Citation Nr: 21023796 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 19-31 247 DATE: April 21, 2021 ORDER Entitlement to service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD), is GRANTED. Entitlement to service connection for bilateral hearing loss is GRANTED. FINDINGS OF FACT 1. The preponderance of the evidence reflects that the Veteran’s current acquired psychiatric disability was incurred during service in the Republic of Vietnam. 2. The preponderance of the evidence reflects that the Veteran’s current bilateral hearing loss was incurred during service in the United States Army. CONCLUSIONS OF LAW 1. The criteria for service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD), have been met. 38 U.S.C. §§ 1110, 5107 (West 2014); 38 C.F.R. §§ 3.303, 3.304 (f) (2020). 2. The criteria for service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1110, 5107 (West 2014); 38 C.F.R. §§ 3.303, 3.385 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served honorably in the United States Army from May 1966 to April 1968. The certificate of release from active duty (DD214) reveals that the Veteran received the Vietnam Service and Campaign Medals. SERVICE CONNECTION Service connection may be established for disability resulting from personal injury suffered or disease contracted while in the active military, naval, or air service. 38 U.S.C. § 1110. Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303 (d). In order to establish service connection for the claimed disorder on a direct basis, generally there must be probative evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999). In each case where service connection for any disability is sought, due consideration shall be given to the places, types, and circumstances of the Veteran’s service as shown by the Veteran’s service record, the official history of each organization in which the Veteran served, the Veteran’s medical records, and all pertinent medical and lay evidence. 38 U.S.C. § 1154 (a). In making these determinations, the Board must consider and assess the credibility and weight of all evidence in the claim file, including the medical and lay evidence, to determine its probative value. In doing so, the Board must provide its reasoning for rejecting any evidence favorable to the claimant. See Masors v. Derwinski, 2 Vet. App. 181 (1992); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992); Barr v. Nicholson, 21 Vet. App. 303 (2007). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Board must give the benefit of the doubt to the Veteran. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). 1. Entitlement to service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD), is granted. In May 2017, the Veteran submitted a VA Form 21-0966. Thereby, the Veteran relayed an intent to file a claim for service connection. In January 2018, the Veteran submitted a VA Form 21-526EZ. Thereby, the Veteran formalized the claim for service connection for PTSD and/or nervous problems. Service connection for PTSD has unique evidentiary requirements. It generally requires: (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125 (a) (i.e., DSM-IV or DSM-5); (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304 (f); see also Cohen v. Brown, 10 Vet. App. 128 (1997). In January 2018, the Veteran submitted a VA Form 21-0781. At that time, the Veteran also submitted a detailed description of psychological stressor incidents that occurred during his service in the Republic of Vietnam. In August 2018, correspondence from the Captain James A. Lovell Federal Health Care Center was associated with the claims file. Therein, an examiner noted multiple stressors incidents the Veteran endured during service in the U.S. Army. The examiner noted the current acquired psychiatric symptoms endured by the Veteran. The examiner opined that the Veteran satisfied the criteria for a PTSD diagnosis. In July 2019, the Veteran underwent a VA examination that considered the nature and etiology of acquired psychiatric disorders. The VA examiner reported that the Veteran did not satisfy the DSM-5 criteria for a PTSD diagnosis. However, the VA examiner reported that the Veteran did satisfy the criteria for other specified trauma- and stressor-related disorder. After describing the pertinent evidence in the claims file, the VA examiner opined that the Veteran’s acquired psychiatric diagnosis was at least as likely as not incurred in, or caused by, service in the U.S. Army. In February 2021, the Veteran supplied sworn testimony to the undersigned Veterans’ Law Judge (VLJ). The Veteran testified that his base in Vung Tau, Vietnam was attacked with rockets in April 1968 the night before he departed Vietnam. The Veteran testified that he was fearful during the attack because he had turned in his weapon during military out-processing. The Board notes that the August 2018 examiner reported a diagnosis for PTSD. The Board also notes that the July 2019 VA examiner reported a diagnosis for other specified trauma- and stressor-related disorder. The Veteran competently and credibly testified about a rocket attack on his duty station in Vietnam, which placed him in fear because he was unarmed. Finally, the July 2019 VA examiner opined that the Veteran’s current acquired psychiatric diagnosis was etiologically related to the in-service stressor incidents. Consequently, all three requisite elements for service connection for an acquired psychiatric disability have been substantiated. See 38 C.F.R. § 3.304 (f); see also Cohen, 10 Vet. App. 128. Ultimately, the preponderance of the evidence favors the Veteran’s claim for service connection for an acquired psychiatric disability. Accordingly, this service-connection claim must be granted.   