BVA9508005 DOCKET NO. 93-13 430 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Philadelphia, Pennsylvania THE ISSUES Entitlement to service connection for bilateral hearing loss and tinnitus. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD Bernard T. DoMinh, Associate Counsel INTRODUCTION The veteran served on active duty in the Army from October 1942 to December 1945. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a January 1991 rating decision by the Philadelphia, Pennsylvania, Regional Office (RO) of the Department of Veterans Affairs (VA), which denied the veteran's claims for service connection for bilateral hearing loss and tinnitus. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that his hearing loss and tinnitus are related to his World War II active service in the Army, which included exposure to acoustic trauma while serving as a rifle instructor. He additionally contends that the disorders are related to his later service in the Air Force Reserve, when he had hearing loss and tinnitus from exposure to acoustic trauma caused by airplane engine noise. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against the veteran's claims for service connection for bilateral hearing loss and tinnitus. FINDINGS OF FACT 1. Chronic bilateral hearing loss and tinnitus were not manifest during active duty service or for many years later, and these disorders were not caused by any incident of active service. 2. Bilateral hearing loss and tinnitus did not begin during, and were not worsened by, periods of reserve active duty for training and inactive duty training. CONCLUSIONS OF LAW 1. Bilateral hearing loss and tinnitus were neither incurred in nor aggravated by active service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1994). 2. Bilateral hearing loss and tinnitus were neither incurred in nor aggravated by active duty for training or inactive duty training with the reserve. 38 U.S.C.A. §§ 101(24), 106, 1110, 1131 (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Factual Background The veteran served on active duty in the Army from October 1942 to December 1945. His military occupational speciality was rifleman instructor. The veteran's active duty service medical records show that he had normal ears and 20/20 (normal) hearing, bilaterally, on entry into active service in October 1942. During the veteran's separation examination, in December 1945, he was found to have normal ears and 15/15 (normal) hearing, bilaterally. The active duty service medical records contain no mention of hearing loss or tinnitus. The veteran also had service in the Air Force Reserve from December 1945 until retirement in September 1981, and this included the usual periods of active duty for training and inactive duty training. Air Force Reserve medical records show that the veteran's civilian occupation was as a textile factory employee. General physical examinations in September 1953 and November 1957 showed normal ears and normal hearing (15/15) on voice testing; in accompanying medical history forms, the veteran denied having ear problems. A July 1960 periodic reserve examination noted normal hearing on voice testing. Audiometric testing showed decibel thresholds in both ears were 10 or less at frequencies below 4,000 hertz; at 4,000 and 8,000 hertz the right ear decibel thresholds were 40, and the left ear decibel thresholds were 45. A general examination in August 1963 showed normal ears. On audiometric testing, decibel thresholds in both ears were 20 or less at frequencies below 4,000 hertz, and 60 or more at 4,000 hertz or above. Hearing was normal by voice testing at that examination and at a September 1966 general examination. During a December 1968 physical examination, bilateral defective hearing was first diagnosed; audiometric testing showed elevated decibel thresholds in both ears, above and below 4,000 hertz, but mostly at high frequencies. At a July 1970 periodic examination, defective hearing of both ears was again noted, and the veteran gave a history of ear problems for 15 years with hearing loss. Bilateral hearing loss, mostly at high frequencies, was noted on periodic examinations, medical history forms, and other medical documents dated in July 1971, August 1975, November 1975, September 1976, July 1977, November 1978, September 1979, and June 1981 (reserve retirement examination). The Air Force Reserve medical records do not refer to tinnitus. Outpatient audiological treatment records from Keller Army Hospital at West Point, New York, show that in May 1990 the veteran had moderate to severe sensorineural hearing loss, bilaterally, with complaints of tinnitus. He was referred to a private audiological clinic for further examination of his condition. The report of the private audiological examination (Arden Hill Speech and Hearing), dated in June 1990, shows that the results of a clinical evaluation of the veteran's bilateral hearing loss were consistent with retrocochlear pathology, bilaterally. Thereafter, audiological examination and ENT (ear, nose and throat) clinic reports from Keller Army Hospital, dated in July 1990 and August 1990, show that the veteran had bilateral tinnitus and sensorineural hearing loss which was worse on the left ear when compared with the right. In October 1990, the veteran first claimed service connection for hearing loss. He reported that he first noticed the problem after boarding an aircraft at Dover Air Force Base, and he said he was treated at that air base by an unknown doctor in 1978- 1979. At a November 1990 VA examination, the veteran reported that during active service in the Army, in 1943, he was a rifle and bayonet instructor and spent many hours on the rifle range, and he would afterward experience ringing noises in his ears which would last for a day but then disappear. He reported that in approximately September 1978, he first noticed that he had constant tinnitus when he boarded a plane on which the engines were still running. He now complained of having hearing difficulties and constant ringing in both ears. Examination of his ears showed clear canals and normal tympanic membranes, bilaterally. Audiological evaluation showed bilateral sensorineural hearing loss with complaints of constant, bilateral, ringing tinnitus. The veteran was diagnosed as having tinnitus and decreased hearing, bilaterally. Records from the Army Audiology and Speech Center at Walter Reed Army Medical Center, dated in March 1991 and April 1991, show that the veteran continued to have bilateral hearing loss, left ear worse than right, with complaints of constant tinnitus, and he had been issued binaural hearing aids for this condition. In statements written and submitted in 1991 and 1992, seven of the veteran's fellow Air Force reservists essentially reported that in September 1978, they and the veteran had been in the process of boarding a military jet transport at Dover Air Force Base, where the reserve unit was performing a training exercise. The individuals stated that, in order to save time, the airplane pilot did not entirely turn off all engines and, as a result, there was extremely