Citation Nr: 21032896 Decision Date: 05/28/21 Archive Date: 05/28/21 DOCKET NO. 15-10 111 DATE: May 28, 2021 ORDER Entitlement to service connection for bilateral hearing loss disability is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, bilateral hearing loss disability is at least as likely as not related to in-service noise exposure. CONCLUSION OF LAW The criteria for service connection for bilateral hearing loss disability are met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1982 to July 1986. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a March 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office. The Veteran's claim was most recently before the Board in February 2020 when it was remanded for further development. See Stegall v. West, 11 Vet. App. 268 (1998). Service connection The Veteran contends he experiences bilateral hearing loss related to service. The Board concludes that the Veteran has a current disability that is related to in-service noise exposure. 38 U.S.C. §§ 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). August 2012 VA treatment records show the Veteran has a current diagnosis of sensorineural hearing loss. See 38 C.F.R. § 3.385. On the authorized audiological evaluation in February 2014, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 30 30 25 35 50 LEFT 20 35 20 50 50 Speech audiometry revealed speech recognition ability of 100 percent in the right ear and of 96 in the left ear. On another authorized audiological evaluation in February 2021, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 25 35 30 40 50 LEFT 25 35 35 55 55 Speech audiometry revealed speech recognition ability of 100 percent in the right ear and of 98 in the left ear. Based on the foregoing evidence, the Veteran has a current hearing loss disability. See 38 C.F.R. § 3.385. The evidence also indicates exposure to loud noises during service. VA has conceded that the Veteran was exposed to hazardous levels of noise and had a threshold shift in hearing during service. Thus, the question becomes whether this in-service noise is related to the current disability. On this question there are probative opinions in favor of and against the claim. The evidence against the claim includes February 2021 VA medical examination and a March 2021 VA addendum medical opinion. The February 2021 VA examiner opined that the Veteran's hearing loss was not at least as likely as not (50 percent probability or greater) caused by or a result of an event in military service. The examiner explained: While the [V]eteran did have a high probability of noise exposure as a cannon crewman a nexus cannot be established at this time due to: normal hearing on both entrance and exit exam. The veteran is not a combat veteran. It has been over 40 years since the veteran was in the service. In the claimant's file, it states that there was a positive threshold shift from entrance to exit exam (although both were within normal limits) for the left ear of 11.67, however, it was not age corrected which should be accounted for. A nexus cannot be established at this time. In March 2021, the VA examiner added, "While the noise exposure is conceded and noted by the veteran, the entrance and exit exam show normal hearing in both ears. A nexus cannot be established at this time." Service connection for a current hearing disability is not necessarily precluded where hearing was within normal limits at separation. See Hensley v. Brown, 5 Vet. App. 155, 159-60 (1993). As such, the probative value of the February and March 2021 VA opinions is reduced due to their overreliance on the June 1986 separation examination indicating normal hearing. The February 2014 VA examiner did not offer a nexus opinion. Further, the August 2020 VA medical opinion was ambiguous ("at least as likely as not (50% probability or greater) was not caused by or a result of an event in military service"), so the Board does not give this opinion any significant probative weight. Obert v. Brown, 5 Vet. App. 30, 33 (1995); Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992). The evidence in favor of the claim includes an April 2019 medical opinion from the Veteran's primary care physician at VA. In April 2019, the physician noted that the Veteran "was exposed to extensive noise which damaged his hearing" and opined that it was "more likely than not his hearing loss and tinnitus are directly due to noise exposure in the Army." A doctor's treating relationship is a factor that may be considered in assigning weight to a physician's opinion. See White v. Principi, 243 F.3d 1378 (Fed. Cir. 2001). As such, the Board gives the April 2019 medical opinion significant weight. Not only is the physician familiar with the Veteran's medical history, the physician also has personally examined the Veteran over time. Further, the opinion is consistent with other evidence of record, such as the Veteran's conceded noise exposure and documented threshold shift in hearing during service, and lay statements made in course of seeking medical treatment such as to a VA audiologist in August 2012, when the Veteran reported tinnitus symptoms beginning during service. Moreover, in July 2020, VA found the Veteran's tinnitus service connected. Upon review of the record, the Board finds the evidence to be at least even as to whether the Veteran's current bilateral hearing loss is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for bilateral hearing loss is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. (Continued on the next page) The claim is granted. C. J. McEntee Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board James Hekel 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.