Citation Nr: 1324309 Decision Date: 07/31/13 Archive Date: 08/07/13 DOCKET NO. 10-07 129 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Louis, Missouri THE ISSUES 1. Entitlement to service connection for bilateral hearing loss. 2. Entitlement to service connection for tinnitus. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD T. Sherrard, Counsel INTRODUCTION The Veteran, who is the Appellant in this case, had active service from June 1973 to June 1977. This matter comes before the Board of Veterans' Appeals (BVA or Board) from a September 2009 rating decision by the above Department of Veterans Affairs (VA) Regional Office (RO). The Board has not only reviewed the Veteran's physical claims file but also the Veteran's file on the "Virtual VA" system to insure a total review of the evidence. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, D.C. VA will notify the appellant if further action is required. REMAND The Veteran contends that he has bilateral hearing loss and tinnitus that are related to acoustic trauma during active service. Specifically, he avers that, as an aviation medical specialist, he worked on the flight lines and took flights on military aircraft in the performance of his duties without proper hearing protection. He states that he received patients on active airfields, and that his barrack was next to the airfield, so that he was subjected to the noise of aircraft taking off and landing on a daily basis. He contends that his tinnitus began during active service. Unfortunately, the Veteran's service separation examination report is unavailable, and no medical records have been received to determine whether the Veteran has a current hearing loss disability for VA purposes. Due to the loss of the records, the Board finds that a VA examination is necessary to determine whether the Veteran has a current hearing loss disability, and, if so, whether his hearing loss and tinnitus are related to noise exposure during active service. Accordingly, the case is REMANDED for the following action: 1. Afford the Veteran a VA audiological examination with an appropriate specialist or specialists to address the causation or etiology of his current hearing loss and tinnitus. Any and all indicated evaluations, studies, and tests deemed necessary by the examiner should be accomplished, and a rationale for any opinion expressed should be provided. The claims file must be made available to the examiner for review of the history in conjunction with the examination, and the examination report should reflect that such review was accomplished. a. First, the examiner should conduct an audiogram and speech recognition test using the Maryland CNC Test to determine whether the Veteran has a hearing loss disability. The numerical results of this test should be included in the examination report. b. Next, the examiner should offer the following opinion: Is it at least as likely as not (i.e., to at least a 50/50 degree of probability) that the Veteran's current hearing loss (if any) was incurred during or caused by active service? The VA examiner should consider the Veteran's contentions regarding noise exposure in service in providing his/her opinion. Note: The term "at least as likely as not" does not mean merely within the realm of medical possibility, but rather that the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of causation as it is to find against it. c. The examiner should offer the following opinion: Is it at least as likely as not (i.e., to at least a 50/50 degree of probability) that the Veteran's current tinnitus was incurred during or caused by active service? The VA examiner should consider the Veteran's contentions regarding noise exposure in service in providing his/her opinion. If the opinions and/or supporting rationale cannot be provided without invoking processes relating to guesses or judgment based upon mere conjecture, the examiner should clearly and specifically so specify in the report, and explain why this is so. In this regard, if the examiner concludes that there is insufficient information to provide an etiologic opinion without result to mere speculation, the examiner should state whether the inability to provide a definitive opinion is due to a need for further information (with such needed information identified) or because the limits of medical knowledge have been exhausted regarding the etiology of the Veteran's claimed hearing loss and tinnitus. 2. When the development requested has been completed, the case should again be reviewed by the RO on the basis of the additional evidence. If any benefit sought is not granted, the Veteran and his representative should be furnished a Supplemental Statement of the Case and afforded a reasonable opportunity to respond before the record is returned to the Board for further review. 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). The Veteran is advised to appear and participate in any scheduled VA examination, as failure to do so may result in denial of the claim. See 38 C.F.R. § 3.655 (2012). 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). _________________________________________________ JOHN J. CROWLEY 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).