Citation Nr: 21011165 Decision Date: 03/01/21 Archive Date: 03/01/21 DOCKET NO. 17-38 728 DATE: March 1, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. FINDING OF FACT The Veteran’s bilateral hearing loss is due to in-service exposure to noise. CONCLUSION OF LAW The criteria for entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1966 to July 1970. This matter comes before the Board on appeal from an April 2015 Regional Office (RO) rating decision. In October 2020, the Veteran testified at a hearing before the undersigned Veterans Law Judge. 1. Entitlement to service connection for bilateral hearing loss is granted. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, an appellant 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, or nexus, between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection for impaired hearing shall only be established when hearing status as determined by audiometric testing meets specified puretone and speech recognition criteria. Audiometric testing measures threshold hearing levels (in decibels) over a range of frequencies (in Hertz). Hensley v. Brown, 5 Vet. App. 155, 158 (1993). 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. The threshold for normal hearing is from 0 to 20 decibels, and higher threshold levels indicate some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 160 (1993). The laws and regulations do not require in service complaints of or treatment for hearing loss in order to establish service connection. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Instead, as noted by the United States Court of Appeals for Veterans Claims (Court): [W]here the regulatory threshold requirements for hearing disability are not met until several years after separation from service, the record must include evidence of exposure to disease or injury in service that would adversely affect the auditory system and post- service test results meeting the criteria of 38 C.F.R. § 3.385. For example, if the record shows (a) acoustic trauma due to significant noise exposure in service and audiometric test results reflecting an upward shift in tested thresholds in service, though still not meeting the requirements for disability under 38 C.F.R. § 3.385, and (b) post-service audiometric testing produces findings meeting the requirements of 38 C.F.R. § 3.385, rating authorities must consider whether there is a medically sound basis to attribute the post-service findings to the injury in service, or whether they are more properly attributable to intercurrent causes. Hensley v. Brown, 5 Vet. App. 155, 159 (1993) (quoting from a brief of the VA Secretary). The Veteran contends that his current bilateral hearing loss is due to in-service noise exposure. He has identified multiple sources of such exposure at his Board hearing. The Veteran has also described this noise exposure in personal statements dated in April 2015, April 2016, and July 2017. First, he has identified noise exposure as coming from his duties as a telephone equipment installer repairman. (See Board hearing transcript, page 3.) Second, he has noted acoustic trauma from his work drilling through concrete, and nearby work with jackhammers, while rewiring an old hospital. (See Board hearing transcript, pages 3-4.) Third, he has noted that his duties briefly placed him on the flight line. (See Board hearing transcript, page 4.) Fourth, he has described selection for an eight-week assignment running a rifle range for a Boy Scout Camp. (See Board hearing transcript, page 4.) He reported that he did not have hearing protection. He also testified that he went back to school immediately following his separation from service and had to sit in the front row of the classroom so that he could hear. (See Board hearing transcript, page 4.) He also testified that none of his post-service employment involved exposure to loud noise without hearing protection. (See Board hearing transcript, page 5.) The Veteran’s DD Form 214 reflects that his military occupational specialty (MOS) was “Tel Equip Instlr-Rpmn.” He has submitted a brochure for the Boy Scout Camp at which he worked, and this assignment as a Rifle Instructor for the Boy Scout Camp is noted in a performance evaluation. The Board therefore finds that the Veteran’s description of his in-service noise exposure is credible and consistent with his circumstances of service. With respect to a current disability, an April 2015 VA examination report reflects that the Veteran has bilateral hearing loss that conforms to the requirements of 38 C.F.R. § 3.385.) With respect to in-service disability, the audiogram from the July 1966 enlistment examination report reads as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 0 0 -10 X 0 LEFT 5 0 -5 X 0 The audiogram from the May 1970 separation examination report reads as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 5 5 0 5 0 LEFT 10 5 0 0 0 He denied a history of, or current, ear trouble on his July 1966 enlistment medical history report. He denied a history of, or current, hearing loss or ear trouble on his May 1970 separation medical history report. (The July 1966 enlistment medical history report does not ask whether the applicant has a history of, or current, hearing loss.) Otherwise, the service treatment records reflect that the Veteran neither complained of nor was treated for any symptoms that have been associated with hearing loss. The Board notes that, historically, it was assumed that, on November 1, 1967, Service Departments changed from using American Standards Association (ASA) standards, to using International Standards Organization - American National Standards Institute (ISO-ANSI) standards when providing audiograms. Now, however, for Service Department audiograms that were conducted between January 1, 1967, and December 31, 1970, VA is to consider the data under both ASA and ISO-ANSI standards and apply the standard that is most favorable to the veteran. For service audiological evaluations conducted after December 31, 1970, VA protocol is to presume the ISO-ANSI standard was used. In the case at hand, it is more favorable to the Veteran to convert the May 1970 separation audiogram findings from ASA to ISO-ANSI standards, as this conversion would presume an in-service hearing threshold shift between his enlistment and his separation. In order to convert examinations that are recorded in ASA standards to ISO-ANSI standards, the following numbers are added to the ASA standard data: HERTZ 500 1000 2000 3000 4000 15 10 10 10 5   Thus, converting the Veteran’s May 1970 audiogram results from ASA to ISO-ANSI standards would yield the following audiogram readings: HERTZ 500 1000 2000 3000 4000 RIGHT 20 15 10 15 5 LEFT 25 15 10 10 5 A positive etiology opinion dated in February 2017 notes that the Veteran was exposed to significant noise in service and that it is more likely than not that his hearing loss is due to his military service. In light of the Veteran’s credible testimony regarding in-service noise exposure and that he went back to school immediately following his separation from service and had to sit in the front row of the classroom so that he could hear, in-service significant threshold shifts of 15 to 20 decibels, the lack of audiometric data at 3000 Hertz upon enlistment, and an etiology opinion linking the Veteran’s current hearing loss to his military service as well as the fact that service connection is in effect for tinnitus, the Board resolves reasonable doubt in favor of the Veteran and finds that service connection for bilateral hearing loss is warranted. (continued on next page) TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Elizabeth Jalley, 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.