—————————————————- Designated for electronic publication only UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS NO. 12-3694 GARY D. CORSON, APPELLANT, V. ERIC K. SHINSEKI, SECRETARY OF VETERANS AFFAIRS, APPELLEE. Before MOORMAN, Judge. MEMORANDUM DECISION Note: Pursuant to U.S. Vet. App. R. 30(a), this action may not be cited as precedent. MOORMAN, Judge: The appellant,GaryD.Corson, appeals through counsel an August 28, 2012, Board of Veterans’ Appeals (Board) decision that denied entitlement to service-connected benefits for bilateral hearing loss. Record (R.) at 3-20. The Board also remanded a claim of entitlement to a separate disability rating for muscle damage to the right leg and the Court therefore lacks jurisdiction over that claim. See Kirkpatrick v. Nicholson, 417 F.3d 1361, 1364-65 (Fed. Cir. 2005); Breeden v. Principi, 17 Vet.App. 475, 478 (2004) (holding that the Court does not have jurisdiction over remanded claims); Hampton v. Gober, 10 Vet.App. 481, 483 ( 1997) (holding that where “a final decision has not been issued by the [Board] with respect to the claims that were remanded, those claims cannot be reviewed by the Court on this appeal”). The appellant and the Secretary both filed briefs, and the appellant filed a reply brief. This appeal is timely, and the Court has jurisdiction to review the Board decision pursuant to 38 U.S.C. § 7252(a). A single judge mayconduct this review. See Frankel v. Derwinski, 1 Vet.App. 23, 25-26 (1990). For the following reasons, the Court will affirm the Board’s August 2012 decision. I. BACKGROUND Mr. Corson served on active duty in the U.S. Army from June 1968 to June 1970, including
a period of service in Vietnam. R. at 433. He served as a combat engineer. Id. Later medical records show that in 1969 Mr. Corson suffered a blast injurywhile in service, with a reportedly”very loud noise” resulting in his inability to hear for several days and a sustained ringing in his ears.1 R. at 545-56. Mr. Corson’s entrance and separation examinations show that his hearing during service was within normal limits. R. at 839-40, 817-18. Beginning in 1991, Mr. Corson was examined periodically for possible hearing loss related to his postservice employment. In conjunction with these examinations, Mr. Corson reported that he had worked at a “noisy company” for seven years and that while he worked there he did not wear ear protection. R. at 631. He also reported that he had previouslyserved in combat and was exposed to gun noise while in service. Id. Mr. Corson’s 1991 baseline audiometric examination revealed bilateral high frequency hearing loss. R. at 637-38. Yearly examinations from 1991 through 1996 showed no change in his hearing. R. at 632-36. In April 1997, an audiologist informed Mr. Corson of a possible change in his hearing since his previous audiometric examination. R. at 629-30. He recommended that Mr. Corson seek examination by a physician. R. at 629. However, hearing evaluation recordsfromtheyears 2000 through2004indicatethatMr.Corson hadmoderatelysevere hearing loss that had not significantly changed since his baseline test in 1991. R. at 624-28. InNovember2004,aVAaudiologistconfirmedadiagnosis ofmoderatelysevereto moderate hearing loss. R. at 617-19. In May 2005, a VA audiologist opined that Mr. Corson’s hearing loss was less likelythan not related to his militarynoise exposure because “ hearingsensitivitywas within the normal range of hearing from time of enlistment to time of separation as documented by his SMRS” and “noise-induced hearing loss typically does not have a delayed onset.” R. at 597-98. Later that month, the VA regional office (RO) denied entitlement to service connection for bilateral hearing loss. R. at 590-96. In August 2007, Mr. Corson underwent another examination, the focus of which was on Mr. Corson’s reported tinnitus symptomatology. The VA examiner diagnosed bilateral tinnitus and opined that “[i]t is at least as likely as not that the veteran’s current diagnosis of tinnitus, both ears, is related to the blast explosion sustained by the veteran in 02/1969 while in Vietnam.” R. at 546. 1 Mr. Corson also sustained fragment and shrapnel injuries to both legs as a result of the explosion. R. at 545-46. 2
