Citation Nr: 18143670 Decision Date: 10/19/18 Archive Date: 10/19/18 DOCKET NO. 11-15 512 DATE: October 19, 2018 REMANDED Entitlement to service connection for left ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1966 to April 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio where the RO, in pertinent part, denied entitlement to service connection for bilateral hearing loss. In a May 2011 rating decision, the RO in pertinent part, granted service connection for right ear hearing loss with a noncompensable evaluation effective December 4, 2008. The Veteran appeared before the undersigned Veterans Law Judge at a Travel Board hearing in May 2017. A copy of the hearing transcript has been associated with the record. In a September 2017 decision, the Board reopened the claim of entitlement to service connection for left ear hearing loss and denied the claim on the merits. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). Pursuant to a Joint Motion for Partial Remand (JMPR), in June 2018, the Court vacated the part of the Board’s September 2017 decision that denied entitlement to service connection for left ear hearing loss and remanded the issue for readjudication. 1. Entitlement to service connection for left ear hearing loss is remanded. The JMPR determined that the Board previously erred when it relied upon an inadequate VA medical opinion (April 2011 VA examination and opinion) that failed to discuss the Veteran’s audiological results on his entrance examination and the audiological results upon separation. The Court determined that the examiner provided insufficient rationale for finding no threshold shift in the Veteran’s left ear, and therefore, concluded that his left ear hearing loss was not aggravated in service. The Court determined that a remand was warranted to obtain a new or clarifying opinion to the April 2011 VA medical opinion that reassesses the Veteran’s complete in-service medical evidence and determines whether he experienced an increase in his left ear hearing disability during service. In light of the foregoing, the Veteran should be afforded a new VA examination to determine the nature and etiology of his left ear hearing loss. Accordingly, on remand the AOJ should procure another VA examination that includes findings regarding whether the Veteran experienced an increase in his left ear hearing loss disability during service. The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA audiological examination to determine the nature and etiology of his left ear hearing loss. The examiner should review the record prior to examination. The examiner must address the following: (a) Review and comment on the audiology threshold shifts from the Veteran’s entrance examination in May 1966 to his separation examination in April 1968. (b) Explain the significance of the absence or presence of threshold shifts and severity of such threshold shifts in regard to the likelihood military noise exposure caused permanent hearing damage. (c) Provide an opinion as to whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran's preexisting left ear hearing loss underwent an increase in severity (i.e., a permanent worsening of the underlying disease as distinguished from a temporary or intermittent flare-up) during his active duty military service. The examiner must discuss any in-service shift in thresholds shown on service audiograms as well as the Veteran’s lay statements regarding the onset of hearing loss. If the examiner determines that there was no increase in severity of the Veteran's preexisting left ear hearing loss, a complete rationale for that opinion must be provided. (d) If the Veteran's preexisting left ear hearing loss did increase in severity during service, the examiner must opine as to whether there is clear and unmistakable evidence that such increase in severity is due to the natural progress of the condition.   A complete rationale for the expressed opinions should be provided with consideration of all relevant medical and lay evidence. S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N.M. Floore, Associate Counsel