BVA9500082 DOCKET NO. 93-08 332 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in San Francisco, California THE ISSUES 1. Entitlement to service connection for residuals of chronic lung disorder, to include pleurisy. 2. Entitlement to service connection for hearing loss of the right ear. REPRESENTATION Appellant represented by: California Department of Veterans Affairs ATTORNEY FOR THE BOARD A. K. Mulroy, Associate Counsel INTRODUCTION The veteran had active duty from June 1974 to July 1990. He was denied service connection for pleurisy and right ear hearing loss in a November 1991 rating decision from the San Francisco, California, Regional Office (hereinafter RO). The veteran has appealed to the Board of Veterans Appeals (hereinafter the Board). The veteran is represented by the California Department of Veterans Affairs. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he suffered from pleurisy and several other lung conditions during service, and that he is therefore entitled to service connection. He also maintains that his right ear hearing loss that existed prior to service worsened during service, and that he is entitled to service connection on the basis of aggravation of his preexisting condition. DECISION OF THE BOARD In accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), following review and consideration of all evidence and material of record in the veteran's claims file, and for the following reasons and bases, it is the decision of the Board that the veteran's claim for service connection for residuals of a chronic lung disorder, to include pleurisy, is not well- grounded, and is therefore dismissed. The Board also concludes that service connection for right ear hearing loss is warranted. FINDINGS OF FACT 1. The claim for service connection for a chronic lung disorder, to include pleurisy, is not supported by cognizable evidence showing that the claim is plausible or capable of being substantiated. 2. All relevant evidence necessary for an equitable disposition of the remainder of the appeal has been obtained. 3. Right ear hearing loss was identified on the veteran's enlistment examination, has been shown to have increased during service, and the veteran has been shown to have been exposed to acoustic trauma in service. 4. An increase in the severity of right ear hearing loss during service has not been shown to be due to the normal course of the disorder, and has been reasonably shown to have had origins in service. CONCLUSIONS OF LAW 1. The appellant has not submitted a well-grounded claim for entitlement to service connection for residuals of a chronic lung condition, to include pleurisy. 38 U.S.C.A. §1110, 1131, 5107 (West 1991); 38 C.F.R. § 3.303 (1993). 2. Preexisting hearing loss of the right ear was aggravated in service. 38 U.S.C.A. §§ 1110, 1131, 1153, 5107 (West 1991); 38 C.F.R. §§ 3.303, 3.306, 3.385 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Board notes that the threshold question to be answered is whether the veteran has presented a well-grounded claim within the meaning of 38 U.S.C.A. § 5107. That is, the veteran must have presented a claim that is plausible. If not, the appeal must fail. The Board finds that the claim for service connection for a chronic lung disorder, to include pleurisy, is not well-grounded. His claim for service connection for right ear hearing loss is well grounded. There is no indication of outstanding evidence; therefore there is no further duty to assist the veteran with the development of this aspect of his appeal as mandated by 38 U.S.C.A. § 5107. The Board's reasoning is summarized below. Service connection may be established for disability resulting from injury suffered or disease contracted in the line of duty, or for aggravation of a preexisting injury or disease. 38 U.S.C.A. §§ 1110, 1131. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Every veteran shall be taken to have been in sound condition when examined for entry into service, except as to defects noted at the time of entry into service, or where clear and unmistakable evidence demonstrates that the injury or disease existed prior to service and was not aggravated by service. 38 U.S.C.A. § 1111. I. The Board will first address the veteran's claim for service connection for a chronic lung disorder, to include pleurisy. As previously noted, the veteran served from June 1974 to July 1990. In service medical records, there are references to the veteran's multiple complaints of left chest pain, coughs, and colds. A chest x-ray dated in November 1979 was interpreted as revealing a blunted right costophrenic angle. Subsequent x-rays dated in December 1980, November 1984, and January 1987, which were interpreted as revealing a blunted costophrenic angle, refer to it as being on the left. An x- ray taken for purposes of a Medical Board in January 1990, was interpreted as revealing left pleural thickening and no other abnormalities. During service, the veteran was variously diagnosed with pleurisy, bronchitis, upper respiratory tract infections, viral syndrome, and colds. In VA outpatient treatment records dated from August 1990 to May 1991, the veteran has complained of aches and pain all over his body, and specifically complained of rib cage pain and left upper quadrant pain in March 1991. He has been diagnosed by the mental hygiene clinic with psychosis, but no definitive diagnoses were given regarding the chest pain complaints. In a VA examination dated in May 1991, the physician noted that the veteran reportedly had several episodes of pleuritic chest pain, but upon examination, had no respiratory symptoms and was reportedly on no medications. A chest x-ray was noted as revealing clear lung fields and the impression was of a normal chest. The diagnosis was history of pleurisy with a history of blunted left costophrenic angle. Upon review of all the evidence, the Board finds that the veteran has not met the threshold requirement of submitting a well- grounded claim regarding his claim for service connection for a chronic lung disorder. There is no evidence that the veteran's service has caused any type of continuing lung disorder, or that a chronic lung disorder is otherwise related to service. There is no medical evidence that the veteran currently suffers from residuals of a chronic