In rationalizing his opinion, the examiner explained that a “loud explosion from a boobytrap or from a grenade at such a close distance creates severe air pressure damage to the ear. This damage can be manifested by hearing loss and/or tinnitus on a long-term basis. Audiology testing done in 11/2004 confirms high frequency hearing loss.” R. at 546. In an August 2007 rating decision, the RO granted entitlement to service connection for tinnitus but denied entitlement to service connection for bilateral hearing loss, among other disabilities, on grounds that Mr. Corson had not presented new and material evidence sufficient to reopen that claim. R. at 529-40. It appears from the record that Mr. Corson then submitted a Notice of Disagreement (NOD), received in July 2008. R. at 491-92. However, the RO determined in a December 2008 Statement of the Case (SOC) that Mr. Corson had not timely appealed the August 2007 rating decision and that, therefore, it became final.2 R. at 297-316. The RO further determined that Mr. Corson had not submitted new and material evidence sufficient to reopen his claim. Id. In August 2010, Mr. Corson testified at a video conference before the Board. R. at 255-69. In a December 2010 decision, the Board, inter alia, determined that the claim for entitlement to service connection for bilateral hearing loss would be reopened and remanded for further development, including a VA examination. R. at 230-51. In January 2011, Mr. Corson underwent a VA examination for his bilateral hearing loss. R. at 94-98. The examiner noted Mr. Corson’s reports of noise exposure during military service and in his pre- and postmilitary employment. R. at 94-95. The examiner further stated that she reviewed Mr. Corson’s claims file. R. at 96. The examiner performed the examination and diagnosed right ear moderately severe sensorineural hearing loss at 3000 to 4000 hertz and left ear severe to moderately severe sensorineural hearing loss at 3000 to 4000 hertz. R. at 95-96. Finally, the examiner opined that Mr. Corson’s current bilateral hearing loss was less likely than not the result of his in-service combat noise exposure, to include the explosion in 1969. R. at 98. To support her opinion, the examiner explained that Mr. Corson’s service entrance and separation examinations 2 From what the Court can discern from the record before us, it appears that the RO may have erroneously failed to process Mr. Corson’s NOD. See 38 U.S.C. § 7105 (stating that a veteran must file an NOD within one year from the date the RO decision was mailed). Neither party has clarified this portion of the claim’s procedural history. However, the Court need not investigate this matter further because this issue is not presently before the Court. See Rogozinski v. Derwinski, 1 Vet.App. 19, 20 (1990) (holding that review in this Court shall be on the record of proceedings before the Secretary and the Board). 3
revealed hearing within normal limits with no significant decrease noted in service. R. at 97. The examiner further discounted the August 2007 medical opinion, stating that it “centers on tinnitus” and the data does not support that examiner’s statement that later onset of hearing loss can result from in-service noise exposure. Id. Specifically, the examiner stated that the August 2007 examination’s statement “is inconsistent with data which supports that hearing loss related to noise exposure is not known to be progressive after the fact (Noise and Military Service-Implications for Hearing Loss and Tinnitus, Institute of Medicine, National Academy of Science, 2006).” Id. InFebruary2012,theRO issuedaSupplementalSOC (SSOC) denyingentitlementto service connection for bilateral hearing loss. R. at 49-55. In August 2012, the Board issued the decision here on appeal denying entitlement to service connection for bilateral hearing loss. R. at 3-20. The Board determined that the appellant has a current bilateral hearing loss disability. R. at 10. The Board also determined that, based on the appellant’s accounts of combat experience, he is presumed to have suffered an acoustic trauma during service. Id.; 38 U.S.C. § 1154(b) (stating that in the case of a veteran who engaged in combat with the enemy during a period of war, the Secretary shall accept as sufficient proof of service connection lay or other evidence of service incurrence of such injury if consistent with the circumstances, conditions, or hardships of such service, notwithstanding the fact that there is no