Citation Nr: 21007099 Decision Date: 02/08/21 Archive Date: 02/08/21 DOCKET NO. 14-40 349A DATE: February 8, 2021 ORDER Entitlement to service connection for left ear hearing loss is denied. FINDING OF FACT The preponderance of the evidence of record is against finding that the Veteran has had left ear hearing loss at any time during or approximate to the pendency of the claim. CONCLUSION OF LAW The criteria for service connection for left ear hearing loss have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1985 to April 1988. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an October 2012 rating decision by the Regional Office (RO) of the Department of Veterans Affairs (VA). This case was previously before the Board in April 2020, on which occasion the claim was remanded. In the April 2020 Board decision, claims of service connection for right ear hearing loss, a left elbow disability, and recurrent tinnitus, were remanded for further development. In October 2020 the RO granted service connection for right ear hearing loss, left elbow bursitis, and recurrent tinnitus. This constitutes a full grant of the benefits sought by the Veteran. Therefore, there is no longer a case or controversy regarding the aforementioned issues for the Board to consider. The remaining claim has been returned to the Board for further adjudication. Entitlement to service connection for left ear hearing loss. The Veteran contends that his left ear hearing loss was caused by his active service. Service connection for hearing loss may be granted where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting the regulatory requirements for hearing loss for VA purposes, and a medically sound basis upon which to attribute the post-service findings to the injury in service (as opposed to intercurrent causes). Hensley v. Brown, 5 Vet. App. 155, 159 (1993). The threshold for normal hearing is from 0 to 20 decibels; higher thresholds show some degree of hearing loss. Id. at 157. For purposes of applying the laws administered by the VA, impaired hearing will be considered a disability when the auditory threshold in any of the frequencies of 500, 1000, 2000, 3000, or 4000 hertz (Hz) is 40 decibels or greater, or when the auditory thresholds for at least three of the frequencies of 500, 1000, 2000, 3000, or 4000 Hz 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. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b). The question for the Board is whether the Veteran has a current diagnosis of left ear hearing loss for VA purposes. The Board concludes that the Veteran’s left ear hearing impairment does not rise to the level of a disability for the purposes of VA disability compensation and has not at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303(a), (d). At the outset, the Board acknowledges the Veteran’s military occupational specialty as a combat engineer and finds that acoustic trauma is consistent with the circumstances of his service. In-service incurrence is therefore not in dispute. In September 2012 the Veteran underwent a VA hearing loss and tinnitus examination. (9/1/2012, VA Examination, p. 4-5). His speech discrimination score using the Maryland CNC test was 100 percent. His reported puretone thresholds in decibels for the left ear were: HERTZ 500 1000 2000 3000 4000 LEFT 20 20 15 25 25 In September 2020 the Veteran was afforded another VA hearing loss and tinnitus examination. (9/25/2020, C&P Exam, p. 3). His speech discrimination score using the Maryland CNC test was 100 percent. His reported puretone thresholds in decibels for the left ear were: HERTZ 500 1000 2000 3000 4000 LEFT 20 20 20 30 35 After a review of the medical evidence of record, the Board finds that the Veteran’s left ear hearing impairment does not rise to the level of a disability for VA purposes. In this regard, his auditory thresholds in the left ear were below 40 decibels at the frequencies of 500, 1000, 2000, 3000, and 4000 Hz during both examinations. Additionally, his auditory thresholds in the left ear were below 26 decibels at the frequencies of 500, 1000, 2000, 3000, and 4000 Hz during the September 2012 examination. While the September 2020 examination revealed auditory thresholds above 26 decibels at the frequencies of 3000 and 4000 Hz, VA regulations require at least three frequencies be 26 decibels or greater for impaired hearing to be considered a disability for VA purposes. Finally, his speech recognition score was 100 percent during both examinations. Based on the objective medical evidence, the Board concludes that the Veteran’s left ear hearing impairment is not a disability for VA compensation purposes. In rendering this decision, the Board acknowledges a January 2012 private medical opinion wherein a private examiner opined that the Veteran has bilateral hearing loss. (1/11/2012, Medical Treatment Record, p. 2). The probative value of medical opinion evidence is based on the medical expert’s personal examination of the patient, the physician’s knowledge and skill in analyzing the data, and the medical conclusion that the physician reaches. Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). Whether a physician provides a basis for his or her medical opinion goes to the weight or credibility of the evidence in the adjudication of the merits. See Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). Other factors for assessing the probative value of a medical opinion are the physician’s access to the claims folder and the thoroughness and detail of the opinion. See Prejean v. West, 13 Vet. App. 444, 448-9 (2000); Nieves-Rodriguez, 22 Vet. App. 295 (2008); Prejean v. West, 13 Vet. App. 444, 448-9 (2000). Here, the January 2012 private medical opinion was not provided by a state-licensed audiologist and does not include a puretone audiometry test. Generally, an examination for hearing impairment for VA purposes must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test and a puretone audiometry test. See 38 C.F.R. § 4.85(a). As the January 2012 private medical opinion was not provided by a licensed audiologist and no puretone audiometry test was provided, the Board assigns no probative value to the opinion. Thus, the Board places more probative weight on the September 2012 and September 2020 VA examinations. In sum, the Board concludes that the competent medical evidence does not demonstrate that the Veteran’s left ear hearing loss rises to the level of a disability. As such, the Board concludes that service connection for entitlement to left ear hearing loss is not warranted.  38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990).   Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Glenn, 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.