Citation Nr: 22017390 Decision Date: 03/24/22 Archive Date: 03/24/22 DOCKET NO. 18-30 435 DATE: March 24, 2022 ORDER Service connection for bilateral hearing loss is granted. Service connection for tinnitus is granted. Service connection for bipolar disorder is granted. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran's favor, the Veteran has experienced decreased hearing related to bilateral hearing loss since his separation from service. 2. The Veteran has experienced ringing in his ear related to tinnitus since service. 3. Resolving reasonable doubt in the Veteran's favor, his bipolar disorder is at least as likely as not related to a training simulation of a helicopter crash. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss are met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 3. The criteria for service connection for bipolar disorder are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served honorably on active duty in the United States Army from August 1969 to April 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2017 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In September 2019, the Board remanded this matter for further development. The Veteran testified at a May 2019 videoconference hearing before a Veterans Law Judge (VLJ) who is no longer employed by the Board. A transcript is of record. In February 2022, the Board sent the Veteran a letter presenting him with an opportunity for another hearing; however, he has not requested another hearing. Service Connection Hearing Loss Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish service connection for a 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 between the present disability and the disease or injury incurred or aggravated during service. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). For VA purposes, impaired hearing is considered disabling 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 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. Certain chronic diseases will be presumed related to service if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303, 3.307, 3.309. The Veteran is diagnosed with bilateral hearing loss. He has undergone multiple VA examinations and audiological examinations for his hearing loss. However, no VA examination has found the audiological results to be valid for rating purposes. VA treatment records note the Veteran undergoing audiological examinations, but the results from these examinations are not available. The Board notes that a February 2021 audiology note includes word-recognition testing of 64% for the right ear and 48% for the left ear. It is unclear if this testing was done using the Maryland CNC Test as required by VA regulations. The Board finds there to be an approximate balance of positive and negative evidence that the Veteran has hearing loss for VA purposes. When there is an approximate balance of evidence, reasonable doubt is resolved in the Veteran's favor. As such, the Board finds that the Veteran has hearing loss for VA purposes. Regarding the second element, the Veteran testified that he was exposed to acoustic trauma in the form of live fire training exercises and from working around helicopters. He testified that his military occupation specialty (MOS) was helicopter repair before he was transferred to telephone lineman. The Veteran is competent to describe the circumstances of service and find his testimony regarding acoustic trauma to be credible. Accordingly, the Board finds the Veteran to meet the second element for service connection. Turning to the third element, medical nexus, the evidence consists of VA examinations and the Veteran's own statements. As explained above, the Veteran has undergone multiple VA examinations, but they have been unable to obtain audiological findings that are valid for rating purposes. Most recently, in December 2019, the examiner found the results to not be valid due to an odor of alcohol. The Veteran challenges that he smelled of alcohol during this examination and his representative argues that the Veteran does not even consume alcohol. The representative also argues that the examination is inadequate as the examiner did not provide an opportunity for the Veteran to explain the odor of alcohol. The Board agrees that the lack of inquiry of whether the odor of alcohol came from the Veteran raises questions of the adequacy of the examination. As such, the Board finds the December 2019 VA examination to be inadequate. In December 2016, the Veteran underwent a VA examination for his claim. Though this examiner found audiological results to not be valid, they did note that the Veteran experienced significant changes in hearing thresholds in service. The Board finds this to support a finding that the Veteran experienced loss of hearing during service. At his May 2019 hearing, the Veteran testified that he noticed hearing problems during service. He described these hearing problems as difficulty hearing people talk to him and that this problem has continued since service. The Veteran is competent to report observable symptoms such as decreased hearing. The Board finds the Veteran to be credible and affords his testimony great probative weight. The Board finds there to be an approximate balance of positive and negative evidence. When there is an approximate balance of positive and negative evidence, reasonable doubt is resolved in the Veteran's favor. 38 C.F.R. § 3.102. Accordingly, service connection for bilateral hearing loss is granted. 38 C.F.R. § 3.304. Tinnitus The Veteran has a current diagnosis of tinnitus. As explained above, the Veteran has provided competent and credible testimony that he was exposed to acoustic trauma during service. As such, the Board finds him to meet the first two elements for service connection. Turning to the third element, medical nexus, the evidence consists of VA examinations and the Veteran's own statements. In December 2016, the Veteran underwent a VA examination for his claim. This examiner though was unable to provide a nexus opinion for the Veteran's tinnitus. As such, the Board affords no probative weight to the findings of this examiner. After remand, in December 2019, the Veteran underwent another VA examination. This examiner found it to be less likely than not that the Veteran's tinnitus was related to service. Their rationale was that the Veteran reported tinnitus starting twelve years ago, and that tinnitus occurs at time of insult. The examiner also noted that there is no notation of tinnitus in the Veteran's service records. The Board notes that the Veteran testified during his hearing that he experienced ringing in his ears during service. The examiner did not consider this portion of the Veteran's testimony when rendering their opinion. As such, the Board finds this examination to be inadequate and affords it little probative weight. At his March 2019 hearing, the Veteran testified that ringing in his ears began during service. The Veteran is competent to report observable symptoms such as ringing in his ears. The Board finds this evidence to support a finding of continuity of symptomatology of the Veteran's tinnitus. Accordingly, service connection for tinnitus based on continuity of symptomatology is granted. Bipolar Disorder The Veteran has a current diagnosis of bipolar disorder. The Veteran submitted a statement and testimony regarding an incident during service that he associates to be the cause of his psychological disability. He describes an incident during training when his MOS was still helicopter repair when he was aboard a helicopter that underwent a simulated crash as part of training. The Veteran at time, did not know this was a simulation and honestly believed that the helicopter was about to crash. He testified that after this incident he requested a change in his MOS and was assigned a new MOS as telephone lineman. Service records confirm that the Veteran had an MOS in aviation prior to his MOS as telephone lineman. The Veteran is competent to describe the circumstances of his training. The Board finds the Veteran's testimony to be credible and finds this incident to meet the second element of service connection. Turning to the third element, medical nexus, the evidence consists of a VA examination. In December 2019, the Veteran underwent an examination for his claim. The examiner diagnosed the Veteran with posttraumatic stress disorder (PTSD) and bipolar disorder. The examiner noted that it is not possible to differentiate what symptoms are attributable to each diagnosis. The examiner found it to be as likely as not that the Veteran's bipolar disorder is related to his in-service stressor of a simulated helicopter crash. Their rationale is that the Veteran is being treated for bipolar disorder and PTSD and that individuals with PTSD are 80% more likely to have symptoms that meet diagnostic criteria for at least one other mental disorder to include bipolar disorder. The Board finds this to support the Veteran's claim that he has a psychiatric disability related to service. Accordingly, the Board finds the evidence to show that the Veteran's bipolar disorder is related to a training simulation of a helicopter crash. As such, service connection for bipolar disorder is granted. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael Chandeck, Associate 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.