Citation Nr: 21015405 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 17-28 413 DATE: March 17, 2021 ORDER Service connection for bilateral hearing loss is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his bilateral hearing loss is at least as likely as not related to service. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from February 1961 to January 1965. In March 2018, the Board denied service connection for bilateral hearing loss. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims. Pursuant to a joint motion for remand, in an April 2020 Order, the Court remanded that Board decision for readjudication in accordance with the joint motion. In August 2020, the Board remanded the appeal for further development. Service Connection—Bilateral Hearing Loss Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection requires competent evidence of (1) a current disability; (2) the incurrence or aggravation of a disease or injury during service; and (3) a causal relationship between the current disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). 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). Where a veteran served for 90 days or more of active service, service incurrence is presumed for certain chronic diseases, including sensorineural hearing loss, if the disease manifested to a compensable degree within one year after separation from active service. While the disease does not need to 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 presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. Impaired hearing is considered a disability for VA purposes when the auditory threshold in any of the frequencies of 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; the thresholds for at least three of these frequencies are 26 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 (1993). In the current appeal, the Veteran asserts that his bilateral hearing loss is due to in service noise exposure while delivering orders to the flight line and serving as a weapons qualifications instructor on the shooting range. He has indicated that he first noticed hearing loss shortly after separation from service. The Veteran’s service treatment records do not show any complaints, findings, or diagnoses of hearing loss. However, a January 1963 hearing conservation data sheet reflects the Veteran’s report that he performs office work but is sometimes exposed to B-52s. An April 2016 letter from a private hearing center reflects that a January 2016 audiological evaluation revealed that the Veteran had bilateral hearing loss. The report also indicates that the Veteran’s in-service noise exposure was sufficient enough to have led to hearing loss per OSHA standards. In a November 2017 letter, a private hearing instrument specialist concluded that the Veteran’s hearing loss could be due to in-service exposure to loud noises. A November 2017 private audiological evaluation report reflects the Veteran’s history of gradual bilateral hearing loss especially noticed after his service in the Air Force where he was exposed to the noise of jets and missiles, which brought about his now service-connected tinnitus. In a June 2020 letter, a private physician noted the Veteran’s history of repeated hazardous noise exposure in service and opined that it is at least as likely as not that his hearing loss is related to that exposure. In a December 2020 examination report, a VA examiner confirmed that the Veteran has bilateral hearing loss but opined that it is not due to in-service noise exposure. The examiner cited a 2006 Institute of Medicine (IOM) report that found that the most profound auditory effects of noise exposure occur immediately following the exposure. The examiner observed that this suggests that, if hearing loss were due to in-service noise exposure, then there would be hearing loss or a threshold shift during service and/or be present at separation. The examiner then concluded that the Veteran’s bilateral hearing loss is not due to in-service noise exposure as there is no evidence of hearing loss or a threshold shift during service or at separation. The Board acknowledges that, indeed, there is no objective evidence of hearing loss in service or for over 50 years thereafter. Citing to an IOM report, a VA examiner has opined that the Veteran’s hearing loss is not related to in-service noise exposure. However, the Veteran has indicated that he has had progressive hearing loss since his separation from service. As a lay person, he is competent to give evidence about observable symptoms such as diminished hearing. Layno v. Brown, 6 Vet. App. 465 (1994). His service treatment records document in-service noise exposure from B-52s. Further, service connection already is in effect for tinnitus due to in-service noise exposure, and, as such, in-service acoustic trauma has been conceded. Moreover, a private hearing care practitioner and a private physician have both opined that the Veteran’s hearing loss is related to in-service noise exposure. Lastly, the April 2016 letter from the private hearing center indicates that his in-service noise exposure was sufficient enough to have led to his hearing loss per OSHA standards. In light of the above, and resolving reasonable doubt in the Veteran’s favor, the Board finds that his bilateral hearing loss is at least as likely as not related to his service. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Thus, service connection for bilateral hearing loss is warranted. THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. W. Kim, 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.