HEARING LOSS

SHEREEN M. MARCUS · 2026 · Case ID: A26040702

GRANTED

Summary

The veteran, who served in the United States Air Force from August 1974 to July 1980, appeals the denial of service connection for bilateral hearing loss. The veteran claims her current hearing loss is due to exposure to hazardous noise during service, citing duties involving generators, amplifiers, and intermittent use of inadequate hearing protection. Service treatment records showed normal hearing at separation, but a March 1980 separation examination noted chronic negative pressure in the left ear drum. Post-service records first documented hearing complaints in July 2009. VA examinations in December 2009, June 2019, and August 2020, along with a July 2019 addendum opinion, generally found the hearing loss less likely than not related to service, citing normal in-service hearing tests and lack of evidence for delayed onset hearing loss. However, private medical opinions from Dr. A.C. (March 2019) and Dr. S.J. (March 2020, April 2025) opined that the bilateral hearing loss was at least as likely as not due to military noise exposure, citing the veteran's MOS, intermittent hearing protection use, lack of post-service noise exposure, and studies suggesting delayed onset hearing loss is possible. The Board found the evidence in approximate balance, with the private opinions being compelling due to consideration of the veteran's specific circumstances and supporting medical literature. The Board also noted the veteran's credible testimony and her son's supporting statement regarding the onset and progression of her hearing issues. Given the approximate balance of evidence, the Board resolved doubt in the veteran's favor, granting service connection for bilateral hearing loss.

Rationale

Evidence in approximate balance; Private opinions compelling; Credible veteran testimony; Benefit of doubt applied

Service Branch

AIR FORCE

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210512-159591

Full Decision Text

Citation Nr: A26040702
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 210512-159591
DATE: April 30, 2026

ORDER

Entitlement to service connection for bilateral hearing loss is granted.

FINDING OF FACT

The persuasive evidence of record is in approximate balance as to whether the Veteran's hearing loss is due to service.

CONCLUSION OF LAW

The criteria for entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Air Force from August 1974 to July 1980.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from an April 2021 rating decision issued by a VA Regional Office (RO).

In the May 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on March 14, 2025, before the undersigned.

Therefore, the Board may only consider the evidence of record at the time of the April 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

In this regard, the Board notes the Veteran's representative timely submitted a supporting statement from the Veteran's son, as well as a private medical opinion in February and April 2025. As such, this additional evidence and argument have been considered and will be addressed in the decision below.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

The Board has limited the discussion below to the relevant evidence required to support its finding of fact and conclusion of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008).

Service Connection

Generally, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

Certain chronic diseases, such as bilateral hearing loss, will be presumed related to service, absent an intercurrent cause, 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 (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

In rendering this decision, the Board has reviewed all evidence of record whether discussed in detail. See Newhouse v. Nicholson, 497 F.
able degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

In rendering this decision, the Board has reviewed all evidence of record whether discussed in detail. See Newhouse v. Nicholson, 497 F.3d 1298, 1302 (Fed. Cir. 2007) (holding the Board must only discuss the evidence which is relevant to the issues on appeal). To the extent the evidence is found in "approximate balance," the Board will afford the benefit of the doubt in favor of the Veteran. Lynch v. McDonough, 21 F. 4th 776 (Fed, Cir. 2021) (holding that exact equipoise is not required for the benefit of the doubt to be applied, but rather the Veteran is entitled to the benefit of the doubt when the evidence is in approximate balance or "nearly equal").

Entitlement to service connection for bilateral hearing loss is granted.

The Veteran contends that her current bilateral hearing loss is a direct result of exposure to hazardous noise she experienced during her active-duty service. Specifically, she asserts that her duties as a satellite communication systems operator required her to work around large diesel generators and amplifiers and was issued only "torn up earmuffs" for protection which had to be taken off repeatedly in order to communicate with fellow servicemembers. See February 2019 Supporting Statement; see also March 2025 Board Hearing, P. 11. Lastly, she has reported that her ear troubles began in service as she suffered a ruptured right ear drum and in March 1980, during separation from service was noted to have had "chronic negative pressure in her left ear drum". See February 2019 Supporting Statement.

Service connection claims for hearing loss, the Board notes that this disability is defined by regulation. Specifically, under the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; when the auditory thresholds for at least three of the above frequencies 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. Additionally, the Board observes that precedential case law provides that the threshold for normal hearing is between 0 and 20 decibels and that higher thresholds show some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993).

