Citation Nr: 21021100 Decision Date: 04/09/21 Archive Date: 04/09/21 DOCKET NO. 19-22 260 DATE: April 9, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. FINDING OF FACT The Veteran’s hearing loss had its onset during his active service. CONCLUSION OF LAW The criteria for entitlement to 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 with the United States Army National Guard from September 1965 to April 1967 and with the United States Army from April 1967 to August 1967. In April 2021, the Veteran testified before the undersigned Veterans Law Judge (VLJ) at a Board of Veterans’ Appeals (Board) videoconference hearing. A transcript of the hearing will be associated with the record. Entitlement to service connection for bilateral hearing loss is granted. Direct service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 C.F.R. § 3.303(a). Direct service connection generally requires credible and competent evidence showing: (1) the existence of a present disability; (2) 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, otherwise known as the “nexus” requirement. Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). The Veteran seeks service connection for bilateral hearing loss. For the following reasons, the Board finds that service connection is warranted. Regarding the first element of service connection, the existence of a present disability, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz (Hz) is 40 decibels (dB) or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000 or 4000 Hz are 26 dB or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. A July 2018 report reveals that the Veteran was diagnosed with bilateral sensorineural hearing loss. The Veteran’s Maryland CNC Word List speech recognition score and pure tone thresholds, in decibels, were as follows: July 2018 HERTZ 500 1000 2000 3000 4000 6000 8000 AVG CNC RIGHT 15 15 30 40 40 65 70 31 92% LEFT 20 15 20 35 45 50 55 29 96% The pure tone threshold results revealed a measurement of 40 decibels at 3000 in the right ear and 4000 hertz, and 45 decibels at 4000 hertz in the left ear. His word recognition score using the Maryland CNC test was 92 percent in right ear and 96 percent in the left ear. The Veteran’s bilateral hearing loss does meet the criteria to be considered a disability for VA purposes. 38 C.F.R. § 3.385 (2020). Thus, the first element of service connection is satisfied. Holton, 557 F.3d at 1366. Regarding the second element of service connection, the Veteran contends he was exposed to loud noise in service while working on and around equipment and artillery as a combat engineer. See November 2018 Medical Treatment Record p. 1. The Veteran’s DD-214 confirm his MOS duties as a combat engineer while serving with the United States Army. See DD-214 Form. Notably, the VA regional office conceded that the Veteran’s military occupation had a high probability of noise exposure. See July 2019 Statement of the Case at 23. Given the Veteran’s noise exposure in service, the Board finds that the second element of service connection is satisfied. Holton, 557 F.3d at 1366. Regarding nexus, the evidence conflicts. However, in this case, the Board finds that the positive and negative evidence of record is evenly balanced as to whether the Veteran’s current bilateral hearing loss is related to active service. The Veteran was afforded a VA examination in July 2018. The examiner concluded the Veteran’s hearing loss was not at least as likely as not caused by or a result of an event in military service. The examiner reasoned that there was no evidence of permanent auditory damage on active duty and no report of decreased hearing in the claims file or at separation. See July 2018 VA examination. In contrast, the Veteran submitted a private nexus opinion from Auburn University’s Speech and Hearing Clinic in November 2018. The examiner concluded the Veteran’s hearing loss was more likely than not made worse by his military service-based noise exposure. She reasoned that his primary history of exposure to excessively loud noise occurred while he served in the National Guard. See November 2018 Medical Treatment Record p. 4. Moreover, the lay evidence supports the favorable nexus opinion. Both the Veteran and his wife provided credible testimony during the April 2021 Board hearing that the Veteran’s symptoms have been present, continuing, and worsening since service. Notably, the Veteran testified that he could not remember a time since service that he has not had a hearing problem. Additionally, the Veteran’s wife testified that she remembered the Veteran’s hearing loss being present for at least 30 years or longer. Accordingly, the Board finds that the evidence of record is in equipoise with respect to the issue of nexus. As all three elements of service connection have been met, service connection for bilateral hearing loss will be granted. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Emily A. Kotroco 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.