2. Entitlement to service connection for bilateral hearing loss is granted. In May 2017, the Veteran submitted a VA Form 21-0966. Thereby, the Veteran relayed an intent to file a claim for service connection. In January 2018, the Veteran submitted a VA Form 21-526EZ. Thereby, the Veteran formalized a claim for service connection for hearing loss. In addition to the above described VA regulations, entitlement to service connection for impaired hearing is subject to additional VA regulations. Specifically, a hearing impairment constitutes a disability for VA purposes when 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. The Court has held that the “the threshold for normal hearing is from 0 to 20 dB (decibels), and higher threshold levels indicate some degree of hearing loss.” Hensley v. Brown, 5 Vet. App. 155, 157 (1993). In January 2018, the Veteran’s service treatment records were associated with the claims file. Therein, the Veteran’s audiological examination reports were included for enlistment (1966) and separation (1968). HERTZ MAY ‘66 500 1000 2000 3000 4000 RIGHT 5 0 5 0 LEFT 0 0 5 5 HERTZ APR ‘68 500 1000 2000 3000 4000 RIGHT 5 5 5 0 5 LEFT 15 15 5 15 15 After review, the Board notes that the Veteran demonstrated a noticeable left ear threshold shift during service in the United States Army. In April 2018, the Veteran underwent a VA examination that considered the nature of any currently endured hearing loss. At that time, the Veteran demonstrated the following audiometric values: HERTZ APR ‘18 500 1000 2000 3000 4000 RIGHT 55 65 70 90 85 LEFT 95 95 60 80 75 The Veteran demonstrated 68 percent right ear speech discrimination, and 8 percent left ear speech discrimination. The VA examiner reported that the STRs did not reflect permanent auditory damage during active duty. The VA examiner did concede in-service hazardous noise exposure. In August 2018, correspondence from the Veteran’s treating physician was associated with the claims file. Therein, the provider discussed the Veteran’s in-service exposure to hazardous noise. The provider noted that that the Veteran endured progressive tinnitus and hearing loss after separation from the U.S. Army. The provider noted that the Veteran demonstrated 60 percent word discrimination in the right ear, and 0 word discrimination in the left. The provider opined that the Veteran’s current sensorineural hearing loss was etiologically related to the Veteran’s in-service hazardous noise exposure. In February 2021, the Veteran supplied sworn testimony to the undersigned VLJ. The Veteran testified that he worked in quarry where rock/stone was blown up during service. After service in the quarry, the Veteran testified that he went to medical personnel to have his ears seen / treated / cleaned. The Veteran testified that he did not notice a difference in hearing after treatment by military medical personnel. The Veteran testified that he worked as an electrician and deliveryman after discharge from the U.S. Army. During the April 2018 VA examination, the Veteran clearly demonstrated current bilateral hearing loss for VA compensation purposes. Consequently, the first requisite element for service connection has been substantiated. See 38 C.F.R. § 3.385. Under VA law, the Court has held section 3.385 does not preclude an award of service connection for a hearing disability established by post-service audiometric and speech-recognition scores, even when hearing was found to be within normal limits on audiometric and speech-recognition testing at the time of separation from service. Hensley v. Brown, 5 Vet. App. 155, 157 (1993); see also Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). The Board notes that the Veteran is service connected for bilateral tinnitus. Additionally, the Veteran’s STRs reflect that the Veteran demonstrated an in-service threshold shift during service in the U.S. Army. The Board finds that the same acoustic trauma that caused damage to the Veteran’s auditory system for purposes of bilateral tinnitus would have likely caused auditory damage leading to hearing loss as well. Consequently, the second requisite element for service connection has been substantiated. See Hickson, 12 Vet. App. at 253. Importantly, the Board observes that, in August 2018, the Veteran’s provider opined that the current sensorineural hearing loss was etiologically related to the Veteran’s in-service hazardous noise exposure. In light of the foregoing, and resolving all doubt in the Veteran’s favor, the Board finds the evidence supports a grant of service connection for bilateral hearing loss. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board RLBJ, 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.