Citation Nr: 21013803 Decision Date: 03/10/21 Archive Date: 03/10/21 DOCKET NO. 15-12 045 DATE: March 10, 2021 ORDER Entitlement to service connection for bilateral hearing loss is denied. FINDING OF FACT The preponderance of the evidence is against finding that bilateral hearing loss began during active service or is otherwise related to an in-service event, injury, or disease. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1976 to October 1980. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously remanded in June 2018 for additional evidentiary development and in January 2020 for an addendum opinion to ascertain the etiology and nature of the Veteran’s claimed bilateral hearing loss. Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran has a current bilateral hearing disability. See September 2019 VA Examination. Thus, the remaining question is whether the current bilateral hearing loss disability is related to service. Service treatment records show no complaints, diagnosis, or treatment related to a hearing loss disability. As the Veteran reported other ailments during service, and hearing problems are the type that a reasonable person would report, if the Veteran was experiencing problems with hearing during service the Board would expect that he would have reported these problems to medical professionals. During the July 1980 separation examination, evaluation of the ears were normal. Hearing examinations taken in July 1976, January 1978, and July1980 were normal. In a corresponding report of medical history, the Veteran specifically denied having had hearing loss. If hearing loss was present during service, the Board would expect the Veteran would have responded “yes” when asked if he had hearing loss at separation because a reasonable person would have interpreted the question to include symptoms of hearing loss. Moreover, the Veteran responded affirmatively when asked whether he had other conditions at separation and the Board would thus expect the Veteran to have also responded affirmatively to having hearing loss. A hearing loss disability is not shown by medical evidence until approximately October 2012, many years after the Veteran’s separation from service. During that October 2012 VA examination, it was noted that the hearing loss exhibited in the examination was not organic and found not to be valid for rating purposes. The reasoning was that the speech recognition thresholds were 20 decibels in each ear and that did not correlate with admitted pure tone thresholds that were no better than 60 decibels in either ear. The examiner also noted that the speech recognition scores of 72 percent in the right ear and 84 percent in the left ear would be impossible at 60 decibels if the results were organic. The Veteran presented for a VA examination in August 2019, at which time he was interviewed by the examiner who also reviewed the pertinent medical history and performed an examination. The examiner opined that the Veteran’s hearing loss disability was less likely than not caused by or a result of an event during military service. In support of this conclusion, the examiner explained that the Veteran’s treatment records, and separation examinations were negative for hearing loss. The addendum opinion issued in February 2020 that the Board requested on remand also supports this conclusion. In support of the opinion, the examiner opines that the examination in October 2012 cited the non-organic hearing loss. The examiner also noted that the shift in 1 Khz from the July 1976 hearing examination and the July 1980 hearing examination was not consistent with noise induced hearing loss. The examiner also opined that the Veteran has several examinations that clearly show non-organic hearing loss that do not allow for the determination as to the etiology in 1980. The examiner also noted that the Veteran retired as a supervisor working in construction and a shipyard and was exposed to occupational noise. The opinion is also supported by other evidence of record. For example, in the June 2013 VA addendum opinion, the examiner noted that even if the Veteran had experienced noise exposure in service, the hearing loss would have been progressive, and would not have reached the levels found upon examination in October 2012. The August 2019 VA examination shows the Veteran’s hearing remarkably improved, averaging 24 Hz in the right ear and 28 Hz in the left ear, while scoring 100 percent in the Maryland CNC speech recognition test in the right ear and 98 percent in the left ear. The August 2019 VA examination only found hearing loss in the Veteran’s left ear. Per the August 2019 VA examination results, there is no compensatory rating for his hearing loss disability. There is a positive nexus opinion for the Veteran’s hearing loss, however the Board does not recognize it as a medical opinion as it was provided by a hearing instrument specialist who does not have the medical expertise to speak to the etiology of the Veteran’s hearing loss. Further, as the February 2020 opinion suggests, the hearing instrument specialist did not have complete access to the Veteran’s medical records and only offered an opinion to the decline from his July 1976 hearing examination to present and deduced this as a high probability that the noise exposure in service led to the Veteran’s hearing loss. In a subsequent opinion in March 2015, the hearing instrument specialist notes that there was a clear decline from the Veteran’s July 1976 and January 1978 examination. As previously noted, the examiners noted that the 1 Khz declination is not enough to be consistent with the hearing loss claimed by the Veteran. The Board has considered the Veteran’s statements, to include his assertions that symptoms began during service when he was serving as an armored tank crewman and was exposed to loud noises. As the Veteran is not shown to have medical education or experience, he is a lay person and is competent to report (1) symptoms that are observable to a layperson, e.g., hearing loss; (2) symptoms at the time supporting a later diagnosis by a medical professional; or (3) a contemporaneous medical diagnosis. See Davidson v. Shinseki, 581 F.3d 1313 (2009). The Veteran is not competent to independently render a medical diagnosis or opine as to the specific etiology of a condition as these are medically complex issues. Thus, his lay assertions do not constitute evidence upon which service connection can be granted. In any event, the Board ultimately assigns greater probative weight to the medical evidence of record, to include the opinion rendered by a trained medical professional based on appropriate diagnostic testing and reasonably drawn conclusions with supportive rationale. To the extent the Veteran asserts a continuity of symptomatology beginning during service, the Board finds these statements to lack credibility as they are in direct conflict with the Veteran’s report of medical history at separation from service where he denied hearing loss. The Board finds the report of medical history at separation from service to be more reliable than more recent assertions as it was done contemporaneous to service and for the purpose of identifying disability at that time. (Continued on the next page)   For the above reasons, the preponderance of the evidence is against the claim and service connection is denied. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Jarman, 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.