Citation Nr: 18142574
Decision Date: 10/16/18	Archive Date: 10/16/18

DOCKET NO. 16-58 509
DATE:	October 16, 2018
REMANDED
Entitlement to service connection for bilateral hearing loss is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the U.S. Marine Corps from May 1986 to February 1999.  
In January 2016, the Veteran was provided a VA examination to determine the nature and likely etiology of his bilateral hearing loss.  At that examination, the examiner diagnosed the Veteran with bilateral sensorineural hearing loss and conceded the Veteran’s noise exposure based on his military occupational specialty as an aircraft power plant mechanic.  However, she ultimately found that his current hearing loss was unrelated to service, reasoning that the Veteran had normal hearing at separation without significant threshold shifts from entrance hearing levels.  She does not identify an alternative, non-service related etiology considered more likely.  Furthermore, at the same examination, the examiner found that the Veteran’s tinnitus was at least as likely as not due to noise exposure in service, and that hair cell and neural damage may occur but not be reflected accurately on an audiogram.  However, the examiner did not explain the basis for dissociating the etiology of the hearing loss from that of the service-connected tinnitus, given that she found that neural damage may not be accurately reflected on an audiogram.  Accordingly, a remand for an addendum opinion is necessary. 

The matter is REMANDED for the following action:
1. Obtain and associate with the claims file any outstanding VA treatment records.
2. After obtaining the necessary authorization from the Veteran, obtain and associate with the claims file any identified relevant private medical records.  All attempts to secure these records must be documented in the record.  If any requested records are unavailable, the Veteran should be notified of such in accordance with 38 C.F.R. § 3.159 (e).
3. The regional office should arrange for the Veteran’s record to be forwarded to an audiologist for review and an addendum medical opinion.  Based on review of the record (to include this remand) the audiologist should provide an opinion that responds to the following:
Please identify the most likely etiology for the Veteran’s hearing loss disability?  Specifically, is it at least as likely as not (a 50% or better probability) that the hearing loss was incurred in service, to include as due to established exposure to noise while serving as an aircraft power plant mechanic? 
If the hearing loss disability is determined to be unrelated to service, please identify the etiology for the hearing loss considered more likely and explain the basis for dissociating the etiology of the Veteran’s hearing loss from the etiology of his service-connected tinnitus.
 
JENNIFER HWA
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	L. Bush