Citation Nr: 21022943 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 19-37 094 DATE: April 19, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. Entitlement to service connection for tinnitus is granted. FINDINGS OF FACT 1. Resolving all doubt in the Veteran’s favor, bilateral hearing loss is causally related to conceded noise exposure during active service. 2. Resolving all doubt in the Veteran’s favor, bilateral tinnitus is causally related to conceded noise exposure during active service as well as secondary to bilateral hearing loss. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5103A, 5107 (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.385 (2020). 2. The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. § 1110 (2012); 38 C.F.R. § 3.303, 3.310 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from September 1966 to September 1968. These matters come before the Board of Veterans’ Appeals (Board) on appeal from rating decisions rendered in November 2016, March 2017, July 2017, and October 2017. In February 2021, the Veteran testified at a Board videoconference hearing before the undersigned at the AOJ. A transcript is associated with the record. 1. Entitlement to service connection for bilateral hearing loss 2. Entitlement to service connection for tinnitus The Veteran has asserted that his claimed bilateral hearing loss and bilateral tinnitus was causally related to noise exposure during active service, including his in-service duties as a fuel and electrical systems repairman. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110 (2012); 38 C.F.R. § 3.303 (2020). Service connection may be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection may be established under the provisions of 38 C.F.R. § 3.303(b) when the evidence, regardless of its date, shows that a veteran had a chronic condition in service or during the applicable presumptive period. For certain chronic disorders, such as other organic diseases of the nervous system (including sensorineural hearing loss), service connection may be granted if the disease becomes manifest to a compensable degree within one year following separation from service. 38 U.S.C. §§ 1101, 1112, 1113 (2012); 38 C.F.R. §§ 3.307, 3.309 (2020). In addition, service connection on the basis of continuity of symptomatology can only be established for the chronic diseases as specified at 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385 (2020). A disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. 38 C.F.R. § 3.310(a) (2020). Here, the Veteran’s in-service duties as a fuel and electrical systems repairman have been conceded to have exposed him to in-service hazardous noise. The record also includes present findings of bilateral hearing loss under 38 C.F.R. § 3.385 and bilateral tinnitus during the appeal period. Service treatment records do not show any complaints or findings of bilateral hearing loss or tinnitus. However, a May 1968 service separation examination report reflected questionable audiogram findings containing only zeroes with horizontal slashes. The Ø symbol is shown to be a medical abbreviation for no or without. See www.abbreviations.com/Ø The Veteran has also specifically asserted that he did not receive any audiological testing at separation as well as any form of hearing protection during service. The Board finds the Veteran’s assertions credible and further notes the Veteran’s post-service lack of occupational noise exposure as a nurse with use of hearing protection during hobbies like bow hunting and target shooting. In the November 2016 VA examination report, the examiner opined that bilateral hearing loss was not at least as likely as not (50 percent probability or greater) caused by or a result of an event in military service. In the cited rationale, the examiner noted that exposure to hazardous noise was conceded. It was further noted that the May 1968 service exit examination showed thresholds well within normal limits in both ears without any discussion of the Veteran’s assertions that he was not given audiological testing at that time. Based on the finding of normal hearing at exit as well as the first report of hearing loss being nearly 30 years post-service, the examiner concluded that the current bilateral hearing loss was less likely than not due to in-service noise exposure. The examiner also opined that the Veteran’s current tinnitus was less likely than not due to military noise exposure due to the significant association between tinnitus, noise exposure and hearing loss. In contrast, private medical statements dated in June 2017 and January 2021 highlighted the Veteran’s lack of use of hearing protection in service while exposed to hazardous noise and lack of post-service occupational noise exposure as a nurse. In the January 2021 medical opinion, a private audiologist specifically opined that if there was no separation audiogram (which the Veteran has credibly asserted), the Veteran’s hearing loss was at least as likely as not (50 percent probability or greater) a result of noise exposure while on active duty. In view of the totality of the evidence, including the divergent but equally probative findings in the November 2016 VA examination report and January 2021 private medical opinion, the Board finds that the Veteran’s bilateral hearing loss and bilateral tinnitus cannot be reasonably disassociated from events during his military service, specifically conceded in-service noise exposure. In addition, tinnitus was found to be associated with bilateral hearing loss. Based on the foregoing, the Board finds that the evidence is at least in equipoise and, therefore, applying the benefit-of-the-doubt doctrine, service connection for bilateral hearing loss and bilateral tinnitus is warranted. 38 U.S.C. § 5107(b) (2012); 38 C.F.R. § 3.102 (2020); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. D. Deane, 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.