The absence of in-service evidence of hearing loss is not fatal to a claim for service connection. Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Evidence of a current hearing loss disability (i.e., one meeting the requirements of 38 C.F.R. § 3.385, as noted above) and a medically sound basis for attributing such disability to service may serve as a basis for a grant of service connection for hearing loss. Hensley v. Brown, 5 Vet. App. at 159. Moreover, to establish service connection for sensorineural hearing loss, a veteran is not obligated to show that his hearing loss was present during active service. However, if there is insufficient evidence to establish that a claimed chronic disability was present during service or during the one-year presumptive period thereafter, the evidence must establish a nexus between his current disability and his in-service exposure to loud noise. Godfrey v. Derwinski, 2 Vet. App. 352 (1992).

Turning to the relevant evidence of record, the Veteran's DD-214 reflects that her military occupational specialty (MOS) was space communications systems equipment operator/specialist. It is not reasonably in dispute that the Veteran has a diagnosis of bilateral hearing loss for VA purposes, and that her MOS has at least a moderate probability of military noise exposure and the RO favorable found as such. See April 2021 Rating Decision. Therefore, the sole remaining question before the Board is whether there is a nexus between the Veteran's current bilateral hearing loss and her in-service noise exposure.

Service treatment records (STRs) contain no complaints, treatment, or diagnosis of any hearing related issues
winski, 2 Vet. App. 352 (1992).

Service treatment records (STRs) contain no complaints, treatment, or diagnosis of any hearing related issues. However, the Veteran's March 1980 separation examination did note "chronic negative pressure" in the left ear drum. No additional details, treatment, or diagnosis were provided. An audiogram conducted at the time revealed the following pure tone thresholds in decibels:

HERTZ

500 1000 2000 3000 4000

RIGHT 5 0 0 0 0

LEFT 10 5 5 0 5

Post service treatment records first document any treatment or complaints for hearing loss in July 2009. See July 2009 VA Audiology Consultation. The Veteran was next seen for hearing related issues in February 2019 in which it was noted that a "slight decrease in hearing compared to 2009" and hearing aids were ordered.

In December 2009, the Veteran was afforded her first VA hearing loss examination. At which time, the examiner noted the Veteran's report that she worked around generators and trucks as well as satellite dishes with hearing protection having been used only intermittently. Post service noise exposure as well as recreational noise exposure was noted to be negative as she worked on computers. The examiner also noted the Veteran's reports of no history of ear infections, surgeries, ear related disease, as well as no family history of hearing loss. After physical examination and audiometric testing, the examiner diagnosed the Veteran with bilateral sensorineural hearing loss which was noted to be mild in the right ear and mild to moderately severe in the left ear. Ultimately, the examiner opined that the Veteran's hearing loss was not caused by noise exposure in the military as she had normal hearing bilaterally upon separation from service. Lastly, the examiner reported that the "configuration and type of hearing loss presented upon today's hearing tests are not that of noise induced etiology bilaterally".

In March 2019, the Veteran submitted a private medical report by Dr. A.C. (received by VA in April 2019). Dr. A.C. noted that the Veteran came to her office with a long-standing history of bilateral hearing loss and tinnitus and that the Veteran reported first noticing difficulty hearing approximately 15 years ago and that it has progressively worsened over time. Dr. A.C. noted that the Veteran served in the Air Force and worked on communications equipment as part of her MOS which had a moderate probability of noise exposure. The examiner also noted that the Veteran was exposed to constant machinery noise from generators and amplifiers on a daily basis. Hearing protection was used; however, she recalled that it was difficult to utilize the over the head earmuffs because of the need to communicate with other servicemembers while working. The Veteran was noted to have no family history of hearing loss, and no post-service noise exposure was indicated. Upon testing, the examiner diagnosed the Veteran with mild to moderate high frequency sensorineural hearing loss bilaterally which was noted to be slightly worse in the left ear.

