Citation Nr: 21021124 Decision Date: 04/09/21 Archive Date: 04/09/21 DOCKET NO. 15-13 367 DATE: April 9, 2021 ORDER Entitlement to service connection for right ear hearing loss is granted. FINDING OF FACT The Veteran’s right ear hearing loss is related to his in-service acoustic trauma. CONCLUSION OF LAW The criteria for entitlement to service connection for right ear hearing loss are met. 38 U.S.C. §§ 1101, 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.309 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1965 to July 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2012 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran originally claimed entitlement to bilateral hearing loss. In December 2020, the RO issued a rating decision granting service connection for right ear hearing loss only. Therefore, the issue has been recharacterized as a claim for entitlement to service connection for left ear hearing loss. This matter was remanded in August 2018 and June 2020 for further development and is now back before the Board for adjudication. Entitlement to service connection for right ear hearing loss is granted. The Veteran claims to be entitled to service connection for right ear hearing loss. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303.  The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).  Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). The Veteran has a current diagnosis of right ear hearing loss as evidenced by October 2020, September 2019, and August 2011 VA examinations as well as recent VA treatment records. Hearing loss is and organic disease of the nervous system, which is an enumerated condition under 38 C.F.R. § 3.309(a); Walker, 708 F.3d 1331. The Veteran has attended three VA examinations for his hearing loss disability. In an August 2011 VA examination, a nexus opinion was not provided for the Veteran’s hearing loss and is therefore not probative as to the issue of whether there is a nexus between the Veteran’s right ear hearing loss and his service. The September 2019 VA examiner opined that it was not possible to determine the etiology of the Veteran’s hearing loss without resorting to mere speculation. The question for the Board is whether the Veteran’s right ear hearing loss either began during service or is otherwise related to his service. The Veteran’s DD-214 indicates that the Veteran served as an aircraft maintenance crewman and had service in the Republic of Vietnam. The Veteran also reported to multiple VA examiners that he served in combat and was exposed to hazardous noise such as gun fire, howitzer noise, and rocket noise without wearing hearing protection. Thus, the Board concedes that the Veteran was exposed to acoustic trauma during service. As discussed above, the October 2011 and September 2019 VA medical opinions are not probative as to whether a nexus exists between the Veteran’s right ear hearing loss and his service. In the October 2020 VA examination, the examiner noted that the Veteran’s separation examination did not contain audiometric testing. However, audiometric testing was conducted at his September 1965 entrance examination as well as in September 1966. In the 1960s, the military changed its standard of measuring hearing acuity, replacing the American Standards Association (ASA) units with the current International Standards Organization (ISO) units. Prior to January 1, 1967, service departments are assumed to have used ASA units. Service departments are assumed to have changed to ISO units after December 31, 1970. The October 2020 VA examiner converted the in-service audiometric data to ISO units and opined that, although the in-service audiometric testing was incomplete, it was at least as likely as not that there was a permanent positive threshold shift greater than normal measurement variability in the Veteran’s left ear based upon a 15 decibel difference at the 2000 Hertz frequency between the September 1965 and September 1966 audiograms. The examiner opined that, although there was no way of knowing whether the significant threshold shift was permanent or temporary in nature, the Veteran’s exposure to hazardous noise during service and report of exposure to hazardous noise without wearing hearing protection supported the opinion that the Veteran’s left ear hearing loss was related to his in-service noise exposure. However, the VA examiner found that determination of whether the Veteran experienced a significant threshold shift in his right ear during service was not possible because there is no audiometric testing from the Veteran’s separation examination available for review. The October 2020 VA examiner further opined that “there was no evidence of acoustic trauma to the right ear.” Importantly, the October 2020 VA examiner did not define what he considered to be a significant threshold shift. However, the September 1966 audiometric testing indicates a 10-decibel difference at the 1000 and 2000 Hertz frequencies in the right ear from the September 1965 audiogram. The VA examiner also did not explain how he concluded that there was evidence of acoustic trauma in the left ear but not in the right ear, especially since acoustic trauma during service has been conceded in this case. Given the inconsistent opinions of the Veteran’s hearing loss in the right ear and left ear, and in particular the lack of explanation of why the Veteran opined that there was “no evidence of acoustic trauma to the right ear” particularly given the Veteran’s occupation and reported noise exposure without wearing hearing protection, the Board will resolve all doubt in favor of the Veteran and find that the Veteran experienced acoustic trauma in his right ear during service, and that a significant threshold shift occurred during service in the Veteran’s right ear. (Continued on the next page)   The Board finds the evidence to at least be in equipoise as to whether the Veteran’s current right ear hearing loss is related to his in-service acoustic trauma. After resolving all doubt in favor of the Veteran, the Board finds that service connection for right ear hearing loss is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. J. B. FREEMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Boal, 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.