Citation Nr: 18144563 Decision Date: 10/24/18 Archive Date: 10/24/18 DOCKET NO. 16-12 809 DATE: October 24, 2018 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1967 to October 1968. This matter comes to the Board of Veterans’ Appeals (Board) from a November 2013 rating decision. In July 2017, the Veteran testified before the undersigned Veterans Law Judge (VLJ) at a videoconference hearing. A copy of the transcript is of record. Entitlement to service connection for bilateral hearing loss and tinnitus are remanded. The Board cannot make a fully informed decision on the issues of entitlement to service connection for bilateral hearing loss and tinnitus at this time. During a during a December 2008 Agent Orange VA examination, the Veteran reported hearing problems for 30 years and that he had worn hearing aids for the last two years. Audiological records pertaining to the issuance of the Veteran’s hearing aids have not been associated with the Veteran’s claims file. A remand is required to allow VA to obtain authorization and request these records. The Veteran was afforded a VA audiologic examination in October 2013. The examiner diagnosed the Veteran with bilateral sensorineural hearing loss. The examiner indicated that the Veteran’s October 1966 induction examination showed mild hearing loss at 4000 Hz in the right ear and normal hearing in the left ear. The examiner found that the right ear hearing loss at 4000 Hz was temporary, however, as the Veteran’s October 1968 separation examination showed normal hearing bilaterally from 500 to 4000 Hz. The examiner explained that there was no scientific basis to conclude that permanent hearing loss directly attributable to noise exposure will develop long after such noise exposure. Thus, the examiner opined that it was highly unlikely that the Veteran’s current bilateral hearing loss was caused by or a result of his military noise exposure. The examiner further found that the Veteran’s hearing loss preexisted service, but opined that it had not been aggravated beyond normal progression, as the Veteran’s hearing loss did not decrease in either ear during his service. As to the Veteran’s tinnitus, the examiner noted that the Veteran reported onset of tinnitus 5 to 6 years earlier. The examiner explained that tinnitus could have delayed onset after noise exposure, but that the Veteran denied such. Since the Veteran’s tinnitus began well after military service, the examiner opined that the Veteran’s tinnitus was at least as likely as not a symptom associated with his hearing loss. The Board finds the October 2013 VA examiner’s opinion inadequate, as it is appears to be based on an incomplete premise. It is not clear that the examiner considered the December 2008 VA record, created four years before the Veteran filed his claims for hearing loss and tinnitus, in which the Veteran reported difficulty hearing for the past 30 years. In addition, the Veteran testified that the examination report was incorrect, and that while the examiner indicated that the Veteran’s hearing loss and tinnitus started five to six years earlier, the Veteran contended that he had hearing and tinnitus problems since service, and that the hearing related disabilities started to worsen five to six years prior. The Board finds that a remand is necesssary so that a new VA examination and medical opinion can be obtained to assess the nature and etiology of the Veteran’s bilateral hearing loss and tinnitus. The matters are REMANDED for the following actions: 1. Ask the Veteran to complete a VA Form 21-4142 for any private treatment he obtained for his bilateral hearing loss and tinnitus, to include prior to 2008. Make two requests for the authorized records from any identified treatment providers, unless it is clear after the first request that a second request would be futile. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any bilateral hearing loss and tinnitus. The examiner must opine whether the Veteran’s bilateral hearing loss and/or tinnitus preexisted the Veteran’s service. If the examiner finds that the Veteran’s bilateral hearing loss or tinnitus did clearly and unmistakably preexist service, the examiner must opine whether the Veteran’s bilateral hearing loss and/or tinnitus were clearly and unmistakably not aggravated by service. If the examiner finds that the Veteran’s bilateral hearing loss or tinnitus either did not clearly and unmistakably preexist service, or were not clearly and unmistakably aggravated by service, the examiner must opine whether the Veteran’s bilateral hearing loss and/or tinnitus are at least as likely as not related to an in-service injury, event, or disease, including the Veteran’s in-service hazardous noise exposure. The examiner is asked to comment on the Veteran’s lay statements concerning onset of his bilateral hearing loss and tinnitus. The Board notes that the etiology of a Veteran’s hearing loss cannot be based solely on a Veteran’s “normal” hearing at entrance to and separation from service. 3. After completing the above, and any other development as may be indicated, the Veteran’s claims should be readjudicated based on the entirety of the evidence. If the claims remain denied, the Veteran and his representative should be issued a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. K. PARAKKAL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Owen, Associate Counsel