BVA9505784 DOCKET NO. 92-21 996 ) DATE ) ) On appeal from a decision of the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to service connection for bilateral defective hearing. 2. Entitlement to service connection for bilateral tinnitus. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD E. A. Artman, Associate Counsel INTRODUCTION The veteran served on active duty in the United States Army from September 1951 to June 1953. This matter comes before the Board of Veterans' Appeals (Board) of the Department of Veterans Affairs (VA) on appeal from a December 1991 rating decision of the Montgomery, Alabama, Regional Office (RO). This decision denied an original claim of service connection for bilateral defective hearing. The veteran subsequently expressed his disagreement with this decision. This appeal was initially reviewed by the Board in August 1993, at which time it was remanded for additional evidentiary development. In its remand, the Board noted that the issue of entitlement to service connection for bilateral tinnitus had been raised in the pleadings. In a rating action of May 1994, a claim for this disorder was also denied. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that his bilateral hearing loss and his bilateral tinnitus, which he now experiences on a continuous basis, are attributable to his active service; specifically, he claims that these disabilities have been incurred due to injury sustained to his ears by mortar fire during the Korean conflict. 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 in favor of the veteran's claim of service connection for bilateral defective hearing, and it is in favor of his claim of service connection for bilateral tinnitus. FINDINGS OF FACT 1. All facts pertinent to the veteran's claims have been fully developed for purposes of adjudication. 2. Audiometric test results obtained at two VA examinations, that performed in April 1992 and one performed in February 1994, fully meet the criteria set forth under 38 C.F.R. § 3.385 (1994); the results demonstrate that the veteran has hearing impairment which is productive of disability within the purview of 38 U.S.C.A. § 1110 (West 1991). 3. A review of service medical records reveals that the veteran did report in June 1957 that he had experienced bleeding of the ears after firing mortar in Korea in 1952; the veteran presently asserts that his hearing difficulties began after this incident. 4. Results of the February 1994 VA ear examination include the opinion that the veteran's bilateral, high-pitched, sensorineural hearing loss with decreased speech discrimination scores is consistent with the acoustic trauma he sustained during the Korean conflict. 5. The veteran has asserted that he has suffered from bilateral tinnitus since the incident which led to bleeding in his ears; at the August 1993 VA examination, the veteran reported that his tinnitus had been present on a continuous basis over the previous four years. 6. The medical evidence demonstrates that the veteran has bilateral sensorineural impairment as a result of acoustic trauma incurred during combat in Korea. CONCLUSIONS OF LAW 1. The veteran's bilateral high-frequency sensorineural hearing loss is the result of acoustic trauma incurred during active (wartime) service. 38 U.S.C.A. §§ 1110, 5107, 7104 (West 1991); 38 C.F.R. §§ 3.303, 3.385 (1994). 2. Bilateral tinnitus is the result of acoustic trauma incurred during active (wartime) service. 38 U.S.C.A. §§ 1110, 5107, 7104 (West 1991); 38 C.F.R. § 3.303 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS A review of the veteran's service medical records shows that, when examined for separation purposes in June 1953, he complained of occasional bleeding of his ears at night. Examination revealed that his hearing was 15/15 for the whispered voice bilaterally, which is the same as when examined for entrance purposes in September 1951. At a June 1957 Army Reserves examination, the veteran reported having some bleeding of both ears upon firing mortar while on active duty in Korea in 1952. The veteran stated that he was not examined by a doctor at that time and that his hearing had been unaffected. He further stated that there had been no recurrence of the bleeding. The veteran's hearing at this examination tested as normal; however, no audiometric testing was performed, and the results are those of whispered- and spoken-voice tests. The veteran applied for VA benefits for his hearing problems in October 1991. See VA Form 21-526, Veteran's Application for Compensation or Pension (received by RO, Oct. 31, 1991). Pursuant to his claim, a hearing evaluation report was received of an evaluation performed by a private audiologist, Rebecca Brooks, M.A., in August 1991. This report includes a history of the veteran having difficulty with his hearing for most of his adult life, and of his bleeding following an explosion in the Korean war. Based on the results of audiometric testing, the veteran was found to have a severe, high-frequency, sensorineural hearing loss in both ears. This loss was noted to be that typically associated with noise exposure. Results of a VA examination, which was performed in April 1992, were consistent with those results obtained at the August 1991 evaluation. Significantly, the veteran complained or tinnitus and dizziness in addition to his loss of hearing acuity. He stated that his tinnitus had commenced following an explosion in 1952, and that he would describe it as moderate in intensity. The April 1992 examiner provided no opinion as to whether the veteran's hearing loss or tinnitus was related to his inservice noise exposure. Pursuant to the remand action of August 1993, the veteran's hearing was again examined by VA. At that time, audiometric test results revealed his hearing acuity to be 15, 15, 65, 70 and 85 decibels in the right ear and 15, 15, 65, 90 and 100 decibels in the left ear at the frequencies of 500, 1,000, 2,000, 3,000 and 4,000 hertz, respectively. Speech discrimination scores of 68 percent in the right and 76 percent in the left ear were obtained. These results were summarized as indicating that the veteran had a severe, high-frequency, sensorineural hearing loss in the right ear, and a severe-to-profound, high-frequency, sensorineural hearing loss in the left ear. The examiner noted that, when asked about his tinnitus, the veteran reported that it had been present on a continuous basis over the previous four years, and that he would rate it as a moderately-severe problem because it was a