Citation Nr: 21012301 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 15-44 619 DATE: March 4, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. FINDING OF FACT The competent medical evidence shows that it is at least as likely as not that the Veteran’s bilateral hearing loss was incurred in or caused by service. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from August 1968 to August 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in August 2018. At that time, the Board issued a remand for further development. This matter has now come back before the Board for final adjudication. Service connection may be granted for a disability resulting from disease or injury incurred or aggravated during active service. 38 U.S.C. §§ 1110, 1131. Generally, service connection requires (1) the existence of a present disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a causal relationship (nexus) between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Applicable regulations provide that impaired hearing shall be considered a disability when the auditory thresholds in any of the frequencies of 500, 1000, 2000, 3000, and 4000 hertz are 40 decibels or greater; the thresholds for at least three of these frequencies are 26 decibels or greater; or when speech recognition scores are 94 percent or less. 38 C.F.R. § 3.385 does not preclude service connection for a current hearing loss disability where the Veteran’s hearing was within normal limits on audiometric testing at separation from service. Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Rather, when audiometric test results at a veteran’s separation from service do not meet the requirements of 38 C.F.R. § 3.385, a veteran may nevertheless establish service connection for current hearing disability by submitting medical evidence that the current disability is causally related to service. Hensley v. Brown, 5 Vet. App. 155 (1993). VA shall consider all information and lay and medical evidence of record in a case, and, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Veteran contends that he has bilateral hearing loss related to in-service noise exposure and, therefore, should be service connected. The Board acknowledges that the Veteran has a current diagnosis of bilateral hearing loss. See October 2020 Hearing Loss and Tinnitus Disability Benefits Questionnaire (DBQ). In an October 2015 rating decision, the RO granted service connection for tinnitus. Here, the RO conceded that the Veteran’s military occupational specialty (MOS), bomb navigation system mechanic with additional duties of flight line mechanic, had a high probability of military noise exposure. The Board agrees with this finding and finds noise exposure is conceded. Lastly, the Board must determine whether there is a nexus between the Veteran bilateral hearing loss and conceded in-service noise exposure. The Veteran’s service treatment records (STRs) show that his July 1968 enlistment examination had the following audiological ASA findings, converted to ISO here: HERTZ 500 1000 2000 4000 RIGHT 15 5 15 10 LEFT 20 5 10 0 The Board notes that this evaluation did not establish any hearing loss, and the Veteran is presumed to be sound in terms of hearing at entry into service. 38 U.S.C. § 1111. The Veteran’s STRs show that the Veteran’s June 1972 separation examination had the following audiological (ISO) findings: HERTZ 500 1000 2000 3000 4000 RIGHT 20 15 10 20 20 LEFT 20 15 10 10 10 These results, compared with the entrance examination findings, are indicative of a high frequency threshold shift during service. In addition, the October 2020 VA examiner noted that there was a permanent threshold shift during service. See October 2020 VA Hearing Loss and Tinnitus DBQ. Furthermore, the October 2020 VA examiner opined that the Veteran’s hearing loss was at least as likely as not a caused by or a result of his military service. The VA examiner found that even though the Veteran’s entrance and separation examinations showed hearing within normal limits, his hearing loss was a result of his military service based in significant permanent threshold shift in service. The Board notes there are negative medical opinions of record. In a December 2019 VA examination, the examiner opined that it was less likely than not that the Veteran’s bilateral hearing loss was caused by or a result of his military service because there was no significant permanent shift in his hearing thresholds. See December 2019 VA Hearing Loss and Tinnitus DBQ. Then, in a December 2019 VA medical opinion, the VA examiner opined that it was less likely than not that his bilateral hearing loss was incurred in or caused by his in-service ear infections as there was no apparent residual impacts on his hearing during service. See December 2019 VA Medical Opinion DBQ. The Board finds that the negative medical opinions fail to address the threshold shift during service. A comparison between the two in-service hearing evaluations does indicate a threshold shift. Giving more weight to the 2020 opinion, the Board finds that service connection for bilateral hearing loss is warranted, and the appeal is granted. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Glaeser, 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.