official record of such incurrence). However, the Board found that competent and credible evidence of record failed to establish a nexus between the appellant’s service and his current hearing loss. R. at 13-15. In support of this conclusion, the Board explained that it found the January 2011 and May 2005 negative nexus opinions to be the most probative evidence of record. R. at 13-14. The Board also noted that the August 2007examinerfocusedsolelyontinnitus symptoms anddid not specificallyindicatewhether the appellant’s hearing loss resulted from in-service acoustic trauma. R. at 13. With regard to the evidence submitted by the appellant, the Board found that he has not submitted evidence to refute the probative medical opinions of record and that he is not competent to relate his current hearing loss to his in-service noise exposure. R. at 14. The Board further found that the appellant is not credible because his statements regarding whether he wore ear protection in postservice employment are contradictory. 4 Id. Accordingly, the Board found that a
preponderance of the evidence weighed against the service-connection claim. R. at 14-15. II. ANALYSIS Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Hickson v. West, 12 Vet.App. 247, 253 (1999); Caluza v. Brown, 7 Vet.App. 498, 506 (1995), aff’d per curiam, 78 F.3d 604 (Fed. Cir. 1996) (table). A finding of service connection, or no serviceconnection, is a finding of fact reviewed under the “clearly erroneous” standard in 38 U.S.C. § 7261(a)(4). See Swann v. Brown, 5 Vet.App. 229, 232 (1993). “A factual finding ‘is clearly erroneous when although there is evidence to support it, the reviewing court on the entire evidence is left with the definite and firm conviction that a mistake has been committed.'” Hersey v. Derwinski, 2 Vet.App. 91, 94 (1992) ( quoting United States v. United States Gypsum Co., 333 U.S. 364, 395 (1948)). The Court may not substitute its judgment for the factual determinations of the Board on issues of material fact merelybecause the Court would have decided those issues differently in the first instance. Id. In his brief, the appellant first argues that the Board’s decision is clearly erroneous because the Board failed to consider evidence and legal theories favorable to the veteran. Appellant’s (App.) Brief (Br.) at 9. Specifically, the appellant argues that the Board failed to consider or discuss the RO’s August 2007 rating decision granting service connection for tinnitus, in which the RO found that the appellant sustained a severe injury in both ears as a result of an explosion. App. Br. at 10 (citing R. at 536-37). The appellant further appears to argue that the record is incomplete because none of the medical records discuss the relationship between the service- connected tinnitus and bilateral hearing loss. App. Br. at 10. On this point he argues that, because there is no medical opinion of record attributing the hearing loss and tinnitus to different etiologies, they are presumed to be of the same etiology. App. Br. at 10-11. Accordingly, the appellant appears to assert that he is entitled to service-connected benefits for bilateral hearing loss by virtue of his entitlement to service-connected benefits for tinnitus. Id. On review of the Board’s decision as a whole, the Court concludes that the Board discussed 5
the evidence relevant to this claim. See Prickett v. Nicholson, 20 Vet. App. 370, 375 (2006) (stating that a Board decision generally should be read as a whole); Dela Cruz v. Principi, 15 Vet.App. 143, 149 (2001) (stating that the Board is only required to discuss relevant evidence). The Court is unpersuaded by the appellant’s arguments for the reasons that follow. See Hilkert v. West, 12 Vet.App. 145, 151 (1999) (en banc), aff’d per curiam, 232 F.3d 908 (Fed. Cir. 2000) (table); Berger v. Brown, 10 Vet.App. 166, 169 (1997). Taking the appellant’s assertions out of order, the Court will first address the appellant’s contention that hearing loss and tinnitus arepresumed to have the same etiologywhere, as here, there is no medical evidence specificallyrelating the disabilities to distinct etiologies. First and foremost, theappellanthascitednoevidenceorauthority–medical,legal, orotherwise–supportinghis apparent belief that, in the absence of medical evidence specifically addressing the matter, hearing loss and tinnitus