Ultimately, Dr. A.C. opined that the Veteran's bilateral hearing loss is at least as likely as not due to noise exposure she experienced while serving in the Air Force. The examiner explained that "sloping sensorineural hearing loss especially in high frequencies is associated with noise exposure" and that "the Veteran's hearing loss is greater than what would be expected for her age". In support thereof, Dr. A.C. noted the findings of a 2005 Institute of Medicine (IOM) study entitled "Noise and Military Service: Implications for Hearing Loss" that stated there is not sufficient evidence from longitudinal studies in humans to determine whether permanent noise induced hearing loss can develop later in one's lifetime long after the cessation noise exposure it further states that the definitive studies to address this issue have not been performed. Contrary to this study, Dr. A.C. cited a Gates and Colleagues 2000 study which indicated that any history of prior noise exposure affects auditory thresholds. The study concluded that ears with prior noise exposure are altered in such a way that fosters continue worsening hearing sensitivity over time. "More specifically, the finding of accelerated loss of hearing indicates a progression of the noise damage in the absence
of Medicine (IOM) study entitled "Noise and Military Service: Implications for Hearing Loss" that stated there is not sufficient evidence from longitudinal studies in humans to determine whether permanent noise induced hearing loss can develop later in one's lifetime long after the cessation noise exposure it further states that the definitive studies to address this issue have not been performed. Contrary to this study, Dr. A.C. cited a Gates and Colleagues 2000 study which indicated that any history of prior noise exposure affects auditory thresholds. The study concluded that ears with prior noise exposure are altered in such a way that fosters continue worsening hearing sensitivity over time. "More specifically, the finding of accelerated loss of hearing indicates a progression of the noise damage in the absence of continuing noise exposure". An additional study by Rosenthal in 2003 was cited which further supported that age-related deterioration of hearing loss was more pronounced in men with prior noise exposure as compared with those who are not. Thus, Dr. A.C. found that there is evidence that the aging process is different from noise damaged hearing. Lastly, Dr. A.C. cited a 2006 study by Kujawa and Liberman which showed that noise exposure can lead to threshold shifts that progress for years after the exposure and are associated with primary degeneration of the collicular nerve. Thus, Dr. A.C. reported that "the fact that the Veteran had normal hearing thresholds upon separation from service does not necessarily indicate that no damage occurred to her ears". Dr. A.C. concluded that "it is my contention that although research cannot support 100% that excessive noise exposure contributes to delayed hearing loss and tinnitus, the existing research also cannot confirm with 100% certainty that these changes do not occur...[a]s referenced above longitudinal studies confirmed that hearing loss can occur later in life as a result of prior noise exposure...[m]oreover an absence of any other probable cause (recreational exposure occupational exposure drugs, head trauma or family history etcetera), it is at least as likely as not that a significant percentage of [the Veteran's] bilateral hearing loss and associated tinnitus is due, at least in part, to military noise exposure".

The Veteran was afforded another VA hearing loss examination in June 2019, pure tone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 20 20 35 45 50

LEFT 35 35 40 50 60

Speech discrimination scores were indicated to reveal 92 percent in the right ear and 96 percent in the left ear. The examiner diagnosed the Veteran with bilateral sensorineural hearing loss and noted the Veteran's difficulties with hearing and understanding speech to include normal conversations, watching television, and when background noise was present. She was noted to current wear VA issued hearing aids which were reported to be helpful. The examiner also noted that the Veteran worked around generators and trucks with the use of intermittent hearing protection while in the military. Post-service and recreational noise exposure were noted to be negative. Ultimately, the examiner opined that the Veteran's bilateral hearing loss was less likely than not related to service. The examiner noted that audiograms conducted during service revealed normal hearing bilaterally and that there were no significant positive in-service threshold changes. The examiner further cited to the 2005 IOM study first noted by Dr. A.C. above, to conclude that "there was no reasonable basis for delayed onset hearing loss".

An addendum VA medical opinion was obtained in July 2019 from a different examiner. The examiner provided a through and highly detailed opinion finding the Veteran's currently diagnosed bilateral hearing loss was less likely than not related to service. The examiner noted that her STRs contained audiograms which revealed normal hearing and that exposure to hazardous noise has been conceded but ultimately noted that "there was no noise injury while in service". Post service treatment records were also noted to reveal the first documented report of hearing complaints occurred in 2009 and there was no further evidence of evaluation or treatment for hearing loss or tinnitus until 2019. In additional support of his opinion, the examiner cited to the 2005 IOM study to conclude that there is insufficient evidence to support the medical probability of delayed onset hearing loss. The examiner therefore concluded that "based on the objective evidence of service records with hearing testing conducted in service and at time of discharge along with the veteran's current audiological assessments beginning in 2009 in which sudden onset of tinnitus and hearing loss was first documented along with a medical history to include a family history of tinnitus... it is the opinion of this examiner that the hearing loss...is less likely than not due to military noise exposure...delayed onset hearing loss due to noise exposure is unlikely to occur...in the absence of an objectively verifiable noise injury while in service, the
his opinion, the examiner cited to the 2005 IOM study to conclude that there is insufficient evidence to support the medical probability of delayed onset hearing loss. The examiner therefore concluded that "based on the objective evidence of service records with hearing testing conducted in service and at time of discharge along with the veteran's current audiological assessments beginning in 2009 in which sudden onset of tinnitus and hearing loss was first documented along with a medical history to include a family history of tinnitus... it is the opinion of this examiner that the hearing loss...is less likely than not due to military noise exposure...delayed onset hearing loss due to noise exposure is unlikely to occur...in the absence of an objectively verifiable noise injury while in service, the association between claimed hearing loss and tinnitus and noise exposure cannot be assumed to exist".

