Citation Nr: 21011699 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 15-10 815 DATE: March 2, 2021 ORDER Service connection for hearing loss of the right ear is denied. FINDINGS OF FACT 1. The Veteran has a current disability of hearing loss of the right ear. 2. The Veteran was exposed to some loud noise during service from weapons fire in combat and aircraft engines. 3. Symptoms of hearing loss of the right ear were not chronic in service, were not continuous since service, and did not manifest to a compensable degree within one year of service. 4. The hearing loss of the right ear did not have its onset during service and is not otherwise related to active duty service. CONCLUSION OF LAW The criteria for service connection for hearing loss of the right ear have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 1154, 5103, 5013A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the Air Force on active duty during Peacetime and the Vietnam Era from June 1970 to May 1977. Service connection for hearing loss of the right ear is denied. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Hearing loss is a “chronic” disease under 38 C.F.R. § 3.309(a); therefore, the presumptive service connection provisions under 38 C.F.R. § 3.303(b) for service connection based on “chronic” symptoms in service and “continuous” symptoms since service are applicable. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With chronic disease as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally, a showing of continuity of symptoms after service is required for service connection. 38 C.F.R. § 3.303(b). In addition, the law provides that, where a veteran served 90 days or more of active service, and certain chronic diseases such as hearing loss become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. The evidence shows a current disability of hearing loss of the right ear for VA purposes that meets the requirements of 38 C.F.R. § 3.385. A VA examination in October 2020 confirmed a diagnosis of hearing loss of the right ear for VA purposes, and measured puretone threshold in the frequency of 4000 Hz at 40 decibels. The Veteran contends that the current right ear hearing loss is caused by exposure to weapons fire in combat and aircraft engines during service. The Veteran does not report or contend that hearing loss symptoms were chronic in service or continuous after service separation. The Veteran’s military occupational specialty (MOS) during service was security specialist, and the Veteran has described working with canine units defending air force bases in Vietnam. From these service duties and the Veteran’s reports of noise exposure, the evidence shows the Veteran was exposed to some loud noise during service. The weight of the lay and medical evidence shows that right ear hearing loss did not begin in service, symptoms were not chronic in service, hearing loss did not manifest to a compensable degree within one year after service, and symptoms of hearing loss were not continuous after service. The evidence shows no complaints of hearing loss in service and no worsening of hearing loss during service. While the audiological evaluations upon enlistment and separation from service at initial glance appear to show a marked decline in hearing in both ears, closer examination of the types of testing used shows no worsening of hearing during service. As explained in a VA examination from November 2020, the type of test performed at entrance was a Bekesy audiometry test, distinct from the standard puretone threshold test performed at service separation. The VA examiner compared the results on these two different tests and interpreted that hearing thresholds in agreement with each other, such that there was no change in hearing levels during service between the two tests in the right ear (there was a decrease in hearing in the left ear in high frequencies). See November 2020 VA Examination. Consistent with these findings of normal hearing at service separation and no reported right ear hearing loss, the Veteran stated in January 2021 that, at the time of discharge from service, his hearing was good. See January 2021 Veteran’s Statement. The Veteran reported that he had never sought private treatment for his hearing symptoms. VA medical records show that the Veteran did not seek treatment for hearing loss until after he filed a claim for compensation for hearing loss in April 2013. In addition, the Board notes that after service the Veteran did not file a claim for service connection for hearing loss when seeking service connection for other disorders believed to be related to service. The record includes several rating decisions prior to the November 2013 rating decision on appeal that include adjudications for disorders, none of which include claims service connection for hearing loss or include even obliquely references an ear injury or symptoms of hearing loss. The weight of the evidence shows that the current right ear hearing loss is not related to the noise exposure during service. The Veteran received two VA examinations, one in December 2015 and October 2020 (with an addendum in November 2020). The December 2015 examiner opined that there was no nexus between the right ear hearing loss and service. The rationale for the opinion was that the entrance and separation examinations were within normal hearing; that medical literature does not support the contention that variations in puretone thresholds automatically reflect changes in hearing; that minimal pure tone differences when comparing entry and exit hearing tests do not always reflect changes in hearing; ear infections, which the Veteran had during service, can temporarily cause hearing issues; normal hearing at service separation indicates the hearing loss must have had a late onset; and the hearing loss from current examinations barely meets criteria for disability and does not reflect an in-service onset. In the November 2020 addendum to the October 2020 examination, the examiner opined that there was no nexus between the right ear hearing loss and service. The rationale for the opinion was that ear infections will cause a temporary threshold shift in hearing, and, once the infection is resolved, hearing returns to previous levels; that in this case all thresholds are in agreement except for a shift found at 2000 Hz, which is not significant as this is a comparison of two different types of testing methodology, with Bekesy audiometric testing obtained at entrance to the military and standard pure tone testing obtained at discharge; and there is no record of hearing evaluation one year post military service. For the reasons described above, the Board finds that a preponderance of the lay and medical evidence is against the Veteran’s claim for service connection for hearing loss of the right ear under all theories. For these reasons, the appeal must be denied. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. J. PARKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Charles Plambeck 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.