loud noise. Some of the individuals reported that the noise had affected their hearing for hours thereafter and that the veteran complained of ringing in his ears. Some reported that, during this boarding procedure, the veteran was the last man to enter the plane, and was exposed to the engine noise the longest. It was additionally reported that this was only one of several times in which they were exposed to the noise of jet engines. During a July 1992 RO hearing, the veteran testified that during his period of World War II active duty in the Army, he served as a rifle instructor, including during a period when he was stationed in China. He said that after several months of this duty he first noticed that he would have ringing in his ears, after finishing a day of instruction on the rifle range, and symptoms would persist for several hours before disappearing. He stated that when he was no longer assigned to this duty, he stopped experiencing ringing in his ears. He reported that he joined the Air Force Reserve when he was discharged from the Army in 1945, and remained in the reserve for many years thereafter. He said it was during the last 15 years of his reserve service that defective hearing was noted. He reported that his duties in the reserve were mostly administrative, and that his normal, civilian occupation had been as a maintenance foreman at a textile mill, where he had worked for approximately 30 years. He stated that hearing examinations were performed on him when he worked at the mill, but that the factory was now out of business and he had no knowledge of where the records of these hearing tests could be obtained. The veteran reported that in September 1978, during a weekend drill with the reserve, he was exposed to jet engine noise for approximately 15 to 20 minutes, while boarding a military plane, and that, from that time forward, his hearing became worse and he started to experience a constant ringing in his ears that has persisted ever since. He stated that his ability to hear steadily decreased over the years and that he now used hearing aids. II. Analysis The veteran's claims are well-grounded within the meaning of 38 U.S.C.A. § 5107(a), in that they are not inherently implausible. Relevant evidence has been properly developed, and no further assistance to the veteran is required to comply with the duty to assist. Id. In order to establish service connection for a claimed disability, the facts, as shown by the evidence, must demonstrate that a particular disease or injury resulting in current disability was incurred during active service or, if preexisting active service, was aggravated therein. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303. Additionally, service connection may be granted for disability resulting from disease or injury incurred in or aggravated while performing active duty for training, or injury incurred or aggravated while performing inactive duty training. 38 U.S.C.A. §§ 101(24), 106, 1110, 1131. The service medical records from the veteran's 1942-1945 active duty Army service show no indication that he had any hearing problems or tinnitus during this period, and there is no medical evidence showing defective hearing for many years after his separation from active service. The normal findings in the active duty Army medical records, and the normal examinations from Air Force reserve service in the 1950s, are considered highly probative evidence of the absence of hearing loss and tinnitus until many years after the veteran's World War II service. The earliest medical documentation of defective hearing is in the reserve service medical records, showing that hearing loss was first noted in the 1960s. All subsequent medical evidence of record does not associate hearing loss or tinnitus with the period of active service. The veteran asserts that the conditions could be due to noise exposure while performing his duties of a rifle instructor in World War II, but the veteran, as a layman, has no competence to give a medical opinion on the diagnosis or etiology of a disorder. Espiritu v. Derwinski, 2 Vet.App. 492, 494 (1992). The Board finds that the absence of medical evidence showing a continuity of hearing loss or tinnitus symptoms for many years after active service is highly probative evidence that these disabilities are not related to the veteran's World War II service. See Mense v. Derwinski, 1 Vet.App. 354 (1991). The preponderance of the evidence establishes that the veteran's bilateral hearing loss and tinnitus were not incurred in or aggravated by his active duty Army service. The veteran also asserts that his hearing loss and tinnitus were incurred in or aggravated by his 1945-1981 Air Force Reserve service, and he particularly argues that an incident in about September 1978, while performing a weekend drill with the reserve (inactive duty training) is implicated. The veteran's hearing testimony and written statements from his fellow reservists, while being probative evidence that they were exposed to jet engine noise in September 1978, do not satisfactorily show that chronic hearing loss and tinnitus (even assuming that these conditions are injuries and not diseases) were caused or worsened by this incident. The veteran and his fellow reservists, as laymen, have no competence to offer medical opinions on the etiology of his current hearing loss and tinnitus. Espiritu v. Derwinski, 2 Vet.App. 492, 494 (1992); Layno v. Brown, 6 Vet.App. 465 (1994). The reserve medical records offer probative evidence against the veteran's assertions. These records show the onset of hearing loss in the 1960s, and gradual deterioration of hearing thereafter. The reserve medical records do not show that tinnitus was ever reported by the veteran, nor do they suggest that the hearing loss was in any way associated with periods of active duty for training or inactive duty training (including the September 1978 episode). There is no medical evidence of tinnitus until 1990 (years after the veteran's 1981 retirement from the reserve). The veteran has reported that he worked for many years in a textile mill and had his hearing tested while employed there, but that the records of these hearing tests were unobtainable. The Board, noting this, finds that it would be all the more speculative to associate the veteran's hearing loss and tinnitus with noise exposure during reserve service, rather than to any of other cause including civilian noise exposure. See Slater v. Principi, 4 Vet.App. 43 (1993). The preponderance of the evidence indicates that chronic hearing loss and tinnitus did not begin during and were not worsened by active duty for training or inactive duty training with the reserve; the conditions were not incurred in or aggravated by reserve service. As the preponderance of the evidence is against the claims, the benefit-of-the-doubt doctrine does not apply, and service connection must be denied. 38 U.S.C.A. § 5107(b); Gilbert v. Derwinski, 1 Vet.App. 49 (1990). ORDER Service connection for bilateral hearing loss and tinnitus is denied. L. W. TOBIN Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.