection for bilateral hearing loss is denied. REMANDED Entitlement to service connection for posttraumatic stress disorder (PTSD) is remanded. Entitlement to service connection for a skin disability is remanded. Entitlement to service connection for a respiratory disability is remanded. FINDINGS OF FACT 1. The record evidence shows that the Veteran’s military occupational specialty (MOS) was armament maintenance and he served onboard several U.S. Navy aircraft carriers; thus, his in-service exposure to significant noise is demonstrated. 2. The record evidence shows that the Veteran underwent audiological evaluation as part of his VA treatment in October 2017, and the speech recognition scores were 88 percent in each ear. 3. The record evidence shows that, because the Veteran did not experience significant threshold shifts in his bilateral hearing during active service, it is less likely than not that his bilateral hearing loss is related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.303, 3.304, 3.385 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran had active service from December 1997 to December 2006 in the U.S. Navy. He also had additional U.S. Navy Reserve service. A videoconference Board hearing was held in September 2020 before the undersigned Veterans Law Judge and a copy of the hearing transcript has been added to the record. Having reviewed the record evidence, to include the Veteran’s hearing testimony, the Board finds that the issues on appeal should be characterized as stated above. 1. Entitlement to service connection for bilateral hearing loss The Board finds that the preponderance of the evidence is against granting the Veteran’s claim of service connection for bilateral hearing loss. The Veteran contends that he incurred bilateral hearing loss during active service, specifically as a result of in-service exposure to significant acoustic trauma while working as a weapons specialist aboard two different U.S. Navy aircraft carriers, U.S.S. CARL VINSON and U.S.S. ABRAHAM LINCOLN. The record evidence shows that, because the Veteran did not experience significant threshold shifts in his bilateral hearing during active service, it is less likely than not that his bilateral hearing loss is related to service. With respect to the assertion of in-service exposure to significant acoustic trauma, the Board notes that the Veteran’s service personnel records, including his DD Form 214, show that his MOS was armament maintenance. These records also show that he served onboard U.S.S. CARL VINSON and U.S.S. ABRAHAM LINCOLN. Thus, the Board finds that his in-service exposure to significant acoustic trauma is conceded. Although the Veteran’s in-service exposure to significant acoustic trauma is conceded, the record evidence shows that, because he did not experience significant threshold shifts in his bilateral hearing during active service, it is less likely than not that his bilateral hearing loss is related to service. The Board acknowledges that the Veteran’s voluminous service treatment records do not include audiometric testing results which show bilateral hearing loss for VA adjudication purposes. See 38 C.F.R. § 3.385 (2019). The Board also acknowledges that the audiometric testing results obtained on VA hearing loss and tinnitus Disability Benefits Questionnaire (DBQ) in April 2017 were considered not valid for rating purposes by the audiologist who conducted this examination. However, contained in the Veteran’s VA treatment records is a September 2017 notation of an audiological evaluation that shows speech discrimination scores of 88 percent in each ear. While it is unclear whether the Maryland CNC word test was used in this instance, as is required under the regulations, for the purposes of this decision only, the Board will assume that the Veteran met the criteria needed to show bilateral hearing loss under VA regulations. On VA hearing loss and tinnitus DBQ in February 2018, the Veteran stated that he “works as a corrections officer and can have difficulty hearing his radio and other around him” due to bilateral hearing loss. His pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 25 25 25 25 25 LEFT 25 25 25 25 25 Speech audiometry revealed speech recognition ability of 94 percent in the right ear and 98 percent in the left ear. The VA examiner opined that it was less likely than not that the Veteran’s bilateral hearing loss is related to active service. The rationale for this opinion was based on a review of the claims file which showed that the Veteran did not experience any significant or permanent threshold shifts in hearing thresholds in either of his ears during active service. The rationale also was based on the Veteran’s in-service exposure to significant acoustic trauma. The diagnoses were bilateral sensorineural hearing loss at 6000 Hertz or higher frequencies. Contrary to the Veteran’s lay assertions and Board hearing testimony, the record evidence shows that, because he did not experience significant threshold shifts in his bilateral hearing during active service, it is less likely than not that his bilateral hearing loss is related to service. It is undisputed that the Veteran likely was exposed to significant in-service acoustic trauma while working as an armaments technician onboard 2 different U.S. Navy aircraft carriers. It also is undisputed that the Veteran wears hearing aids to help him deal with the effects of his bilateral hearing loss. VA audiometric testing results obtained in February 2018 showed that the Veteran did not experience bilateral hearing loss for VA adjudication purposes at that examination. The Board concludes that it is unclear whether the Veteran currently experiences bilateral hearing loss for VA adjudication purposes. Nevertheless, even if the Board assumes, for the purposes of this decision only, that the Veteran experiences hearing loss for VA Purposes, the February 2018 VA examiner opined that it was less likely than not that the Veteran’s bilateral hearing loss is related to active service. This opinion was fully supported. