Citation Nr: 21022984 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 15-44 856 DATE: April 19, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted, subject to the laws that govern the payment of monetary benefits. FINDING OF FACT Resolving all doubt in the Veteran’s favor, the Board finds that the currently diagnosed bilateral hearing loss was incurred during the Veteran’s service. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss are met. 38 U.S.C. §§ 1110, 5103, 5103(a), 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1969 to December 1971, with service in the Republic of Vietnam. His decorations include the Combat Action Ribbon. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran was originally scheduled for a hearing before a member of the Board in March 2019. However, in a February 2019 signed correspondence, the Veteran indicated that he no longer desired a hearing. As such, the Board has determined that the initial hearing request has been successfully and knowingly waived and adjudication shall proceed accordingly. Under the laws administered by VA, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110 (2012); 38 C.F.R. § 3.303 (a). Service connection may also be granted for any disease diagnosed after discharge from service when all the evidence, including that pertinent to service, establishes that the disease was incurred during service. 38 C.F.R. § 3.303 (d). 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. 38 C.F.R. § 3.303 (a); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). The Veteran contends that his currently diagnosed bilateral hearing loss is the result of his military service. In particular, the Veteran has provided that he was exposed to loud gunfire and explosions during combat service in Vietnam. In this regard, it is noted that the Veteran’s DD 214 shows that he had service in the Republic of Vietnam and that he was awarded the Combat Action Ribbon. Therefore, the Board finds that the Veteran did engage in combat and it is conceded that he was exposed to acoustic trauma during the course of his service. For the reasons described below, the Board finds that the Veteran is entitled to service connection for bilateral hearing loss. A review of the Veteran's service treatment records reveal a threshold shift at 500 hertz in the left ear. The Veteran was provided with a VA audiological examination in February 2014. The examiner diagnosed the Veteran with bilateral sensorineural hearing loss. The examiner opined that the hearing loss was not the result of military. In support, the examiner explained that a comparison of the thresholds from entry to exit indicated no significant decreases in thresholds except for the 500 Hertz in the left. However, this mild loss is not typically associated with noise exposure and was not replicated on a August 2013 hearing evaluation and was not replicated on this date. Therefore, it was not a permanent hearing loss. Thresholds upon discharge did not meet the VA criteria for a service connected disability and there was no permanent significant decrease in hearing from entry to exit to be considered for a service connected disability. The Veteran was provided with an addendum opinion to the February 2014 VA audiological examination in August 2017. The examiner opined that there currently is no evidence that hearing loss progresses after noise exposure ceases. Therefore, it is not likely that his current hearing loss is related to the Veteran’s hazardous noise exposure while in service given that hearing was within normal limits at time of service exit and worsening did not begin until decades later. The examination reports of record are inadequate as the examiners did not adequately consider the Veteran’s statements regarding no noise exposure since service. What is left, without the VA examination reports, is the March 2021 appellate brief which provided citation to a March 2014 United States Department of Health and Human Services, National Institute on Deafness on Communication Disorders, study on noise induced hearing loss. The study found that initial hearing loss induced by noise may disappear shortly after exposure, but then again return at later time causing residual long-term damage. Noise induced hearing loss was found to have been caused by short bursts or pulses of sound, such as gunshots or explosions. Additionally, a 2011 to 2012 study by the Centers for Disease Control found that people at any age can develop noise induced hearing loss. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. Gilbert, 1 Vet. App. at 49. In light of the evidence of record, The Board finds, upon resolving all reasonable doubt in this combat Veteran’s favor, service connection for bilateral hearing loss is warranted. 38 U.S.C. § 5107 (b). S. Sorathia Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Dodd, Ryan 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.