Citation Nr: 21030599 Decision Date: 05/19/21 Archive Date: 05/19/21 DOCKET NO. 14-41 659 DATE: May 19, 2021 ORDER Entitlement to service connection for right ear hearing loss is denied. Entitlement to service connection for polyuria and urinary urgency is denied. FINDINGS OF FACT 1. The preponderance of the competent evidence of record indicates that the Veteran's current right ear hearing loss was not present during service, did not manifest within a year of separation from service, and is not otherwise causally or etiologically related to an in-service event, injury or disease. 2. The preponderance of the competent evidence of record indicates that the Veteran's current polyuria and urinary urgency (urinary disability) is not causally or etiologically related to an in-service event, injury or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for right ear hearing loss have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310. 2. The criteria for service connection for polyuria and urinary urgency are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Marine Corps from July 1966 to April 1970, April 1970 to March 1978, and the Army from May 1-9, 1992. For his meritorious service, the Veteran was awarded (among other decorations) the Combat Action Ribbon This matter is before the Board of Veterans' Appeal (Board) on appeal from a September 2012 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO). The Board previously remanded the appeal in September 2018 and the matter has been returned for appellate consideration. The Board is satisfied there was substantial compliance with its remand orders. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999); Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection Service connection may be granted directly as a result of disease or injury incurred in service based on nexus using a three-element test: (1) The existence of a current 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 in or aggravated by service. See 38 C.F.R. §§ 3.303 (a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Certain chronic diseases, including sensorineural hearing loss, may be presumed to have been incurred in or aggravated by service if manifest to a compensable degree within one year of discharge from service, even though there is no evidence of such disease during service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309(a). For 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, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies at 500, 1000, 2000, 3000, and 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. 1. Entitlement to service connection for right ear hearing loss. The Veteran contends he is entitled to service connection for right ear hearing loss. For the reasons outline below, the Board finds that service connection for right ear hearing loss is not warranted as a preponderance of the evidence is against finding that it onset in service or within a year of separation from service or that it is causally related to the Veteran's service, to include his exposure to loud noise. First, the Board concedes that the Veteran was exposed to hazardous noise during active service. The Board acknowledges the Veteran's own descriptions of his noise exposure and finds him competent and credible to describe such noise exposure. The Veteran was afforded a VA examination in May 2011 to obtain an opinion on the nature and etiology of his claimed right ear hearing loss. The VA examiner opined that the Veteran's right ear hearing loss was unrelated to his active duty service. In September 2018, the Board found the May 2011 VA examination report to be inadequate for rating purposes and remanded the claim for a new VA examination. To that end, the Veteran was afforded a VA audiology examination in February 2020. The VA examiner opined that the Veteran's right ear hearing loss is unrelated to his active service, to include his exposure to loud noise. The VA examiner acknowledged that the Veteran was exposed to hazardous noise during service, but also highlighted that the Veteran presented with normal hearing at discharge. She cited a study by the Institute of Medicine, which provided that, "there is no scientific basis for delayed or late onset noise induced hearing loss." The VA examiner also cited another medical study that noted that both Veterans and civilians are equally likely to have hearing loss and increase in degree with the natural aging process. Finally, the VA examiner noted that the Veteran did not seek treatment for hearing loss until 20 years after service. The VA examiner concluded that the Veteran's hearing loss was likely a gradual progression over the years unrelated to his service. In this case, as to the issue of whether the Veteran's right ear hearing loss is related to his active service, the Board finds that the February 2020 VA examination report is the most probative evidence of record as it was definitive, based upon a complete review of the Veteran's entire claims file and considered the Veteran's reported history and prior physical evaluation of the Veteran. Furthermore, the February 2020 examiner provided a complete and thorough rationale in support of her opinion. See Prejean v. West, 13 Vet. App. 444, 448-9 (2000); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Service connection is also not warranted on a presumptive basis, as there is no evidence that the Veteran's right ear hearing loss was manifest to a compensable degree within one year of his separation. The earliest