Citation Nr: 21065720 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 15-13 854 DATE: October 27, 2021 ORDER Service connection for bilateral hearing loss is denied. FINDING OF FACT The Veteran's bilateral hearing loss was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1962 to September 1966. In March 2019, a videoconference board hearing was held before the undersigned. A transcript of the hearing is associated with the Veteran's claims file. In August 2019, the Board issued a decision that, in pertinent part, denied service connection for bilateral hearing loss. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court), and the Board's decision was vacated pursuant to an November 2020 Order, following a Joint Motion for Partial Remand (JMR). The issue was again remanded pursuant to the JMR in May 2021. The requested development has been accomplished and the case has been returned for further appellate consideration. Entitlement to service connection for bilateral hearing loss The Veteran contends that service connection should be established for bilateral hearing loss. During the hearing before the undersigned, the Veteran stated that he had experienced hearing loss as early as his second year of active duty service and that it had continued to worsen since that time. It is pointed out that the Veteran worked on aircraft engines during service, which exposed him to significant acoustic trauma. Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). The Veteran has a current diagnosis of sensorineural hearing loss as evidenced by a September 2012 VA audiometric examination. This is an enumerated condition under 38 C.F.R. § 3.309(a); Walker, 708 F.3d 1331. Review of the record shows that sensorineural hearing loss was not shown as chronic in service, did not manifest to a compensable degree within a presumptive period, and was not noted in service with attributable continuity of symptomatology. In this regard, the record shows that audiometric examinations at entry and separation from service showed pure tone air conduction thresholds to be normal. Specifically, audiometric thresholds at entry into active duty were shown to be as follows: Hertz 500 1000 2000 3000 4000 6000 Right ear -5 -5 0 -5 5 5 Left ear -10 -10 -10 0 0 5 On examination for separation from service, pure tone audiometric thresholds were shown to be as follows: Hertz 500 1000 2000 3000 4000 6000 Right ear 5 0 0 5 15 15 Left ear 0 -5 -5 5 10 10 The Board notes that, as the examinations were performed prior to January 1, 1967, and it has not been specified which units were utilized in the testing, the results are presumed to have been conducted according to the same American Standards Association (ASA) units rather than International Standards Organization-American National Standards Institute (ISO-ANSI) units. An examination was conducted by VA in September 2012. At that time, pure tone air conduction thresholds, which are noted to be in ISO-ANSI units were reported to be as follows: Hertz 500 1000 2000 3000 4000 6000 8000 Right ear 15 25 25 40 55 60 70 Left ear 10 20 25 40 55 70 85 Speech discrimination scores at that time were 100 percent correct in each ear. Regarding etiology, the examiner opined that it was not at least as likely as not that the Veteran's hearing loss was caused by or the result of an event in military service. The rationale was that, while the Veteran's service record documented that he had served as an aviation machinist's mate and was presumed to have been exposed to acoustic trauma, examinations from enlistment and separation showed normal hearing bilaterally from 250 to 6000 hertz. The examiner stated that as the Veteran had normal hearing in both ears at separation, his current hearing loss had to begin after he separated from service. The examiner further noted that a 2005 report had concluded that, based on current knowledge, noise induced hearing loss occurred immediately with no scientific support for delayed onset, weeks, months, or years after the event. Therefore, it was the examiner's opinion that the bilateral hearing loss was less likely than not due to in-service noise exposure while serving as an aviation machinist's mate. A private audiologic evaluation was performed in April 2019. The examiner noted that the Veteran had a significant history of military noise exposure while working around jet aircraft engines on board the USS Enterprise. It was stated that hearing protection was not worn as communications headphones were worn. Pure tone testing (which was detailed graphically) showed mild to severe mixed sloping hearing loss in the right ear and normal to severe mixed sloping hearing loss in the left ear. Speech recognition scores were noted to be 100 percent correct in the right ear and 92 percent correct in the left ear. No opinion regarding the etiology of the Veteran's hearing loss was specifically stated. Another examination was conducted by VA in July 2021. At that time, pure tone audiometry demonstrated sensorineural hearing loss in the frequency ranges between 500 and 6000 hertz bilaterally. Regarding etiology, the examiner stated that there was not a permanent positive threshold shift greater than normal measurement variability in any frequency between 500 and 6000 hertz in each ear. The examiner also stated that as no positive threshold shift was demonstrated in either ear when comparing the Veteran's service entrance and separation audiograms, and that hearing loss was not shown until 2012 over 45 years after service, the hearing loss was not service connected. The examiner also cited the 2005 report that concluded that, based on current knowledge, noise induced hearing loss occurred immediately. In response to the questions posed by the Board in the 2021 remand, the examiner stated that there were no threshold shifts from entrance examination to exit examination and that, while the Veteran reported that his hearing loss began while he was in service, his exit audiogram was normal. The treatment records show the Veteran was not diagnosed with sensorineural hearing loss until 2012, decades after his separation from service and decades outside of the applicable presumptive period. While the Veteran is competent to report having experienced symptoms of hearing loss in service and soon thereafter, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of sensorineural hearing loss as the Veteran has not demonstrated the necessary medical expertise. The issue is medically complex, as it requires knowledge of the interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Service connection may still be granted on a direct basis; however, the preponderance of the evidence is against finding that a medical nexus exists between the Veteran's sensorineural hearing loss and an in-service injury, event or disease. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303. The VA examiners have opined that the Veteran's hearing loss is not at least as likely as not related to an in-service injury, event, or disease, including exposure to aircraft engines during service. The rationale for both opinions was, essentially, that the Veteran's separation audiogram showed normal hearing and that there was no appreciable threshold shift from entrance to separation. Moreover, the examiners cited a study that showed that noise induce hearing loss would not likely appear many years after separation from service. While the private audiologist made a note of the Veteran's military service noise exposure, no opinion regarding the etiology of the Veteran's bilateral hearing loss was provided. Thus, there is no opinion (or other competent evidence) in the record that establishes that the Veteran's hearing loss is attributable to military service. The Board may not reject medical opinions based on its own medical judgment. Obert v. Brown, 5 Vet. App. 30 (1993); see also Colvin v. Derwinski, 1 Vet. App. 171 (1991). For these reasons, the Board finds that a preponderance of the evidence is against the Veteran's claim for service connection for bilateral hearing loss, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Joseph P. Gervasio 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.