Citation Nr: 21023498 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 17-36 579 DATE: April 20, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, the Veteran’s current bilateral hearing loss is related to his in-service acoustic trauma. CONCLUSION OF LAW The criteria for entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1963 to May 1967. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a January 2017 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned in January 2021. The transcript is of record. Entitlement to service connection for bilateral hearing loss. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. In order to establish entitlement to service connection, there must be (1) evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) a causal connection between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may be presumed for certain chronic diseases, such as hearing loss, which develop to a compensable degree within one year after discharge from service, even though there is no evidence of the disease during the period of service. That presumption is rebuttable by probative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. § 3.307, 3.309(a). To establish the presence of hearing loss for VA compensation purposes, the Veteran must show his bilateral hearing loss constitutes a disability by proffering evidence that the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz are 40 decibels or greater; or at least three of the frequencies 500, 1000, 2000, 3000, 4000 Hertz are 26 decibels or greater; or when speech recognition scores are less than 94 percent (Maryland CNC Test). 38 C.F.R. § 3.385. In this case the Veteran maintains that his bilateral hearing loss disability is related to noise exposure during active service. The Veteran has a current diagnosis of bilateral hearing loss for VA purposes under § 3.385. See June 2017 C&P Exam. As such, the first element of service connection is met. During the January 2021 Board hearing, the Veteran reported that as a clerk and inventory management specialist during active service, he experienced noise exposure. See January 2021 Hearing Transcript. He indicated that he worked in a warehouse about 300 feet off the runway and that he was in a supply area where he delivered and retrieved things to and from aircrafts. He indicated no hearing protection was provided to him at that time. He also reported using forklifts at that time. The Veteran reported hearing jets constantly taking off and landing. The Veteran also indicated planes would come real low right over where he was and go straight up to do victory rolls when MiGs were shot down. Although the Veteran’s military occupational specialist (MOS) is listed as an inventory management specialist with the U.S. Air Force, the Board highlights the Veteran’s detailed and consistent account of his exposure to significant noise during active service and finds the Veteran competent and credible in his assertions of in-service noise exposure. See March 2017 Correspondence and January 2021 Hearing Transcript. Therefore, exposure to in-service acoustic trauma is conceded. See 38 U.S.C. § 1154(a); 38 C.F.R. § 3.303(a) (each disabling condition for which a veteran seeks service connection must be considered based on factors including the basis of places, types, and circumstances of service as shown by service record). What remains for consideration is whether the Veteran’s current bilateral hearing loss is related to his in-service noise exposure. A review of the service treatment records (STRs) shows an August 1963 enlistment report of medical examination that notes the Veteran’s ears and drums to be normal. A review of the STRs shows the Veteran was provided with audiological testing at enlistment in August 1963. See December 2016 STR – Medical. The Board notes that as the Veteran’s enlistment examination date was prior to January 1, 1967, the Board will assume his service department audiometric results were reported using standards set forth by the American Standard Association (ASA). Since VA’s current definition for a hearing loss disability, found at 38 C.F.R. § 3.385, is based on International Standards Organization (ISO)-American National Standards Institute (ANSI) (ISO-ANSI units), his in-service audiograms must be converted from ASA to ISO-ANSI units prior to making findings related to claimed hearing loss disabilities. ASA units are converted to ISO-ANSI units by adding 15 decibels to the finding at 500 Hz; 10 decibels to the findings at 1000 Hz, 2000 Hz, and 3000 Hz; and 5 decibels to the finding at 4000 Hz. Based on the above, the August 1963 enlistment examination shows the following audiometric testing results: ASA Standard HERTZ 500 1000 2000 3000 4000 RIGHT 10 5 0 0 -5 LEFT 15 5 5 0 0 ISO-ANSI Standard HERTZ 500 1000 2000 3000 4000 RIGHT 25 15 10 10 0 LEFT 30 15 15 10 5 There is no showing of any hearing loss in the STRs, to include the August 1963 audiometer results. A February 1967 separation report of medical examination, the Veteran’s ears and drums were noted as normal on clinical evaluation and he denied hearing loss at the February 1967 separation report of medical history. However, at separation examination in February 1967, the reviewing examination noted that audiometer was not available at the station and that audiological testing was to be accomplished at Travis Air Force Base prior to separation. See December 2016 STR – Medical. It does not appear that the audiological testing at Travis Air Force Base was completed. After a review of the claims file, to include all service treatment records and personnel records, and the Veteran’s reports that he was never given a hearing exam on release from his military service, the associated STRs appear complete. See December 2016 Military Personnel Record and July 2017 Form 9. There is conflicting evidence of record. The June 2017 VA examiner opined that it is less likely than not that the Veteran’s bilateral hearing loss is caused by or a result of an event in military service. See June 2017 C&P Exam. The examiner acknowledged that the Veteran experienced noise exposure during his military service but noted that considerable hazardous recreational noise outside of service and presbycusis cannot be ruled-out as major contributing factors to the degree of hearing loss currently revealed at this time. The examiner also noted the Veteran’s reports in an October 2016 VA treatment record that he has had progressive decrease in his hearing bilateral over the past eight to ten years. See June 2017 CAPRI. During the January 2021 Board hearing, the Veteran disputed the findings noted in the June 2017 VA examination and provided further clarification. See January 2021 Hearing Transcript. Specifically, the Veteran noted the VA examiner’s reference to noise exposure outside of military service, to include the two times he went hunting at age 15 and used a .22 rifle. The Veteran indicated that a .22 rifle is not very loud, a little bigger than a BB gun or a pellet gun. The VA examiner also had pointed out noise exposure from the Veteran’s (sometimes) car races and personal lawn care. However, the Veteran explained that car races in the modern day have noise controls. He also reported the use of ear protections for the last years going to the car races and use of ear protection while taking care of his lawn, edging, or any other task with noise. The Veteran also clarified that he has had ongoing hearing loss for many years and that it was eight to ten years ago that his hearing loss had become so severe that he had to do something about it, and not that his hearing loss started eight to ten years ago. In support of the claim, in a January 2021 opinion, a private examiner opined the Veteran’s hearing loss is more likely than not related to his service. See January 2021 Medical Treatment Record Non-Government Facility. The audiologist noted the Veteran’s longstanding asymmetric bilateral sensorineural hearing loss that has been progressive in nature since she began seeing the Veteran in 2010. The examiner noted the loss is now of mild to severe degree for high frequencies in his right ear and mild to severe profound degree across frequencies in the left ear. The examiner noted the Veteran’s history of significant noise exposure during his service in the Air Force, particularly while he was stationed in Thailand for one year. The examiner noted the Veteran’s reports that he worked in supply, seven days per week, that his primary workplace was located 300 feet from the middle of a runway, and that he recalled jet aircrafts regularly taking off nearby or flying overhead, often unexpectedly. The examiner also noted he was required to deliver materials along the flight line and that no hearing protection devices were provided during his tenure. Based on the case history and test findings, the examiner found the Veteran had hearing loss of a degree and configuration commonly associated with significant noise exposure and that it is as likely as not that the hearing loss he experiences is related to noise exposure during his military service. After evaluating the probative value of the opinions both for and against the claim for bilateral hearing loss, the Board is ultimately unable to assign greater probative value to any particular opinion. In light of evidence both for and against the claim, the evidence in this case therefore is at least in equipoise. Thus, resolving reasonable doubt in the Veteran’s favor, service connection for bilateral hearing loss is warranted. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Cheng, 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.