Citation Nr: 18144988 Decision Date: 10/25/18 Archive Date: 10/25/18 DOCKET NO. 16-44 851 DATE: October 25, 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 in the United States Navy from January 1955 to September 1957. This matter is before the Board of Veterans’ Appeal (Board) on appeal from a July 2013 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania. The Board denied these claims in a November 2014 decision. In an April 2016 memorandum decision, the United States Court of Appeals for Veterans Claims (CAVC) vacated the November 2014 Board decision, and ordered that additional development be undertaken consistent with the terms of the memorandum decision. Accordingly, for the reasons that follow, the Veteran’s claims must be remanded. First, the Veteran was afforded a VA examination in June 2013 to determine the nature and etiology of his claimed bilateral hearing loss and tinnitus. The examiner concluded that the Veteran’s claimed bilateral hearing loss and tinnitus were not related to his military service. The examiner opined that the Veteran had post-service occupational noise exposure since the Veteran’s discharge from service 50 years prior that caused his current conditions. As noted above, this claim was remanded by CAVC in April 2016 for action consistent with the terms the CAVC memorandum decision. In the decision, CAVC held: 1) that the June 2013 VA examiner did not explain the usual genesis and progression of sensorineural hearing loss or tinnitus, (2) the examiner did not explain the likelihood of whether the Veteran’s hearing disorder developed independently of the in-service noise exposure, and (3) the examiner erroneously stated that the Veteran’s “claim is not for tinnitus.” As such, the Board is required to address the aforementioned deficiencies upon further review of the claims file. Under these circumstances, the Board will not proceed with final adjudication of the claim until a competent medical opinion with supporting rationale is obtained that adequately addresses the nature and etiology of the Veteran’s bilateral hearing loss and tinnitus. Due to the need for a remand in this matter, the Board will also provide the opportunity for the procurement of any outstanding VA or private medical records. The matters are REMANDED for the following actions: 1. Provide the Veteran with the opportunity to submit any medical records in support of his claim or to allow VA to obtain such records on his behalf. 2. After all records and/or responses received from each contacted entity have been associated with the claim (to the extent possible), schedule the Veteran for a VA examination before an appropriate examiner to determine the nature and etiology of his claimed hearing loss and tinnitus. Following a review of the and all indicated tests, the examiner must address the following questions: (a) Is it at least likely as not that the Veteran’s bilateral hearing loss is related to his active duty service? (b) Is it at least likely as not that the Veteran’s claimed tinnitus is related to his active duty service? (c) If the answer to (a) or (b) is negative, then the examiner must explain the usual genesis and progression of sensorineural hearing loss or tinnitus and explain the likelihood of whether the Veteran’s hearing disorder developed independently of the in-service noise exposure. In answering these questions, the examiner should consider the lay testimony of record. A detailed rationale supporting the examiner’s opinion must be provided. If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. See Jones v. Shinseki, 23 Vet. App. 382 (2010). (Continued on next page) 3. After undertaking the above ordered development, the AOJ should review the obtained examination and opinion to ensure that all of the Board’s and the Court’s questions have been addressed. If any question remains outstanding, obtain additional addendum opinions as needed. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. R. Higgins, Associate Counsel