constant irritation to him. A VA examination of the ear was also performed in February 1994. At this examination, it was reported that the veteran had been involved in several campaigns during his service in Korea in which he had been subjected to significant mortar fire. It was further reported that the final episode of this combat had resulted in acoustic trauma, as manifested by a sudden onset of tinnitus, hearing loss and bilateral bloody otorrhea. It was noted that the discharge resolved without difficulty, but that the tinnitus and hearing loss had persisted. The veteran stated that the loss had increased in severity over the years, and that his tinnitus, while a constant, seemed to be worse at night. Upon physical examination, the veteran was found to have normal- appearing auricles. The right external auditory canal had some cerumen but the tympanic membrane was easily-visualized. No evidence of middle ear fluid or perforation could be found in this ear. Furthermore, there were no postauricular scars and the right side of the mastoid was found to be non-tender. Turning to the left side, it was noted that the external auditory canal was clear with a slight amount of sclerosis in the anterior-inferior quadrant but with no evidence of middle ear fluid. The ossicles were normal in appearance and there were no postauricular scars and no mastoid tenderness. Based on these findings and a review of the audiometric test results, the examiner provided an impression of bilateral, high-pitched, sensorineural hearing loss with decreased speech discrimination scores, which was found to be consistent with the acoustic trauma sustained by the veteran during the Korean conflict. Throughout his appeal, the veteran has contended that his hearing loss and tinnitus are the result of acoustic trauma which he sustained during his service in Korea. In support of his contentions, he has submitted lays statements from family and acquaintances which attest to the fact that he has had hearing problems since his discharge. Letter of Louise K. Watson (Apr. 24, 1992); letter of William H. Smith (Apr. 23, 1992); letter of Daniel E. Riales (Apr. 14, 1992). After reviewing the evidence of record, the Board notes that it finds the veteran's claims of service connection to be well- grounded, within the purview of 38 U.S.C.A. § 5107(a). That is to say, the veteran has submitted claims which are plausible, as supported by the requisite competent medical evidence to that effect. See Grottveit v. Brown, 5 Vet.App. 91 (1993). Furthermore, we find that VA has met its duty under § 5107(a) to assist the veteran in the development of all facts pertinent to his well-grounded claims. See Grottveit at 93. Thus, these claims are adequately developed for purposes of appellate adjudication. I. Service Connection for Bilateral Defective Hearing Service connection may be established for disability resulting from an injury or disease incurred in or aggravated by active service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303(a) (1994). Each disabling condition shown by a veteran's service records, or for which he seeks a service connection must be considered on the basis of the places, types and circumstances of his service as shown by service records, his medical records, and all pertinent medical and lay evidence. 38 C.F.R. § 3.303(a). Impaired hearing will be considered a disability for purposes of granting service connection provided the veteran's auditory threshold in any of the frequencies of 500, 1,000, 2,000, 3,000 and 4,000 hertz is 40 decibels or greater; or his auditory thresholds for at least three of the frequencies of 500, 1,000, 2,000, 3,000 and 4,000 hertz are 26 decibels or greater; or his speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385 (1994). In the present case, the veteran's audiometric test results of both the April 1992 and February 1994 VA examinations satisfy all three criteria set forth in § 3.385; hence, the evidence demonstrates that the veteran has a bilateral hearing impairment which is productive of "disability" within the purview of 38 U.S.C.A. § 1110. The question of whether service connection is merited thus rests upon a consideration of whether this disability was incurred as a result of active service. The record supports a finding that some acoustic trauma was incurred in service since, as early as 1953, the veteran was reporting bleeding in his ears. In 1957, he indicated that the bleeding began in 1952 in Korea, as a result of his exposure to mortar firing in 1952. Furthermore, the February 1994 examiner clearly states that he finds the veteran's hearing loss to be consistent with that induced by the type of acoustic trauma experienced by the veteran during his Korean service. The August 1991 conclusions of the private audiologist seem to concur with this finding, particularly since no other incident of noise exposure which would lead to acoustic trauma is recounted in this examiner's history. Finally, we note that the veteran's assertions, along with those of his sister and acquaintances, indicate that the onset of the veteran's difficulties with hearing can be dated back until the time of his discharge. Given this evidence, the Board can only conclude that the preponderance of the evidence supports a finding that the veteran's bilateral hearing loss is due to acoustic trauma incurred during his active military service. Accordingly, this evidence is in favor of his claim of service connection for bilateral defective hearing, and this claim is granted. II. Service Connection for Bilateral Tinnitus With regard to the veteran's claim of service connection for bilateral tinnitus, we must conclude that the evidence of record is equally supportive of a grant. The veteran has asserted that he has had this condition since an injury was incurred to his ears in service, and that he continues to experience it at the present time. Moreover, the medical evidence establishes that the veteran has sustained sensorineural impairment to each ear, and that, as stated above, this impairment is attributed to the acoustic trauma he incurred during combat in Korea. Thus, the evidence shows that the veteran currently has tinnitus which is the result of an injury incurred during active service; consequently, his claim of service connection for bilateral tinnitus is established. ORDER Service connection for bilateral defective hearing is granted, as is service connection for bilateral tinnitus. BARBARA B. COPELAND 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.