Citation Nr: 1320733 Decision Date: 06/27/13 Archive Date: 07/05/13 DOCKET NO. 10-03 611 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Cleveland, Ohio THE ISSUE Entitlement to service connection for bilateral hearing loss disability. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD A. Michel, Associate Counsel INTRODUCTION The Veteran had active military service from September 1961 to July 1970. This case comes before the Board of Veterans' Appeals (Board) on appeal from an August 2008 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio. 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 asserts that he is entitled to service connection for a bilateral hearing loss disability as it is related to in-service acoustic trauma, to include a land mine incident and other events surrounding his combat experiences. The Board concedes that the described acoustic trauma is consistent with the Veteran's documented service in Vietnam, receiving the Purple Heart Medal. The Veteran's April 1970 separation examination reflects that a clinical examination of the ears at that time was normal. However, hearing loss was subjectively reported by the Veteran in the attached report of medical history; in the physician's summary and elaboration, it was noted "hearing loss age 25 in [Vietnam]." In this case, audiometric test results expressed in a February 2008 VA examination report show that the Veteran has been diagnosed with bilateral sensorineural hearing loss which meets the threshold severity under 38 C.F.R. § 3.385. The February 2008 VA examiner later submitted an addendum, after reviewing the claims file, in which she stated that a hearing loss or standard threshold shift in hearing was not evident during the Veteran's period of service. She opined, in pertinent part, that the Veteran's hearing loss was not caused by or a result of military noise exposure. The Board finds that a new examination and opinion are necessary because the basis of the February 2008 opinion is insufficient for adjudication purposes. In short, the examiner based her opinion, that the Veteran's hearing loss was not caused by or a result of military noise exposure, on the lack of evidence indicating a hearing loss disability during service. See 38 C.F.R. § 3.385. As the examiner noted, objective evidence of hearing loss or standard threshold shift in hearing was not evident during the Veteran's period of service. See Hensley v. Brown, 5 Vet.App. 155, 157 (1993) (the threshold for normal hearing is from 0 to 20 decibels, and higher threshold levels indicate some degree of hearing loss). As noted in Hensley, however, the lack of a demonstrated hearing loss disability in service "does not preclude service connection for a current hearing disability where hearing was within normal limits on audiometric testing at separation from service." Hensley, 5 Vet. App. at 159. A VA examiner must base an opinion on not only what was evident during service, but also on what has happened since service. Accordingly, the case is REMANDED for the following action: 1. Schedule the Veteran for a VA audiology examination by an examiner who has not yet examined the Veteran. Any indicated tests should be accomplished. The examiner should review the claims folder prior to examination. The examiner is asked to provide opinions as to the following: is it at least as likely as not likely that the Veteran's current bilateral hearing loss disorder is related to any in-service disease, event, or injury. In answering this question, please consider that it is conceded that the Veteran was exposed to acoustic trauma during his military service and that he subjectively reported hearing loss in his April 1970 separation examination. The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached. Please note that the term "as likely as not likely" does not mean "within the realm of medical possibility," but rather that the evidence of record is so evenly divided that, in the examiner's expert opinion, it is as medically sound to find in favor of the proposition as it is to find against it. Please also not that the absence of a measured hearing loss alone during service cannot serve as the sole basis for finding that a current hearing loss disability is not related to service. 2. Thereafter, readjudicate the claim of service connection for bilateral hearing loss. If the benefit sought on appeal remains denied, the Veteran and his representative should be provided with a supplemental statement of the case. Allow an appropriate period of time for response. 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). _________________________________________________ MICHAEL PAPPAS 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).