Citation Nr: 21025699 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 17-20 142 DATE: April 28, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. Entitlement to service connection for tinnitus is granted. FINDINGS OF FACT 1. The evidence is at least in equipoise as whether the Veteran’s current bilateral hearing loss is etiologically related to in-service acoustic trauma. 2. The most probative evidence of record indicates the Veteran’s current tinnitus is related to in-service acoustic trauma and/or 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. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.385. 2. The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1952 to April 1954. These matters come before the Board of Veterans’ Appeals (Board) on appeal from rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a Board hearing before the undersigned in March 2021. The transcript is of record. The claimant has not raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). Service Connection 1. Entitlement to service connection for bilateral hearing loss Service connection may be granted for a disability resulting from disease or injury incurred coincident with or aggravated by service.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). To establish a right to compensation for a present disability, a Veteran 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 (nexus) between the present disability and the disease or injury incurred or aggravated during service. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F. 3d 1163, 1167 (Fed. Cir. 2004)). The absence of any one element will result in denial of service connection. Coburn v. Nicholson, 19 Vet. App. 247, 431 (2006). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303 (d).  In addition, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including other organic diseases of the nervous system (which includes sensorineural hearing loss and tinnitus), are presumed to have been incurred in service if they manifested to a compensable degree within one year of separation from service.  38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309.  For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim. 38 C.F.R. §§ 3.303 (b), 3.309; 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.   Thresholds for normal hearing are between 0 and 20 decibels, and higher thresholds show some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 159 (1993).  The Veteran contends that his bilateral hearing loss has been caused by in-service acoustic trauma. Specifically, the Veteran has averred that his service exposed him to rifle fire and other acoustic trauma, as a result of which he has suffered hearing loss. The Veteran’s statements with respect to hazardous noise exposure are consistent with service records, and the Board finds them credible. The Veteran also has current bilateral hearing loss for VA purposes, confirmed by an August 2016 VA audiological evaluation. Although the examiner who conducted the evaluation opined that the Veteran’s hearing loss was less likely than not service-related, given the lack of explicit evidence of threshold shifts in service and the gulf of time between separation and initial complaint of hearing loss, the Board also notes the February 2021 private opinion furnished by a private provider, explaining that his overall impression of the record, including the nature of the Veteran’s service and his hearing loss progression, suggested the condition was likely related to service. Both expert opinions are offered following in-person examination of the Veteran, review of the medical file, and consideration of the Veteran’s lay statements, including his account of in-service noise exposure, and the Board does not find cause to elevate one opinion above the other. Thus, finding the expert medical opinions of record of equal probative value, and finding credible the Veteran’s account of the progression of his hearing loss since separation, the Board finds the evidence at least in equipoise as to whether current hearing loss is related to in-service acoustic trauma. As such, the appeal for service connection for bilateral hearing loss must be granted. 2. Entitlement to service connection for tinnitus Secondary service connection may be granted for a disability that is proximately due to, or aggravated by, a service-connected disease or injury. 38 C.F.R. § 3.310 (2018). In order to prevail on the issue of entitlement to secondary service connection, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) nexus evidence establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). The Veteran has credibly averred that he has tinnitus as a result of in-service noise exposure. Because the Veteran in this case has offered competent, credible statements that he experiences tinnitus, the Board finds he has met the current disability threshold. See Charles v. Principi, 16 Vet. App. 370, 374 (2002)(“ringing in the ears is capable of lay observation”). The dispositive issue is therefore whether tinnitus is related to service. As discussed above, the Veteran’s credible account of his service has led the Board to concede exposure to hazardous noise therein. Moreover, the August 2016 VA examiner explained that the Veteran’s tinnitus was most likely directly related to his hearing loss, which disability is service connected by the instant decision. These facts convince the Board that sufficient evidence exists to establish a basis for service connection for tinnitus on a secondary basis in this case. Accordingly, the claim for service connection for tinnitus is granted. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Z. Sahraie, 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.