Citation Nr: 21001929 Decision Date: 01/12/21 Archive Date: 01/12/21 DOCKET NO. 17-22 034 DATE: January 12, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. FINDINGS OF FACT 1. The record evidence shows that the Veteran’s military occupational specialty (MOS) was U.S. Army infantryman and his principal duties were a grenadier in a U.S. Army infantry unit; thus, his in-service exposure to significant noise is presumed. 2. The record evidence is in relative equipoise as to whether the Veteran’s bilateral hearing loss is related to active service. CONCLUSION OF LAW The criteria for entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.385 (2019). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran had active service from January 1974 to January 1977 in the U.S. Army. He also had additional unverified U.S. Army Reserve service. The Veteran appointed his current agent to represent him before VA by filing a completed VA Form 21-22a at the Agency of Original Jurisdiction (AOJ) in July 2020. A videoconference Board hearing was held in November 2020 before the undersigned Veterans Law Judge and a copy of the hearing transcript has been added to the record. The Board finds that the evidence is in relative equipoise as to whether the Veteran’s current bilateral hearing loss is related to active service. In other words, there is evidence both supporting and going against the claim of service connection for bilateral hearing loss. The Veteran essentially contends that in-service exposure to significant acoustic trauma while serving as a U.S. Army infantryman caused or contributed to his current bilateral hearing loss. The available service personnel records show that his military occupational specialty (MOS) was infantryman. These records also show that his principal duties included working as a grenadier with a U.S. Army infantry unit in the Republic of Korea. Thus, the Veteran’s in-service exposure to significant acoustic trauma is presumed. The medical evidence shows that the Veteran currently experiences bilateral hearing loss. For example, a private audiological evaluation in July 2011 shows that his pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 15 10 15 10 20 LEFT 10 15 25 30 70 Speech audiometry revealed speech recognition ability of 96 percent in the right ear and 88 percent in the left ear. The diagnoses were moderate high frequency sensorineural hearing loss in the right ear and mild sloping to severe high frequency sensorineural hearing loss in the left ear. On VA hearing loss and tinnitus Disability Benefits Questionnaire (DBQ) in January 2016, the Veteran’s pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 15 20 20 30 30 LEFT 15 40 55 80 85 Speech audiometry revealed speech recognition ability of 96 percent in each ear. The VA examiner opined that it was less likely than not that the Veteran’s claimed bilateral hearing loss is related to active service. The rationale for this opinion was that the Veteran did not experience right ear hearing loss for VA adjudication purposes. The rationale also was that there was no significant threshold shift in the Veteran’s bilateral hearing during active service. The rationale further was based on a review of relevant medical literature. The diagnoses were right ear sensorineural hearing loss in the frequency range of 6000 Hertz (Hz) or higher and left ear sensorineural hearing loss from 500 to 4000 Hz. On VA audiological evaluation in January 2018, the Veteran’s pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 15 15 20 40 45 LEFT 20 25 35 55 80 Speech audiometry revealed speech recognition ability of 92 percent in the right ear and 80 percent in the left ear. The diagnoses were mild to moderate sensorineural hearing loss from 3000 to 8000 Hertz (Hz) in the right ear and mild to severe sensorineural hearing loss from 1500 to 8000 Hz in the left ear. On VA audiological evaluation in March 2019, the Veteran’s pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 25 25 30 50 40 LEFT 30 45 65 85 80 Speech audiometry revealed speech recognition ability of 92 percent in the right ear and 52 percent in the left ear. The diagnoses were mild to severe sensorineural hearing loss in the right ear and severe sensorineural hearing loss in the left ear. The Veteran’s voluminous post-service VA outpatient treatment records indicate that he has been prescribed bilateral hearing aids to deal with his current bilateral hearing loss. In an October 2019 letter which was date-stamped as received electronically by VA in November 2019, B. W., AuD, CCC-A, a private audiologist, opined that it was as likely as not that the Veteran’s bilateral hearing loss is related to active service. The rationale for this opinion was based on the Veteran’s report that he was exposed to significant acoustic trauma during active service, including “exposure starting in basic training to rifles, pistols, grenades, artillery, mortars, heavy equipment and generators.” The rationale also was that audiometric testing showed moderate to severe sensorineural hearing loss bilaterally. The Veteran essentially contends that his current bilateral hearing loss is related to active service, specifically as a result of in-service exposure to significant acoustic trauma. Although his in-service exposure to significant acoustic trauma is undisputed, the medical evidence is in relative equipoise as to whether his current bilateral hearing loss is related to active service. In other words, there is evidence both supporting and going against the Veteran’s claim. On the one hand, the January 2016 VA examiner opined that it was less likely than not that the claimed bilateral hearing loss is related to active service. This examiner noted that the Veteran did not experience right ear hearing loss at that time although subsequent VA audiometric testing results demonstrated the presence of right ear hearing loss for VA adjudication purposes. See 38 C.F.R. § 3.385 (2019). On the other hand, Dr. B. W. opined in October 2019 that it was at least as likely as not that the Veteran’s bilateral hearing loss is related to active service. This private clinician noted the Veteran’s (undisputed) report of in-service exposure to significant acoustic trauma and stated that audiometric testing demonstrated the presence of bilateral hearing loss. Both of these opinions were 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"). In summary, and after resolving any reasonable doubt in the Veteran’s favor, the Board finds that service connection for bilateral hearing loss is warranted. See also 38 C.F.R. § 3.102 (2019). 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.