must be presumed to have the same etiology. See Hilkert and Berger, both supra. In most cases, it is the appellant, and not the Government, who bears the burden of demonstrating that each current disability results from an in-service injury. See Davidson, supra. Here, the Board relied on two VA medical examinations rendering negative nexus opinions on the question of etiology of bilateral hearing loss. As will be discussed more fully below, the Board did not err in relying on these pieces of medical evidence in denying the claim. The Secretary had no duty to provide a medical examination discussing the relationship between the appellant’s service-connected tinnitus and his hearing loss. Accordingly, the Court is unpersuaded by the appellant’s assertion that a lack of evidence attributing these disabilities to different etiologies weighs in his favor, such that remand is appropriate. See Locklear v. Nicholson, 20 Vet.App. 410, 416 (2006) (explaining that the appellant must provide reasons for his argument); Evans v. West, 12 Vet. App. 22, 31 (1998) (stating that the Court will give no consideration to a “vague assertion” or “ unsupported contention”). Furthermore, contrary to the appellant’s assertion that the Board failed to explicitly consider the RO’s August 2007 grant of entitlement to service-connected benefits for tinnitus, the Court can discern no error in the Board’s discussion for two reasons. First, it is presumed that the Board has considered all evidence of record. Newhouse v. Nicholson, 497 F.3d 1298, 1302 (Fed. Cir. 2007). To the extent that the appellant argues that the Board failed to consider that the appellant suffered an in-service acoustic trauma, the Board’s decision controverts that argument. See R. at 10 (“[G]iven 6
that his service treatment records show that he was injured by an explosive device and experienced multiple shrapnel wounds, his account of having experienced acoustic trauma is presumed credible and bylaw presumed.”). Second, the Board discussed the relevant evidence of record supporting the RO’s tinnitus decision and related to the appellant’s presently appealed bilateral hearing loss claim. See Dela Cruz, 15 Vet.App. at 149 (stating that the Board is only required to discuss relevant evidence). Specifically, the Board considered the relevant August 2007 medical examination that stated that the appellant’s in-service exposure to an explosion could have caused hearing loss on a long-term basis. R. at 13. However, the Board clearly rejected that opinion in favor of the two medical opinions concluding that, in the appellant’s case, hearing loss was not caused by in-service noise exposure. R. at 13. Accordingly, the Board properlyconsidered the relevant evidence and the Court is unpersuaded by the appellant’s argument. See Hilkert and Berger, both supra. Next, the appellant argues that the Board relied on an inadequate January 2011 VA medical examination to support its decision. App. Br. at 11-12. The Secretary’s duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination. 38 U.S.C. § 5103A; see Stefl v. Nicholson, 21 Vet.App. 120, 123 (2007); see also Green v. Derwinski, 1 Vet.App. 121, 124 (1991). An examination is adequate “where it is based upon consideration of the veteran’s prior medical history and examinations and also describes the disability, if any, in sufficient detail so that the Board’s ‘evaluation of the claimed disability will be a fully informed one.'” Stefl, 21 Vet.App. at 123 (quoting Ardison v. Brown, 6 Vet.App. 405, 407-08 (1994)); Green, supra. It is a medical examiner’s responsibility to provide a well-supported opinion so that the Board maycarryout its duty to weigh the evidence of record. Nieves-Rodriguez v. Peake, 22 Vet.App. 295, 304 (2008) (concluding that medical opinion is not entitled to any weight “if it contains only data and conclusions”); Stefl, 21 Vet.App. at 124 (stating that VA medical opinion “must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions”). As provided by VA regulations, “accurate and fully descriptive medical examinations are required,” 38 C.F.R. § 4.1 (2013), and “[i]f a diagnosis is not supported by the findings on the examination report or if the report does not contain sufficient detail, it is incumbent upon the rating board to return the report as inadequate for evaluation purposes,” 38 C.F.R. § 4.2 (2013). Stegall 7 v. West, 11 Vet.App. 268, 270-71 (1998) (remanding matter where VA examination was inadequate under § 4.2); Hicks v. Brown, 8 Vet.App. 417, 422 (1995) (concluding that an inadequate medical examination frustrates judicial review). An examination report may be inadequate if it fails to discuss something that is necessary. See 38 C.F.R. § 4.2. The Court must review an examination report “as a whole” to determine whether the Board clearly erred in assessing the adequacy of the report. See Monzingo v. Shinseki, 26 Vet.App. 97, 106 (2012). The Board’s determination as to whether the Secretary fulfilled his duty to assist with regard to providing an adequate medical examination is a finding of fact that the Court reviews under the “clearly erroneous” standard. See Nolen v. Gober, 14 Vet.App. 183, 184 (2000). In this case, the Board determined that the May2005 and January2011 VA examinations are the most probative evidence of record. R. at 13. The Board accorded them probative value because they are “based on a review of the claims file, audiological evaluations, and questioning of the Veteran’s noise exposure history.” Id. The Board further found that they are supported by adequate rationale and medical literature. Id. On review of the examinations, the Court holds that the Board’s determination was not clearly erroneous. The appellant makes several arguments that are not entirely clear and that are wholly unpersuasive. See Hilkert and Berger, both supra. They center around the January 2011 examination. He appears to assert that the examiner failed to address the cumulative effects of multiple acoustic traumas or whether the appellant would have had a hearing loss disability in 1991 absent his in-service acoustic trauma. App. Br. at 11-12. Contrary to the appellant’s assertion, the medical examiner was not required to specifically address these two narrow issues. See Monzingo, 26 Vet.App. at 106 (explaining that the VA examiner is not required to “explicitly lay out the examiner’s journey from the facts to a conclusion”); Acevedo v. Shinseki, 25 Vet.App. 286 (2012)(stating that the law imposes no reasons-and-bases requirements on examiners). On review of the January 2011 examination, the examiner noted the appellant’s report of acoustic trauma following an explosion in service. R. at 94. The examiner also acknowledged the appellant’s report of experiencing noise exposure throughout his period of service from 1968 to 1970. R. at 95-96. The examiner noted the appellant’s postservice noise exposure as well. R. at 95, 97. The examiner’s conclusion states that “it is less likely as not the veteran’s currently diagnosed hearing 8
disability is likely the result of his in-service exposure to combat noise, to include the 1969 explosion.” Accordingly, the examination and opinion address all instances of noise exposure. The examiner further provided the required examination, a medical opinion, and an explanation supporting that opinion. Accordingly, the Board’s conclusion that the Secretary satisfied his duty to assist in providing an adequate medical examination was not clearly erroneous. See Nolen, supra. The Board relied on this adequate medical examination, along with other evidence, to find that a preponderance of the evidence weighs against the claim. Accordingly, contrary to the appellant’s contention, the Board was not required to apply the benefit of the doubt doctrine. App. Br. at 12; Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001). Finally, the appellant asserts that the Board provided an inadequate statement of reasons or bases for its decision. App. Br. at 13-14; 38 U.S.C. § 7104(d)(1); see Allday v. Brown, 7 Vet.App. 517, 527 (1995); Gilbert v. Derwinski, 1 Vet.App. 49, 56-57 (1990). However, the appellant merely restates arguments previously made and addressed elsewhere in the Court’s decision. Accordingly, the Court will not further address these arguments.
III. CONCLUSION The Court holds that the Board’s findings and conclusions were not clearly erroneous nor was the Board’s decision otherwise deficient. After consideration of the appellant’s and Secretary’s briefs, and a review of the record on appeal, the August 28, 2012, Board decision is AFFIRMED. DATED: April 10, 2014 Copies to: Robert A. Hall, Esq. VA General Counsel (027) 9
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