lung disorder. The veteran has stated that he believes his current left chest pain is the result of his inservice lung problems. The veteran's belief that he currently has what could be considered a chronic lung disability is not, of itself, a sufficiently probative basis for granting the appeal, given the other factual circumstances present in this case. Matters involving substantiating a medical diagnosis, or which involve other medical questions, such as causation, require supportive evidence developed through individuals having the expertise necessary to render their findings and opinions probative. Espiritu v. Derwinski, 2 Vet.App. 494 (1992). Although the veteran's statements regarding his symptomatology are well meaning and informative, the Board does not find his contentions constitute a well-grounded claim, considering the absence of any supportive, corroborating documentary evidence of a current disorder or residuals of a chronic disorder which may have been present during service. The Board concludes that the veteran's claim is not well-grounded and that the claim of entitlement to service connection for a chronic lung disorder, to include pleurisy, is dismissed. II. The Board will next address the claim for service connection for hearing loss of the right ear. In addition to the previously noted law and regulations regarding service connection, impaired hearing will be considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, 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 (1994). On his enlistment examination dated in February 1974, it was noted that the veteran's right ear hearing had a 5 decibel threshold at the frequency of 500 hertz; a 5 decibel threshold at the frequency of 1000 hertz; a zero decibel threshold at the frequency of 2000 hertz; a 15 decibel threshold at the frequency of 3000 hertz; a 45 decibel threshold at the frequency of 4000 hertz; and a 50 decibel threshold at the frequency of 6000 hertz. During service, it was noted on hearing examinations that the threshold for the frequency of 4000 hertz was 55 in 1977; 45 in 1978; 50 in 1979 and 1984; 60 and 65 in 1989. On his Medical Board examination at separation in January 1990, it was noted that his right ear hearing had a zero decibel threshold at the frequencies of 500, 1000, 2000, and 3000 hertz; a 65 decibel threshold at the frequency of 4000 hertz; and a 55 decibel threshold at the frequency of 6000 hertz. At a VA examination dated in May 1991, it was noted that the veteran's right ear hearing had a 10 decibel threshold at the frequency of 1000 hertz; a 5 decibel threshold at the frequency of 2000 hertz; a 10 decibel threshold at the frequency of 3000 hertz; and a 60 decibel threshold at the frequency of 4000 hertz. Speech recognition of the right ear was noted as 96 percent. The diagnosis was bilateral high frequency sensorineural hearing loss. Service connection has been granted for left ear hearing loss. In his substantive appeal dated in October 1992, the veteran has stated that he believed his right ear hearing loss had increased during service more than it would have under "normal" working conditions. He attributed the increase to being around extensive noise, including aircraft and flight line noise. He also stated that he worked in the field of communication from 1972 to 1984, and he wore headsets and listened to radio signals for an average of seven hours a day. Personnel records indicate that the veteran was a ground radio communication technician, a Morse system operator, a Morse system supervisor, and a services supervisor. The Board concludes that the veteran is entitled to service connection for right ear hearing loss. His enlistment examination was interpreted to reveal that hearing loss of the right ear existed prior to service. Therefore, he is not entitled to the presumption of sound condition upon entry into service, because such presumption is not applicable with regard to any "defects" noted upon entry into service. 38 U.S.C.A. § 1111. The question for the Board, therefore, becomes whether the veteran's preexisting hearing loss was aggravated by service. A preexisting injury or disease will be considered to have been aggravated by active service where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progression of the disease. 38 U.S.C.A. § 1153. Additionally, with respect to veteran's of wartime service, clear and unmistakable evidence (obvious or manifest) is required to rebut the presumption of aggravation where preservice disability underwent an increase in severity during service; this includes medical facts and principles which may be considered to determine whether the increase is due to the natural progress of the disease. 38 C.F.R. § 3.306(b). The Court of Veteran's Appeals has found that this presumption of aggravation applies where there is a worsening of the disability regardless of whether the degree of worsening was enough to warrant compensation; and that the veteran need not show a specific link between his inservice activity and the deterioration of his preservice disability. Browder v. Derwinski, 1 Vet.App. 204, 207 (1991); Hensley v. Brown, 5 Vet.App. 163 (1993). The Board concludes that the veteran's right ear hearing loss is reasonably shown to have increased during service. It has not been shown that such increase was due to the natural progression of the disease; nor is there any evidence which otherwise rebuts the presumption of aggravation. In view of all the evidence, particularly the veteran's military occupational specialty and his service during wartime, it is found that the evidence is at least in equipoise, and reasonably supports a finding that the veteran's preservice right ear hearing loss was aggravated during service. The veteran must also be accorded the benefit of the doubt. The Board concludes that given the evidence of record, and the lack of clear and unmistakable evidence to rebut the presumption of aggravation, service connection for right ear hearing loss is warranted. ORDER Because the claim is not well-grounded, the claim of entitlement to service connection for residuals of a chronic lung disorder, to include pleurisy, is dismissed. Service connection for hearing loss of the right ear is granted. JEFF MARTIN 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.