objective evidence of hearing loss is from 2010, about 20 years after his separation from service. The Board acknowledges the statements provided by the Veteran regarding his right ear hearing loss. The Veteran is competent to report his lay observation of decreased hearing acuity; however, he is not competent to opine as to whether his bilateral hearing loss is related to his active duty service, to include noise exposure. The Board further notes that hearing loss for VA purposes is defined by the results of objective testing. The etiology of hearing loss is medically complex and is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). As the Veteran's statement is not competent as to the question of nexus, it is assigned no probative weight. Although the Veteran has established a current disability and in-service noise exposure, the preponderance of the evidence weighs against finding that the Veteran's right ear hearing loss is causally related to his service or manifested within an applicable presumptive period. There is no doubt to resolve. For these reasons, service connection for right ear hearing loss is denied. 2. Entitlement to service connection for polyuria and urinary urgency. The Veteran is seeking service connection for polyuria and urinary urgency. The Veteran contends that his claimed polyuria and urinary urgency is related to an in-service occurrence of prostatitis. As to the first element of service connection, the January 2020 VA examination confirmed the Veteran's diagnosis of a voiding dysfunction. Regarding the second element of service connection, the Veteran asserts that his current disability is related to an in-service diagnosis of prostatitis. The Veteran's service treatment records support that in March 1970 the Veteran presented with obstructive urinary tract symptoms. As such, the second element of service connection is met. The question for the Board is whether the Veteran's current voiding dysfunction is related to his in-service prostatitis. The Veteran was afforded the May 2011 VA examination to determine the nature and etiology of the Veteran's claimed urinary disability. The May 2011 VA examiner found that the Veteran did not have a diagnosable condition. The September 2018 Board decision remanded the claim because the Board found the VA examiner findings to be inadequate and directed that the Veteran be provided with another VA examination. To that end, the Veteran was provided with a new VA examination in January 2020. The VA examiner held that the Veteran's voiding dysfunction was not related to his active duty service, to include his in-service prostatitis. The VA examiner acknowledged that in March 1970, the Veteran presented with obstructive urinary tract symptoms, including frequency, urgency, dysuria, and incomplete voiding, which the VA examiner concluded were indications of prostatitis. The VA examiner noted that prostatitis is an infection or inflammation of the prostate gland. The Veteran was treated with resolution in three months per his service treatment records. The rest of the Veteran's service treatment records are absent for any reported urinary issues. The VA examiner noted that the Veteran's urologist found that the Veteran's prostate was enlarged (BPH). The VA examiner highlighted that prostatitis is the most common urologic diagnosis in men younger than 50 and third most common for men older than 50. The examiner stated that theere is no causal relationship between prostatitis in younger men leading to BPH or prostate cancer later in life. The VA examiner found the Veteran's symptoms of urinary frequency and polyuria were more likely from the Veteran's enlarged prostate and not the Veteran's active service, to include his in-service prostatitis. In this case, as to the issue of whether the Veteran's urinary disability is related to his active service, the Board finds that the January 2020 VA examination report is the most probative evidence of record as it was definitive, based upon a complete review of the Veteran's entire claims file, in consideration of the Veteran's reported history, prior physical evaluation of the Veteran, and pursuant to the Board's remand instructions. Furthermore, the January 2020 examiner provided a complete and thorough rationale in support of her opinion. See Prejean v. West, 13 Vet. App. 444, 448-9 (2000); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Board acknowledges the statements provided by the Veteran regarding his urinary disability. The Veteran is competent to state symptoms experienced due to his urinary disability, he is not competent to opine as to whether his urinary disability is related to his active duty service, to include in-service prostatitis. Such an issue is medically complex, as it requires knowledge of internal body systems, pathology, and interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). As the Veteran's statement is not competent as to the question of nexus, it is assigned no probative weight. Although the Veteran has established a current disability and an in-service event, the preponderance of the evidence weighs against finding that the Veteran's urinary disability is causally related to his service or manifested within an applicable presumptive period. There is no doubt to resolve. For these reasons, service connection for polyuria and urinary urgency will therefore be denied. Amanda Christensen Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Higgins, J.R. 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.