Citation Nr: 18142853 Decision Date: 10/17/18 Archive Date: 10/16/18 DOCKET NO. 16-07 082 DATE: October 17, 2018 REMANDED Service connection for hearing loss is remanded. Service connection for tinnitus is remanded.   REASONS FOR REMAND The Veteran served on active duty from September 1954 to December 1957. This case comes from March 2013 and October 2014 rating decisions. In October 2018, the Veteran appeared at a Travel Board hearing. He submitted additional evidence at that time. 1. Service connection for hearing loss. 2. Service connection for tinnitus. The Veteran asserts that he has hearing loss and tinnitus as a result of service, to include noise exposure. At the October 2018 Board hearing, he stated that he noticed hearing loss shortly after separation, as well as ringing in in his ears, both of which he has had ever since. The January 2013 VA examination report and February 2013 addendum opinion reflecting current bilateral sensorineural hearing loss and tinnitus note that the Veteran’s duties as an airborne radio operator during service has a high probability of hazardous noise exposure. Although the VA examiner opined that it is less than likely that the Veteran’s hearing loss and tinnitus are related to service, noting no significant changes in hearing thresholds between service entrance and separation, the September 1954 service entrance examination report notes audiometric testing was “NOT DONE.” Thus, there could be no threshold shifts. In addition, the Board notes that prior to October 31, 1967, service department 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). In this case, it appears the Veteran’s November 1957 separation examination used the ASA standard. To facilitate data comparison, where applicable, the ASA standards have been converted to ISO-ANSI standards with respect to the results of audiometric testing at separation which are recorded as follows (figures in parentheses represent the conversion from the ASA units to the current “ISO” units, which is the standard used in 38 C.F.R. § 3.385): HERTZ 500 1000 2000 3000 4000 RIGHT 5(20) 5(15) 0(10) - 0(5) LEFT 20(35) 15(25) 10(20) - 5(10) The Board notes that 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, 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. In addition, and although the VA examiner noted no reference to hearing loss or tinnitus in the service treatment records (STRs), sensation of pressure in the left ear was noted in a February 1957 STR. Further, and although the VA examiner noted that results of whispered voice testing were noted to be normal, whispered voice testing is not generally considered reliable. In view of the above, the VA opinion is not completely adequate. Thus, a new VA examination is warranted. Prior to the examination, any outstanding records of pertinent medical treatment must be obtained and added to the record, to include any additional records the Veteran identifies. In that respect, the record reflects that the Veteran began employment with the federal government shortly after separation from service and retired therefrom in 1983. See February 2014 statement, and February 2014 VA scars examination report. In addition, in a February 2014 submission, the Veteran indicated treatment through the Central Texas Veterans Health Care System at the Austin Outpatient Clinic (“Austin Regional Clinic”) from 1992 to 2000. Although a February 2016 RO record notes that the records could not be released due to a discrepancy in dates of treatment, on remand, the discrepancy should be resolved to the extent possible, and another attempt to obtain the records made. Moreover, at the Board hearing, the Veteran noted VA treatment from 1971-1972 through the VA North Texas Health Care System (VANTHCS). Although an August 2014 record reflects that a search of the Dallas VA Medical Center (VAMC) yielded no medical records pertaining to the Veteran from January 1971 to May 2004, it is not entirely clear whether the search was through an electronic records search of the CAPRI database or through a search of archived or retired paper records. The Board notes that VA medical facilities did not begin using an electronic medical records database until, at the earliest, the late 1990’s, so all records prior to that time were in paper form. As such, another request is to be made to obtain the Veteran’s VA treatment records in 1971 and 1972, including a search of archived or retired paper records. Furthermore, in May 2013, the Veteran referenced his service personnel records (SPRs) in association with the claims. As the records may contain relevant evidence, on remand, the SPRs should be associated with the claims file. Lastly, the Veteran submitted additional evidence at the October 2018 Board hearing and did not waive initial RO consideration. See 38 C.F.R. § 20.1304(c). Thus, the case must be remanded for the RO to consider the new evidence. The matters are REMANDED for the following action: 1. Associate the Veteran’s SPRs with the claims file. 2. Make another request for treatment records from the Austin Outpatient Clinic (“Austin Regional Clinic”) from 1992 to 2000. 3. Make another request for medical records pertaining to the Veteran from the VANTHCS/Dallas VAMC from 1971 to 1972, and associate the records with the claims file. Given the time frame, this should include a search of any retired/archived/non-electronic records. 4. Associate with the claims file the Veteran’s VA treatment records since July 2017. 5. After completion of the above, schedule the Veteran for a VA hearing loss and tinnitus examination by an appropriate medical professional. The entire claims file must be reviewed by the examiner. The examiner is to conduct all indicated tests. The examiner is to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s hearing loss or tinnitus had its onset during, or is otherwise related to, his active service, to include exposure to loud noise. A rationale for all opinions expressed should be provided. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. TAYLOR