Citation Nr: 1303680 Decision Date: 02/04/13 Archive Date: 02/08/13 DOCKET NO. 09-17 567 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUE Entitlement to service connection for bilateral hearing loss. REPRESENTATION Appellant represented by: California Department of Veterans Affairs WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Elizabeth Jalley, Counsel INTRODUCTION The Veteran served on active duty from February 1968 to December 1969. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2007 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia. In October 2012, the Veteran testified at a personal hearing before the undersigned Veterans Law Judge. A transcript of this hearing was prepared and associated with the claims file. In October 2012, the Veteran submitted additional evidence to the Board accompanied by a waiver of initial review by the agency of original jurisdiction. See 38 C.F.R. § 20.1304 (2012). The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The Veteran has claimed entitlement to service connection for bilateral hearing loss, which he essentially contends was incurred as a result of in-service noise exposure associated with his combat service in Vietnam. Specifically, the Veteran has reported suffering acoustic trauma while serving as a mortar man in Vietnam. He has described having served in a mechanized infantry unit and being around armored personnel carriers, heavy weaponry, guns, and vehicles. At his October 2012 Board hearing, he endorsed his representative's characterization that "being around heavy weaponry and vehicles and guns being that your job was in the infantry, it came to the point where you were around loud noises and explosions continuously." The Veteran's DD Form 214 reflects that he served as a fire crewman during service. A DD Form 215 reflects that he received, among other awards, a Purple Heart and a Combat Infantryman Badge, which demonstrate that he served in combat. The Board finds the Veteran's accounts of in-service noise exposure to be consistent with the places, types, and circumstances of his military service, and VA has thus conceded that the Veteran suffered acoustic trauma during service. For the purposes of applying 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; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 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. The Veteran's August 1967 pre-induction examination report reflects that his right ear auditory thresholds were 0, 0, 0, 35, and 25 decibels at 500, 1000, 2000, 3000, and 4000 Hertz, respectively, and his left ear auditory thresholds were 5, 5, 5, 35, and 25 decibels. The Veteran reported no history of, or current, hearing loss on his August 1967 pre-induction medical history report. The Veteran's December 1969 separation examination report reflects that his right ear auditory thresholds were 0, 0, 0, x, and 25 decibels at 500, 1000, 2000, 3000, and 4000 Hertz, respectively, and his left ear auditory thresholds were 0, 0, 0, x, and 30 decibels. The Veteran reported no history of, or current, hearing loss on his December 1969 separation medical history report. In terms of a current disability, the June 2007 VA examination report notes right ear air conduction audiogram results reflecting that the Veteran's right ear auditory thresholds were 10, 15, 60, 75, and 80 decibels at 500, 1000, 2000, 3000, or 4000 Hertz, respectively, for a four-frequency average of 57.5 decibels. The Veteran's left ear auditory thresholds were 15, 25, 75, 90, and 95 decibels at 500, 1000, 2000, 3000, or 4000 Hertz, respectively, for a four-frequency average of 71.5 decibels. His speech recognition scores were 94 percent for the right ear and 96 percent for the left ear. The examiner diagnosed bilateral sensorineural hearing loss. The June 2007 VA examiner noted that the Veteran's hearing loss has existed since 1968. It noted the Veteran's exposure to noise from firing weapons and from explosions while in combat. The examiner noted that the Veteran was in the infantry in service. His post service jobs included working (1) in a shoe factory for one year without hearing protection; (2) as a machine tool operator for one year without hearing protection; (3) in a stock room for one year without hearing protection; (4) as a construction laborer for four months without hearing protection; and (5) as a telephone service technician for 32 years without hearing protection. He entered a hearing conservation program while in the construction and telephone service positions. He participated in hunting or recreational shooting with hearing protection. He reported having used power tools with hearing protection. He reported no family history of ear disease, no personal history of ear disease, and no history of head or ear trauma. The examiner offered an etiology opinion in a June 2007 addendum to the VA examination. The examiner opined that "[h]earing loss is more likely due to noise exposure post military discharge." However, the examiner offered no rationale for this opinion. The Board thus finds it necessary to remand this case in order to obtain a new VA examination and etiology opinion. In deciding whether a remand is appropriate, the Board has considered whether a May 2009 opinion from the Veteran's VA audiologist provides a sufficient basis to decide this claim. This medical record notes a slight hearing loss on the entrance and separation examinations and that there was no change from entrance to separation. The examiner stated that, "[b]ased on the available evidence presented by the patient, it is my professional opinion that veteran's above claimed condition of hearing loss was not caused by or a result of his military noise exposure." The Board notes, however, that the only citation to the evidence of record is to the hearing thresholds of the entrance and separation examination reports. This opinion does not demonstrate review of the Veteran's claims folder, and it does not contemplate the lay reports of in-service hearing difficulty from the Veteran, and the June 2009 report of the Veteran's hearing problems as witnessed by his spouse. Therefore, the Board finds that it is necessary to remand this claim in order to schedule a new VA examination and obtain an etiology opinion with complete rationale. Accordingly, the case is REMANDED for the following action: 1. Arrange for the Veteran to undergo an appropriate VA examination to determine the etiology of his current hearing loss. The claims folders must be thoroughly reviewed by the examiner in connection with the examination, and a complete history should be elicited directly from the Veteran. Any tests and studies deemed necessary by the examiner should be conducted. All findings should be reported in detail. The examiner should express an opinion as to whether it is at least as likely as not (a 50 percent probability or more) that any hearing loss disability had its onset in service, was aggravated by service, or is otherwise related to any incident of service. The examiner should expressly discuss the Veteran's history of noise exposure (to include in-service exposure, occupational post-service exposure, and recreational noise exposure) and the lay contentions of the Veteran and his spouse. Any opinion expressed must be accompanied by a complete rationale. 2. After the development requested above has been completed, again review the record. If any benefit sought on appeal remains denied, the appellant and his representative should be furnished a supplemental statement of the case and given the opportunity to respond thereto. Thereafter, the case should be returned to the Board, if in order. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ DEBORAH W. SINGLETON Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).