Citation Nr: 21021668 Decision Date: 04/13/21 Archive Date: 04/13/21 DOCKET NO. 16-49 572 DATE: April 13, 2021 ORDER Entitlement to 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 in-service noise exposure. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss are met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from May 1974 to May 1976. This claim was remanded in December 2018 and August 2020. 1. Entitlement to service connection for bilateral hearing loss Under the relevant laws and regulations, 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. Generally, the evidence must show: (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. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) (noting that nexus may be demonstrated by a showing of continuity of symptomatology where the disability claimed qualifies as a chronic disease listed in 38 C.F.R. § 3.309(a)). For the purpose of applying the laws administered by the VA, 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. With regard to a present disability, audiometric results from an August 2015 VA audiological examination showed auditory thresholds of 26dB or greater at 2000Hz, 3000Hz, and 4000Hz bilaterally. VA Hearing Loss and Tinnitus examination, August 2015. This meets the definition of hearing loss for VA purposes. 38 C.F.R. § 3.385. The first element of Shedden/Caluza is met. With regard to an in-service event, the Veteran’s DD-214 shows a military occupational specialty of Vulcan crewman and his personnel records show additional duty as a gunner. Both of these positions suggest loud noise exposure. Further, he has already been granted service connection for tinnitus based on in-service noise exposure. As such, in-service noise exposure can be conceded and the second element of Shedden/Caluza is also met. The remaining question is whether there is a medical nexus between the Veteran’s in-service noise exposure and his current bilateral hearing loss. The Board determined in its prior remands that the August 2015 and June 2019 VA opinions were not adequate to decide the Veteran’s hearing loss claim. Subsequent to the Board’s most recent remand, a new opinion was obtained in September 2020. The examiner provided a positive nexus opinion for tinnitus, relying on the Veteran’s notation of ear, nose, and throat (ENT) problems on his separation report of medical history and the lay statements attesting to his complaints of ringing in the ears shortly after discharge. However, the examiner did not provide a medical nexus for hearing loss because his hearing was normal at separation with no significant threshold shifts. However, she failed to address whether the Veteran’s complaints of tinnitus at discharge could constitute evidence of some amount of hearing loss, notwithstanding the lack of hearing loss for VA purposes at separation. This is particularly important as the August 2015 VA examiner opined that the Veteran’s hearing loss and tinnitus were associated. The Board notes that the hearing loss claim could be remanded for a new VA opinion that addresses whether the Veteran’s reports of tinnitus and ENT problems at separation could support his claim. However, in light of the complaints of tinnitus since service, grant of service connection for tinnitus based on in-service noise exposure, August 2015 VA opinion linking hearing loss and tinnitus, and limited probative value of the September 2020 opinion, the Board finds that the evidence is, at minimum, in equipoise regarding the question of whether the Veteran’s current bilateral hearing loss disability is related to his military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. The benefit-of-the-doubt will be conferred in the Veteran’s favor and remand is not necessary. The claim for service connection for bilateral hearing loss is granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). [CONTINUED ON THE NEXT PAGE] YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Moore, 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.