The Veteran was afforded another VA hearing loss examination in August 2020, pure tone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 35 35 45 50 60

LEFT 40 40 50 55 65

Speech discrimination scores were noted to be 100 percent bilaterally. The examiner then diagnosed the Veteran with bilateral sensorineural hearing loss. It was also noted that the Veteran served six years in the Air Force with exposure to generators, amplifiers, and weapons and that she had no post-service noise exposure due to her occupation repairing computers. Ultimately, the examiner opined that the Veteran's hearing loss was less likely than not caused by or a result of her military service. The examiner explained that her entrance and separation examinations were normal thus there were no significant shifts in hearing acuity during service. The examiner concluded that "currently the Veteran has bilateral hearing loss, however, hearing loss 30 plus years after exiting military service cannot be due to military service".

In March 2020, the Veteran submitted a private opinion by Dr. S.J. of Florida E.N.T. & Allergy dated from March 2020. Dr. S.J. reported that the Veteran had been seen in their offices in January 2020 for evaluation and presented a long standing history of bilateral hearing loss. Dr. S.J. noted the Veteran's service in the Air Force for six years and her reports of having been exposed to constant machinery noise due to her MOS and that the use of hearing protection was intermittent due to the need to communicate properly. The Veteran's pre and post service noise exposure history was noted to "not significant" and the Veteran was noted to have no family history of hearing related issues. Dr. S.J. than reported that "aside from genetic disposition or a disease/syndrome, sloping sensorineural hearing gloss especially in high frequencies are associated with noise exposure". She then concluded that "based on the Veteran's history and audiometric evaluation, it is at least as likely as not that her bilateral hearing loss and tinnitus are due to noise exposure while serving in the United States Air Force".

Another VA medical opinion was obtained in April 2021. The examiner provided a negative nexus opinion and reported that the Veteran "clearly had hearing well within normal limits at separation from the military and the first documented reports of hearing loss occurred in 2009. The examiner than remarked that Dr. A.C. (Pasadena Hearing Center) had noted in her opinion the Veteran's own reports of onset of hearing loss 15 years prior to her examination and that she had normal hearing at time of separation. Therefore, the VA examiner concluded that Dr. A.C.'s opinion was provided without "using the objective information provided in STRs and did not provide a nexus between the onset of hearing and military noise exposure but instead provided an onset 14 years after separation...therefore this examiner is not in agreement with [Dr. A.C.]. The examiner further noted that since the Veteran's hearing acuity was normal at separation, there is no evidence that the Veteran's military noise exposure caused a permanent noise injury affecting hearing sensitivity. "Therefore, the Veteran's current hearing loss is deemed less likely than not cause by or resulting from military noise exposure".

In March 2025, the Veteran testified before the undersigned that during service, she worked on big satellite dishes "four leaf clovers" that ran 10kw generators constantly along with amplifiers which have a high-pitched whine. See March 2025 Board Hearing, P. 11. She worked around this equipment constantly over the course of her 6-year career and was only given "torn-up" earmuffs as protection which could not be used constantly because of the need to communicate frequently with fellow servicemembers. Id. This exposure is what she believes has caused her current hearing loss. Id. The Veteran also testified that she does not remember exactly when she first noticed hearing loss, "I just found myself after out of the military saying more huh, what, huh, and I don't know if it was habit or what...but it's gotten so bad now where I can't even hear my family half the time". Id. at 4-5. She did report that her hearing loss became worse enough to seek treatment in 2008/2009 shortly before filing her first claim for benefits with VA. Id. at 5. Post-service, she reported building satellites for RCA, which was done in a very sterile, clean, and quite environment. Id. at 7. She further testified that she currently owns and operates a computer business in which she repairs personal computers and doesn't even listen to the radio in order to concentrate on her work. Id. Lastly, she testified to participating in leisure activities such as bowling and fishing and occasionally attending a club that is "not noisy or anything". Id.

