Citation Nr: 21012511 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 14-42 892 DATE: March 4, 2021 ORDER Entitlement to service connection for right ear hearing loss is granted. FINDING OF FACT The Veteran’s right ear hearing loss is etiologically related to service. CONCLUSION OF LAW The criteria for service connection for right ear hearing loss have been met. See 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1963 to June 1967. This matter comes to the Board of Veterans’ Appeals (Board) from an October 2013 rating decision which denied service connection for bilateral hearing loss. In May 2018 and June 2019, the Board remanded for further development. A September 2020 rating decision granted service connection for left ear hearing loss. Entitlement to service connection for right ear hearing loss is granted. Service connection may be granted for a disability resulting from an injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, a veteran must establish: (1) evidence of a current disability; (2) in-service incurrence or aggravation of an injury; and (3) a causal relationship between the current disability and the injury incurred or aggravated during service. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). 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 at 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies at 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. See 38 C.F.R. § 3.385. The law provides, “[E]very Veteran shall be taken to have been in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance, and enrollment, or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service.” 38 U.S.C. § 1111. Where a condition is noted on entrance to service, a Veteran generally is not presumed sound, and a presumption of aggravation analysis is performed. See 38 U.S.C. § 1153. However, in cases where hearing loss is noted on entrance to service, the presumption of soundness attaches where the audiometric results at entrance do not meet the regulatory definition of a hearing loss disability under 38 C.F.R. § 3.385. See McKinney v. McDonald, 28 Vet. App. 15, 29 (2016). Pure tone thresholds, in decibels, are listed for each examination; however, the Board notes that service audiograms were recorded using American Standards Association (ASA) units or International Standards Organization-American National Standards Institute (ISO-ANSI) units during different periods. Prior to January 1, 1967, audiometric results must be converted from ASA to ISO-ANSI units. Between January 1, 1967, and December 31, 1970, and where it is unclear if the results were recorded using ASA or ISO-ANSI units, the Board will consider the audiometric results under both standards, relying on the units most favorable to the Veteran’s appeal. Here, the results of the June 1963 entrance examination must be converted from ASA units to ISO-ANSI units; accordingly, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 0 (15) -10 (0) -10 (0) 0 (10) 30 (35) LEFT 10 (25) -10 (0) -10 (0) -5 (5) 30 (35) The entrance examination noted slight bilateral hearing loss at 4000 Hertz. Here, the results of the February 1967 separation examination must be converted from ASA units to ISO-ANSI units; accordingly, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT -5 (10) -5 (5) -5 (5) 5 (15) 40 (45) LEFT -5 (10) -5 (5) 0 (10) 5 (15) 45 (50) Here, the results of an April 1967 examination must be converted from ASA units to ISO-ANSI units; accordingly, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 0 (15) 5 (15) 0 (10) 5 (15) 35 (40) LEFT 10 (25) 0 (10) 0 (10) 5 (15) 45 (50) The Veteran’s DD 214 identified his military occupational specialty as aerospace ground equipment repairman. A November 2019 VA examination showed the following audiometric results: HERTZ 500 1000 2000 3000 4000 RIGHT 25 20 45 85 80 LEFT 20 15 40 90 95 Speech audiometry revealed speech recognition ability of 92 percent in the right ear. The examiner opined that the Veteran’s right ear hearing loss is less likely than not caused by service because there is no evidence or indication of a shift in hearing thresholds, nor is there aggravation of the preexisting high frequency hearing loss. A December 2020 VA examination showed the following audiometric results: HERTZ 500 1000 2000 3000 4000 RIGHT 25 30 65 85 95 LEFT 25 25 65 100 105 Speech audiometry revealed speech recognition ability of 86 percent in the right ear. The examiner noted the Veteran’s reports of noise exposure from aircraft engines, generators, gas turbines, and weapons firing during service and that noise levels associated with these exposures are known to exceed the safe levels of noise. The examiner opined that the Veteran’s right ear hearing loss is less likely than not caused by service because there is no significant threshold shift when comparing his separation and entrance audiograms. In written pleadings, the Veteran alleges that service connection is warranted for right ear hearing loss due to in-service exposure to noise. The Veteran also questioned the definition of normal progression, suggesting that he experienced worsening hearing loss during and after service. As a preliminary matter, the Board finds that the Veteran was presumed sound at entrance. Although the entrance examination noted slight bilateral hearing loss at 4000 Hertz, the presumption of soundness still attaches because the audiometric results at entrance did not show an auditory threshold of 40 decibels or greater in any of the frequencies at 500, 1000, 2000, 3000, or 4000 Hertz, or an auditory threshold of 26 decibels or greater at three of these frequencies. See McKinney, 28 Vet. App. at 29. Therefore, the Veteran was presumed sound at entrance. Turning to service connection, the Board finds that the Veteran has a current right ear hearing loss disability because the post-service audiometric results show an auditory threshold of 40 decibels or greater at 2000, 3000, and 4000 Hertz; an auditory threshold of 26 decibels or greater at three frequency levels; and speech recognition scores of less than 94 percent. See 38 C.F.R. § 3.385. The Board further finds that the Veteran was exposed to an in-service injury. The Veteran’s DD 214 supports his lay statements that he was exposed to noise during service. Moreover, the December 2020 VA examiner confirmed that noise levels associated with aircraft engines, weapons firing, gas turbines, and generators are known to exceed the safe levels of noise. The Board finally finds a nexus between the Veteran’s current right ear hearing loss disability and an in-service injury. The converted audiometric results at separation and in April 1967 show an auditory threshold of 40 decibels or greater at 4000 Hertz and, therefore, show a hearing loss disability under 38 C.F.R. § 3.385. Moreover, post-service audiometric results show worsening right ear hearing loss and support the Veteran’s lay statements of continued right ear hearing loss after service. This conclusion is consistent with the September 2020 rating decision that granted service connection for worsening left ear hearing loss due to the same in-service injury related to noise exposure. While negative nexus opinions and a negative aggravation opinion were provided by the VA examiners, the Board accords probative weight to the evidence showing worsening right ear hearing loss during and after service due to the in-service injury related to noise exposure. (Continued on the next page.)   Because the preponderance of the evidence supports the Veteran’s claim for service connection, the claim for service connection for right ear hearing loss is granted. K. Parakkal Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Ormson, 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.