Citation Nr: 21006356 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 19-06 272A DATE: February 3, 2021 ORDER Service connection for hearing loss is granted.   FINDING OF FACT The Veteran’s hearing loss is due to his in-service noise exposure. CONCLUSION OF LAW The criteria for service connection for hearing loss have been met. 38 U.S.C. §§ 101, 1110, 1131, 5107; 38 C.F.R. §§ 3.6, 3.102, 3.303, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty for training (ACDUTRA) from April 1964 to November 1964. He had additional service with the Marine Corps Reserve. The case is on appeal from a December 2016 rating decision. In January 2021, the Veteran testified at a Board hearing. Service connection for hearing loss. Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: “(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 or aggravated during service.” Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). 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, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, 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. Active service includes periods of ACDUTRA when service connection may be granted for disabilities resulting from a disease or injury incurred in or aggravated while performing ACDUTRA. 38 U.S.C. § 101(22), (24); 38 C.F.R. § 3.6(a), (c). Active service also includes periods of inactive duty training (INACDUTRA) when service connection may be granted for disabilities resulting from an injury incurred in or aggravated while performing INACDUTRA. 38 U.S.C. § 101(23), (24); 38 C.F.R. § 3.6(a), (d). Analysis The Veteran contends that his in-service noise exposure led to his current hearing loss. He submitted a March 2019 substantive appeal in which he stated during service, he performed maintenance in a very loud noise-filled environment. He reported he worked on planes, such as the A-4 Skyhawk and F-18 Hornet and that his work consistently exposed him to loud engine noise which was the onset of his hearing loss. The Board notes a January 2019 VA examination report from an audiologist established current bilateral hearing loss. See 38 C.F.R. § 3.385. The Veteran’s service treatment records (STRs) do not reveal hearing loss during his period of ACDUTRA, including a November 1964 examination near the end of his period of ACDUTRA. During his Reserve service, hearing loss was not found in examinations dated September 1965, September 1968 and September 1972. In a December 1973 examination, normal hearing was found, although left ear puretone thresholds were elevated, including 35 decibels at 4000 Hertz. Left ear hearing loss was first found in testing dated March 1976 and right ear hearing loss was first indicated in testing dated October 1984. See 38 C.F.R. § 3.385. The Veteran’s Reserve records also show bilateral hearing loss in a November 1986 examination and thereafter. Id. Following the Veteran’s August 2016 claim, a December 2016 VA opinion was provided. The examiner indicated the Veteran’s hearing loss is not related to service. She reported the Veteran’s separation examination showed normal hearing in both ears via “whispered voice test” and that VA does not consider the “whispered voice test” to have probative value. The examiner noted multiple examinations from 1965 to 1968, following the Veteran’s active duty, showed normal hearing in both ears. The Veteran submitted a July 2017 notice of disagreement (NOD) in which he disagreed with the examiner. He reported while the examiner addressed his Reserve records from 1965 to 1968, she did not discuss his later records from 1968 to 1995. The Veteran was afforded another VA examination in January 2019 in which the examiner indicated she cannot provide a medical opinion regarding the etiology of the Veteran’s hearing loss without resorting to speculation. However, she reported there was no documented hearing loss or threshold shifts in hearing following service, including in September 1972 and October 1979 examinations. She stated hearing examinations completed from 1984 to 1994 showed gradual hearing loss in both ears and it is likely/possible that aging, occupational and recreational noise exposure, as well as general health have contributed to the Veteran’s hearing loss. She noted it would be speculative to allocate a degree of hearing loss to any or each of the etiologies. Thereafter, a January 2021 medical opinion from an audiologist was submitted in which the examiner found the Veteran’s hearing loss is related to service. She indicated the Veteran has been a patient of hers since October 2018. She stated results from recent hearing testing showed mild to severe sensorineural hearing loss bilaterally. She indicated she became familiar with the Veteran’s active duty as it relates to occupational noise exposure. She noted including his Reserve service, the Veteran served a total of 32 years in the Marine Corps and was exposed to numerous occupational noise sources, including aircraft, firearms and machinery. She stated in the Veteran’s earlier years, hearing protection was not provided or required. She opined after examining the Veteran’s pattern and degree of hearing loss, as well as reviewing his charts and reported history of noise exposure, it is more likely than not that his noise exposure during service caused or contributed to his hearing loss. The Board determines the Veteran’s bilateral hearing loss is related to service. The Veteran has current bilateral hearing loss and the record contains medical evidence in favor of and against the claim. Although the December 2016 VA examiner provided a negative nexus opinion, she did not address the Veteran’s Reserve medical examinations following his period of ACDUTRA which showed left ear hearing loss from March 1976 and right ear hearing loss from October 1984. Additionally, the January 2019 VA examiner stated she cannot provide a medical opinion regarding the etiology of the Veteran’s hearing loss without resorting to speculation. In contrast, the January 2021 audiologist opined the Veteran’s history, pattern and degree of hearing loss support that his in-service noise exposure led to or at least contributed to his current hearing loss. Therefore, the Board finds the evidence is at least in equipoise as to whether the Veteran’s bilateral hearing loss is related to service, including noise exposure during a period of ACDUTRA in the Reserves. Thus, when resolving reasonable doubt in the Veteran’s favor, the Board finds that his current hearing loss is due to his in-service noise exposure. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Accordingly, service connection for hearing loss is warranted. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Isaacs, 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.