In April 2025, the Veteran's representative submitted an additional private opinion by Dr. S.J. dated from February 2025. Dr. S.J. once again noted the Veteran's MOS and duties in service which resulted in exposure to hazardous noise. She also reported that upon audiologic evaluation in her office, the Veteran was diagnosed with mild to moderately severe bilateral sensorineural hearing loss. Ultimately, Dr. S.J. opined that "based on the Veteran's history and audiometric evaluation it is at least as likely as not that her bilateral hearing loss and tinnitus are due to noise exposure while serving in the United States Air Force...the Veteran's hearing loss is greater than what would be expected for her age based on aging alone". In support of her opinion, Dr. A.C. noted the findings of the 2005 IOM study discussed earlier by prior examiners noted above, and cited to several contrary studies which were also cited to by Dr. A.C. in her March 2019 opinion, to include a 2000 Gates report. Dr. S.J. further cited to findings made by the Occupational Safety and Health Administration (OSHA), which has found that "steady state noise levels of 90 decibels can cause hearing damage in eight hours and noises of 100 decibel damage hearing in just two hours of exposure...this along with research stating that exposure to high noise levels over a period of time gradually causes permanent damage to the ear, provides a link between the Veteran's symptoms and her period of military service".

In further support of her claim, the Veteran submitted a supporting statement from her son in April 2025. At which time, her child reported remembering his parent left the military in 1980 and he was roughly 4 years old at the time. Nonetheless, he reported remembering having to repeat himself often during conversations with her "because it seemed like my parent wasn't catching what I was saying". He further reported observing his parent struggle to hear during family dinners and that the TV was always turned up really loud. Lastly, he reported remembering that "back then my parent didn't seem to realize that their hearing was an issue, it wasn't clear to anyone how much these hearing problems would affect life later on".

Analysis

It is not reasonably in dispute that the Veteran has a diagnosis of bilateral hearing loss for VA purposes as the auditory thresholds for at least three of the above frequencies are 26 decibels or greater, and that based on the nature of her MOS and competent lay statements regarding her service experiences, exposure to military noise is conceded. As such, the determinative question is whether in-service noise exposure resulted in the current bilateral hearing loss.

In that regard, the Board finds the evidence at least in approximate balance.

On the one hand, the VA examiners found the Veteran's bilateral hearing loss unlikely attributable to military noise exposure given the lack of significant threshold shifts during service (i.e., any indication of significant hearing loss during service) as well as the lack of available scientific evidence confirming the possibility of delayed onset hearing loss.

On the other hand, the Veteran's private physicians largely opined to the contrary noting additional important factors, to include the Veteran's in-service MOS duties with only intermittent use of hearing protection
statements regarding her service experiences, exposure to military noise is conceded. As such, the determinative question is whether in-service noise exposure resulted in the current bilateral hearing loss.

In that regard, the Board finds the evidence at least in approximate balance.

On the other hand, the Veteran's private physicians largely opined to the contrary noting additional important factors, to include the Veteran's in-service MOS duties with only intermittent use of hearing protection, her lack of post-service noise exposure, as well as medical literature finding delayed onset of hearing loss possible, particularly in the Veteran's case.

The Board finds the private opinions, when considered together, compelling in that the Veteran's specific circumstances were considered and noting medical studies finding delayed hearing loss possible under certain circumstances. These findings are all the more persuasive given the credible testimony by the Veteran as well as the supporting statement by her son of noticing the onset of the Veteran's hearing loss shortly after separation from service with continued symptoms ever since.

Furthermore, no medical report, VA or private, specifically addressed the Veteran's reported and documented March 1980 separation examination which noted "chronic negative pressure" in her left ear drum. The importance, if any, of this notation was missed by all and normally would be grounds for remand as a pre-decisional duty to assist error. However, in this case the evidence is already in relative equipoise on a direct theory of service connection and thus, to remand would only unduly delay the Veteran's appeal and possibly result in negative evidence. See Hart v. Mansfield, 21 Vet. App. 505 (2007); see Mariano v. Principi, 17, Vet. App. 305, 312 (2003) (holding the Secretary has a duty to assist a claimant in the development of his or her case but may not undertake additional development if the purpose of such development is to obtain evidence against the claim).

Accordingly, at a minimum, the competing persuasive medical opinions of record renders the appeal in approximate balance. Accordingly, any reasonable doubt must be resolved in the Veteran's favor, and, therefore, the appeal is granted. Service connection for bilateral hearing loss is granted.

SHEREEN M. MARCUS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Minnitte, Samuel F.

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.

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