Citation Nr: 18142611 Decision Date: 10/16/18 Archive Date: 10/16/18 DOCKET NO. 18-35 638 DATE: October 16, 2018 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1961 to March 1967. He seeks service connection for bilateral hearing loss. The Veteran was afforded a VA examination in February 2018, where he was diagnosed with bilateral hearing loss for VA purposes pursuant to 38 C.F.R. § 3.385. Regarding an in-service incident, the Veteran reports significant in-service noise exposure as a pilot in the Air Force. The February 2018 VA examiner opined that it was less likely than not that the Veteran’s bilateral hearing loss was related to service. As rationale, the examiner relied heavily on the determination that the Veteran’s hearing was “normal” during active service and there was “no shift in hearing thresholds” during service. Several in-service audiometric readings were taken. Prior to November 1967, audiometric results were reported in standards set forth by the American Standards Association (ASA). Since November 1, 1967, those standards have been set by the International Standards Organization (ISO)-American National Standards Institute (ANSI). Thus, all audiometric testing results provided in the Veteran’s service treatment records (STRs) are assumed to reflect ASA standards. Since VA evaluates current hearing loss in ISO-ANSI standards, the units have been converted as shown in the adjoining parentheses below. On entrance examination in April 1961, audiometric testing revealed the following pure tone thresholds, in decibels: HERTZ 500 1000 2000 3000 4000 RIGHT -10 (5) -10 (0) -10 (0) -- -5 (0) LEFT -10 (5) -10 (0) -10 (0) -- -10 (-5) On annual examination in March 1962, audiometric testing revealed the following pure tone thresholds, in decibels: HERTZ 500 1000 2000 3000 4000 RIGHT 0 (15) -10 (0) -10 (0) -10 (0) -5 (0) LEFT -10 (5) -10 (0) -10 (0) -10 (0) -5 (0) On annual examination in July 1962, audiometric testing revealed the following pure tone thresholds, in decibels: HERTZ 500 1000 2000 3000 4000 RIGHT -5 (10) -5 (5) -10 (0) -- -10 (-5) LEFT -10 (5) -5 (5) -5 (5) -- -10 (-5) On annual examination in June 1964, audiometric testing revealed the following pure tone thresholds, in decibels: HERTZ 500 1000 2000 3000 4000 RIGHT -10 (5) -10 (0) 0 (10) -5 (5) 0 (5) LEFT -10 (5) -10 (0) -10 (0) 0 (10) -5 (0) On annual examination in April 1965, audiometric testing revealed the following pure tone thresholds, in decibels: HERTZ 500 1000 2000 3000 4000 RIGHT -5 (10) -10 (0) -10 (0) -5 (5) -5 (0) LEFT -10 (5) -10 (0) -10 (0) 0 (10) -5 (0) On annual examination in July 1965, audiometric testing revealed the following pure tone thresholds, in decibels: HERTZ 500 1000 2000 3000 4000 RIGHT -5 (10) -5 (5) -5 (5) -- 0 (5) LEFT -5 (10) -5 (5) -5 (5) -- 0 (5) On annual examination in July 1966, audiometric testing revealed the following pure tone thresholds, in decibels: HERTZ 500 1000 2000 3000 4000 RIGHT 0 (15) 0 (10) -10 (0) 0 (10) 0 (5) LEFT 0 (15) 0 (10) -10 (0) 0 (10) 0 (5) On separation examination in November 1966, audiometric testing revealed the following pure tone thresholds, in decibels: HERTZ 500 1000 2000 3000 4000 RIGHT 0 (15) 0 (10) -10 (0) 0 (10) 0 (5) LEFT 0 (15) 0 (10) -10 (0) 0 (10) 0 (5) The Board finds the examiner’s rationale that there were no threshold shifts during service factually inaccurate. To that end, as shown above, the Veteran was noted to have several threshold shifts from entrance to separation. As the examiner’s rationale is based on a factually inaccurate premise, it is inadequate. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that a medical opinion based on an inaccurate factual premise has no probative value). Thus, the Board must remand this matter for an addendum opinion based on an accurate factual basis. Moreover, it appears there are outstanding VA treatment records. To that end, the Veteran reported treatment at the Mann-Grandstaff VA Medical Center (VAMC) in Spokane, Washington. See Claim for Service Connection. However, there is only is a single VA treatment record dated February 2018 in the claims file. As this matter is being remanded, efforts to obtain all of the Veteran’s VA treatment records should be made. The matter is REMANDED for the following action: 1. Obtain from the Mann-Grandstaff VAMC and any associated facility(ies) all outstanding, pertinent records of VA evaluation and/or treatment of the Veteran. Follow the procedures set forth in 38 C.F.R. § 3.159(c) with regards to requesting records from Federal facilities. All records and/or responses received should be associated with the claims file. 2. Then return the claims file to the audiologist who conducted the February 2018 VA examination, or any other qualified VA audiologist. No additional examination is necessary, unless the examiner determines otherwise. Following review of the claims file, the audiologist should respond to the following: Is it at least as likely as not (50 percent or greater probability) bilateral hearing loss is related to either of the Veteran’s period of active service, to include noise exposure therein? In offering an opinion, the examiner must comment on the threshold shifts experienced during active service. (Continued on the next page)   The examiner must provide a complete rationale for each opinion given. If the examiner is unable to provide an opinion without resorting to speculation, he or she should explain why this is so and what if any additional evidence would be necessary before an opinion could be rendered. David Gratz Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Michael Sanford, Counsel