Citation Nr: 21039883 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 18-38 977 DATE: July 1, 2021 ORDER Entitlement to service connection for left ear hearing loss is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, his left ear hearing loss is at least as likely as not related to his military service. CONCLUSION OF LAW The criteria for service connection for left ear hearing loss have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.385. REASONS AND BASES FOR FINDING AND CONCLUSION The served on active duty from October 1992 to December 2001. This matter is before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued by the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). In March 2021, the Veteran testified at a Virtual Board hearing before the undersigned Veterans Law Judge. In March 2021, the Board remanded entitlement to service connection for bilateral hearing loss for further development. An April 2021 rating decision granted service connection for right hearing loss disability. 1. Entitlement to service connection for left ear hearing loss The Veteran seeks service connection for left ear hearing loss that incurred, he asserts, because of his exposure to excessive levels of noise during his time in service. VA has conceded that the Veteran has in-service noise exposure. Notably, right ear hearing loss as well as tinnitus has been found to be due to in-service noise exposure. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110. Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303 (a). A January 2016 VA examination as well as a recent March 2021 VA examination confirms current left ear hearing loss, which is disabling for VA purposes, indicating that the Veteran has "Moderate Severe SNHL [sensorineural hearing loss] above 1K Hz." 38 C.F.R. § 3.385. Thus, the current disability requirement is satisfied. Regarding the in-service requirement, as noted, VA concedes in-service noise exposure. Thus, the in-service occurrence or injury requirement is likewise satisfied. Turning to the final question of whether a causal relationship exists between the present disability and service, the opinion provided in the most recent March 2021 VA examination is inadequate regarding left ear hearing loss because it appears to rest on the fact that the Veteran had normal hearing on separation from service. The fact that left ear hearing loss was not identified during service is not fatal to a claim for service connection. A veteran may establish direct service connection for a hearing loss disability, which initially manifested several years after separation from service, by showing evidence of a current hearing loss disability and a causal relationship to active duty service. See Hensley v. Brown, 5 Vet. App. 155 (1993); see also 38 C.F.R. § 3.303(d). Therefore, a showing of normal hearing at the last noted in-service audiogram is not sufficient to provide the sole basis for a denial of a claim for service connection for left ear hearing loss absent any other rationale. Furthermore, as noted, right ear hearing loss as well as tinnitus has been noted to be due to in-service noise exposure. The Veteran indicates that he has had difficulty with hearing since service discharge. The Board finds the Veteran is competent to report hearing difficulty. Accordingly, the Board finds that the evidence for and against the claim is at least in equipoise. When the evidence for and against the claim is in relative equipoise, the Board must resolve all reasonable doubt in favor of the Veteran. Service connection for left ear hearing loss is warranted. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. McPhaull, 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.