Citation Nr: 21009282 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 16-13 902 DATE: February 22, 2021 ORDER Entitlement to service connection for left ear hearing loss is granted. FINDINGS OF FACT 1. The record evidence shows that the Veteran served as an aircraft maintenance mechanic during active service; thus, his in-service exposure to significant noise is presumed. 2. The record evidence is in relative equipoise as to whether the Veteran’s current left ear hearing loss is related to active service. CONCLUSION OF LAW The criteria for entitlement to service connection for left ear 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 March 1971 to March 1975. A videoconference Board hearing was held in January 2019 before the undersigned Veterans Law Judge and a copy of the hearing transcript has been added to the record. In January 2019, the Board remanded the currently appealed claim to the Agency of Original Jurisdiction (AOJ) for additional development. A review of the claims file shows that there has been substantial compliance with the Board’s remand directives. The Board directed the AOJ to schedule the Veteran for an examination to determine the nature and etiology of his hearing loss. This examination occurred in October 2020. See Stegall v. West, 11 Vet. App. 268 (1998); see also Dyment v. West, 13 Vet. App. 141 (1999) (holding that another remand is not required under Stegall where the Board’s remand instructions were substantially complied with), aff’d, Dyment v. Principi, 287 F.3d 1377 (2002). The Board notes that the AOJ granted service connection for right ear hearing loss, assigning a zero percent rating effective December 21, 2012. Thus, the Board finds that the issue on appeal should be characterized as stated above. 1. Entitlement to service connection for left ear hearing loss The Board finds that the evidence is in relative equipoise as to whether the Veteran’s current left ear hearing loss is related to active service. In other words, there is evidence which both supports and goes against the claim. The Veteran essentially contends that in-service exposure to significant acoustic trauma while serving as a U.S. Marine Corps aircraft maintenance mechanic caused or contributed to his current left ear hearing loss. His DD Form 214 shows that his military occupational specialty (MOS) was maintenance mechanic. VA already has conceded that the Veteran likely was exposed to significant acoustic trauma as a result of his in-service duties as an aircraft maintenance mechanic. Thus, the Veteran’s in-service exposure to significant acoustic trauma is presumed. The medical evidence shows that the Veteran currently experiences left ear hearing loss. The Board notes initially that, because of discrepancies in audiometric testing results obtained on VA hearing loss and tinnitus Disability Benefits Questionnaire (DBQ) in March 2013 and a private audiogram completed in September 2013, this evidence was not used in adjudicating the currently appealed claim. The Board also notes initially that, because it previously found that a private audiology evaluation in March 2016 is insufficient for VA adjudication purposes in the July 2019 remand, this evidence also was not used in adjudicating the currently appealed claim. On VA hearing loss and tinnitus DBQ in October 2020, the Veteran complained that he had to ask people to repeat themselves and conversations were difficult in situations with background noise. His pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 30 40 40 45 45 LEFT 30 35 45 50 50 Speech audiometry revealed speech recognition ability of 44 percent in the right ear and 80 percent in the left ear. The VA examiner opined that it was less likely than not that the Veteran’s left ear hearing loss is related to active service. The rationale for this opinion was based on the review of the Veteran’s claims file. The rationale also was that, because there was no significant threshold shift in the Veteran’s left ear hearing between his enlistment and separation physical examinations, any current left ear hearing loss occurred after active service. The diagnoses included sensorineural hearing loss in the left ear. In an undated letter date-stamped as received electronically by VA in January 2021, D. H. C., M.D., F.A.C.S., opined that it was at least as likely as not that the Veteran’s current left ear hearing loss is related to active service. The rationale for this opinion was based on a review of certain of the Veteran’s medical records. The rationale for this opinion also was based on a review of relevant medical literature which “suggest[s] that acoustic and impulse trauma (both single and prolonged exposures) cause damage to the hearing system even with a ‘normal’ behavioral audiogram.” Dr. D. H. C. also stated: It is reasonable to assume that, given the intensity and duration of noise exposure experienced by [the Veteran] that the seeds of hearing loss in both ears were planted during his active duty, despite a normal left audiogram at the time. (Emphasis in original.) Dr. D. H. C. then opined: [A]t least some of [the Veteran’s] current hearing loss is due to noise exposure during his service in the military. I do believe it is very reasonable to assume his exposure to explosions/artillery and complaints of continued ringing and hearing loss that began shortly after his service caused at least some degree (admittedly difficult to quantify) of hearing loss. Dr. D. H. C. stated that the Veteran reported an in-service history of exposure to significant acoustic trauma from ordnance and aviation sources. The Veteran also complained to Dr. D. H. C. of constant severe hearing loss, difficulty with conversation, especially with background noise or in groups, and difficulty with his hearing since active service. The Veteran essentially contends that his current left ear 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 left ear 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 October 2020 VA examiner opined that it was less likely than not that the Veteran’s current left ear hearing loss is related to active service. On the other hand, Dr. D. H. C. opined in a letter received by VA in January 2021 that it was at least as likely as not that the Veteran’s current left ear hearing loss is related to active service. 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”). The Board notes in this regard that service connection currently is in effect for tinnitus and for right ear hearing loss, each as a result of the same in-service exposure to significant acoustic trauma and post-service medical evidence. This suggests that the Veteran’s left ear hearing loss also is related to the same in-service experiences and post-service medical evidence (as Dr. D. H. C. essentially concluded in January 2021). In summary, and after resolving any reasonable doubt in the Veteran’s favor, the Board finds that service connection for left ear 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.