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (finding that a medical opinion "must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). The Veteran finally has not identified or submitted any equally probative evidence demonstrating his entitlement to service connection for bilateral hearing loss. Thus, the Board finds that service connection for bilateral hearing loss is not warranted. REASONS FOR REMAND 1. Entitlement to service connection for PTSD is remanded. The Veteran contends that he incurred PTSD during active service. He has identified 2 different in-service stressors which caused or contributed to his PTSD. The first in-service stressor occurred while he served onboard U.S.S. CARL VINSON and witnessed an accident involving the aircraft elevator doors trapping and grievously injuring a fellow service member. Although the Veteran dated this incident to 2001, following considerable development efforts by the AOJ, it appears that this incident occurred in October 1999. The AOJ concluded in the currently appealed rating decision that the Veteran’s lay assertions regarding this in-service stressor were not credible because of the disparity in the dates when this incident occurred and because he reported that this accident resulted in the death of a fellow service member when the official reports concluded that the injured service member had lost consciousness and was transferred to a U.S. Navy hospital onshore at the time of this accident. The Board disagrees with the AOJ’s findings as to this in-service stressor. The Veteran served onboard U.S.S. CARL VINSON from at least mid-1998 through at least mid-2001. In other words, he served on this ship at all times relevant to this in-service stressor (whether it occurred in 2001, when the Veteran remembered that it occurred, or in October 1999, when official records noted that it occurred). It seems reasonable to conclude that, if the Veteran witnessed an unconscious fellow service member being transferred off of his ship immediately following this accident, he could have thought that this person had been killed by the aircraft elevator. The fact remains that the Veteran credibly reported witnessing the aircraft elevator accident which grievously injured a fellow service member while both served on U.S.S. CARL VINSON. Thus, the Board finds that the Veteran’s alleged in-service stressor regarding witnessing an aircraft elevator accident on U.S.S. CARL VINSON which grievously injured a fellow service member in October 1999 to be credible. The Board next notes that the Veteran’s second in-service stressor involves a civilian and is incapable of corroboration. Thus, it cannot support a valid diagnosis of PTSD. The Board notes further that the Veteran’s voluminous post-service VA outpatient treatment records include multiple diagnoses of PTSD. Unfortunately, none of these diagnoses appear to be based on the credible in-service stressor regarding an aircraft elevator accident onboard U.S.S. CARL VINSON which grievously injured a fellow service member in October 1999. Thus, the Board finds that, on remand, the AOJ should schedule a Veteran for examination to determine the nature and etiology of his PTSD. 2. Entitlement to service connection for a skin disability and for a respiratory disability is remanded. The Veteran finally contends that he incurred a skin disability and a respiratory disability during active service. He alternatively contends that an undiagnosed illness initially experienced while he served in the southwest Asia theater of operations during the Persian Gulf War caused or contributed to his respiratory disability. The Board notes that the Veteran’s voluminous post-service VA and private outpatient treatment records show ongoing complaints of and treatment for each of these disabilities. The Board next notes that, although the Veteran did not have active service during the Persian Gulf War, he was deployed on U.S. Navy aircraft carriers for Operations Desert Fox and Southern Watch in the southwest Asia theater of operations (as the AOJ noted in the currently appealed rating decision). Thus, the Veteran is not considered a “Persian Gulf Veteran” for purposes of presumptive service connection for certain disabilities incurred as a result of Persian Gulf War service. See 38 C.F.R. § 3.317(e)(1) (2019). The Board notes further that, to date, the Veteran has not been provided with examinations to determine the nature and etiology of either of these disabilities. There is no medical evidence currently of record addressing these matters. Thus, the Board finds that, on remand, the AOJ should obtain medical nexus opinions addressing these matters. The matters are REMANDED for the following action: 1. Obtain an opinion to determine the nature and etiology of his PTSD. The claims file should be provided to the clinician for review. Only if the clinician determines that one is necessary should the Veteran be scheduled for an in-person examination. Based on a review of the claims file and the results of the Veteran’s examination, if one is conducted, the clinician is asked to state whether it is at least as likely as not (i.e., a 50 percent or greater probability) that PTSD, if diagnosed, is related to the Veteran’s active service or any incident of service. If PTSD is diagnosed, then the clinician is asked to identify the in-service stressor(s) which supports this diagnosis or whether this diagnosis is related to the Veteran’s fear of hostile military or terrorist activity. A rationale must be provided for any opinion(s) expressed. The clinician is advised that the Veteran’s in-service stressor of witnessing an aircraft elevator accident onboard U.S.S. CARL VINSON which grievously injured a fellow service member is deemed credible. 2. Forward the claims file to an appropriate clinician for a medical nexus opinion concerning the nature and etiology of the Veteran’s skin disability. Based on a review of the claims file, the clinician is asked to state whether it is at least as likely as not (i.e., a 50 percent or greater probability) that a skin disability, if diagnosed, is related to active service or any incident of service. A rationale must be provided for any opinion(s) expressed. The clinician is advised that the Veteran’s VA outpatient treatment records show that he complained of and sought treatment for a skin rash of the hands in approximately August 2020. 3. Forward the claims file to an appropriate clinician for a medical nexus opinion concerning the nature and etiology of the Veteran’s respiratory disability. Based on a review of the claims file, the clinician is asked to state whether it is at least as likely as not (i.e., a 50 percent or greater probability) that a respiratory disability, if diagnosed, is related to active service or any incident of service. A rationale must be provided for any opinion(s) expressed. The clinician is advised that the Veteran’s post-service treatment records document ongoing complaints of and treatment for multiple respiratory disabilities, to include obstructive sleep apnea and bronchitis. The clinician also is advised that the Veteran did not serve in the southwest Asia theater of operations during the Persian Gulf War. 4. Readjudicate the appeal. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael T. Osborne, 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.