Citation Nr: 21002897 Decision Date: 01/19/21 Archive Date: 01/19/21 DOCKET NO. 16-24 012 DATE: January 19, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. Entitlement to service connection for a lung disability is granted. FINDINGS OF FACT 1. The most probative evidence of record reveals that the Veteran’s hearing loss is etiologically related to service. 2. The evidence of record shows lung disease began in service and has been present continuously since separation. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.385. 2. The criteria for entitlement to service connection for a lung disability have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from April 1976 to July 1986. These matters come before the Board of Veterans’ Appeals (Board) on appeal from rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a Board hearing in October 2020. The transcript is of record. The claimant has not raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Service Connection Service connection may be granted for a disability resulting from disease or injury incurred coincident with or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (nexus) between the present disability and the disease or injury incurred or aggravated during service. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F. 3d 1163, 1167 (Fed. Cir. 2004)). The absence of any one element will result in denial of service connection. Coburn v. Nicholson, 19 Vet. App. 247, 431 (2006). Service connection may be granted for any disease initially diagnosed after discharge 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). In addition, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including other organic diseases of the nervous system (which includes sensorineural hearing loss and tinnitus), 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. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309. For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim. 38 C.F.R. §§ 3.303 (b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). 1. Entitlement to service connection for bilateral hearing loss 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, or 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. Thresholds for normal hearing are between 0 and 20 decibels, and higher thresholds show some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 159 (1993). The Veteran contends that his bilateral hearing loss has been caused by in-service acoustic trauma. Specifically, the Veteran testified at his Board hearing that during his work as a correctional specialist, he was not afforded hearing protection, and was exposed to hazardous noise, including gunfire and helicopters. The Veteran further testified that he noticed diminished hearing in service, and that his hearing loss has continued unabated since separation. Based on a review of service records and post-service medical records in this case, the Board finds the Veteran’s testimony credible. Further, the medical record shows current bilateral hearing loss, confirmed by a December 2016 statement submitted by a private provider. That provider further indicates that the Veteran “displays a pattern of hearing loss often associated with excessive noise exposure,” noting his exposure to noise during service, including from rifle ranges and helicopters. The provider also indicated that service records reveal threshold shifts during service, further indicating that the Veteran’s current hearing disability began in service. The Board accepts the provider’s assessment as the most probative evidence of record with respect to etiology in this matter, and thus, based on that evidence, along with the Veteran’s credible lay statements and the conceded in-service noise exposure, the Board finds in favor of the claim for service connection for bilateral hearing loss, and the appeal is granted. 2. Entitlement to service connection for a lung disability The Veteran appeals for service connection for a lung disability. He has metallic densities in the left lung of unattributed origin. Further, diagnostic imaging conducted at separation from active duty service reveals the presence of two small metallic densities in the left chest cavity. There is no indication these were present at entry into service. Thus, the Board finds that the in-service incurrence element is present in this case. As for the nexus element, the record reveals no plausible alternative provenance for these densities. The Veteran believes they bear a relation to his in-service assignments as a military police officer in the chemical and nuclear surety program. While no treating or examining provider has ever explicitly linked the lung condition to active duty service, the record is altogether bare of evidence that they were present before entry into service, and indeed entrance examination records indicate a normal examination, and there is no doubt that they were present by separation, and that they remain present through the appeal period. The Veteran is beset by a range of current symptoms, including difficulty breathing and chest pain, particularly on exertion. This symptomatology has not been attributed to any disease process separate and apart from the metallic densities in the Veteran’s left lung, and the Board will not order development in this matter to disprove the Veteran’s theory of entitlement to service connection. Given this evidence, the Board finds that the Veteran’s current lung condition began in service and has been present continuously since service, and accordingly, service connection for a lung condition must be granted. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Z. Sahraie, 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.