Citation Nr: 18145964 Decision Date: 10/30/18 Archive Date: 10/30/18 DOCKET NO. 18-45 048 DATE: October 30, 2018 REMANDED Entitlement to service connection for right ear hearing loss is remanded. Entitlement to service connection for a right wrist disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from January 2012 to January 2016. These matters come before the Board of Veterans’ Appeals (Board) on appeal from March 2017 and March 2018 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for right ear hearing loss is remanded. The Veteran asserts that her right ear hearing loss is related to her active service, or alternatively to her in-service treatment for otitis media. Notably, the Veteran has not established service connection for otitis media, or filed a claim for such disability. The Veteran’s DD Form 214 shows that her military occupational specialty was aviation boatswain’s mate and aircraft handling. Moreover, her personnel records show her primary duties were as a plane handler, elevator operator, and aircraft director under instruction, and that such duties involved being responsible for the safe and efficient movement of aircraft on the flight deck, for the documentation of aircraft moves, launches, and recoveries and the safe operation of aircraft elevators, among other things. Thus, it is conceded the Veteran was exposed to acoustic trauma during her active service. The Veteran was afforded a VA examination in March 2017 wherein she was diagnosed with right ear conductive hearing loss, and it was opined that it was not at least as likely as not caused by or a result of an event in military service, and further that conductive hearing loss is not indicative of noise-induced hearing loss. A May 2018 VA opinion opined that no significant threshold shifts occurred during service. The Board finds these opinions to be inadequate. First, the lack of any evidence showing the Veteran had hearing loss during service is not fatal to her claim for service connection for service connection. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). In addition, to the extent the May 2018 examiner opined that there were no significant threshold shifts during service, the Board finds such conclusion to be not supported by the evidence of record. While the Veteran’s hearing is within normal limits during her active military service, comparing her audiograms in November 2011 prior to service with that conducted in August 2015 shows elevated pure tone thresholds at 500, 2000, and 4000 Hertz in the right ear. And while the pure tone thresholds at 6000 Hertz are not applicable for rating purposes, the evidence shows a change of 20 decibels from November 2011 to August 2015. The Board also finds significant that the Veteran complained of hearing loss within a year after separation from service, and she has denied any significant noise exposure since service. See August 2018 VA Form 9. Considering her statements, which the Board has no reason to question the credibility of, there has been no opinion addressing the significant change in hearing acuity since the August 2015 audiometry and the March 2017 VA examination and the findings therein. As an aside, it is also noted that service connection for tinnitus is in effect, but see VA examiner’s March 2017 opinion. Therefore, the Board finds an addendum opinion should be secured as to the etiology of the Veteran’s right ear hearing loss. 2. Entitlement to service connection for a right wrist disability is remanded. In August 2018, the Veteran submitted a timely VA Form 21-0958 (Notice of Disagreement), with a March 2018 rating decision that denied service connection for a right wrist disability. The RO has not yet issued the Veteran a Statement of the Case (SOC) regarding this claim, and must do so on remand. See Manlincon v. West, 12 Vet. App. 238, 240-41 (1999). The matter is REMANDED for the following action: 1. Issue a SOC addressing the claim of service connection for a right wrist disability. 2. Obtain any outstanding VA treatment records. 3. Forward the Veteran’s claims file to an audiologist for preparation of an addendum opinion. No additional examination of the Veteran is necessary, unless the examiner determines otherwise. The claims file, including a copy of this remand, must be provided to the examiner in conjunction with the requested opinion. The examiner should opine as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s right ear hearing loss had its onset in service or is otherwise related to service, to include as a result of conceded acoustic trauma therein. In addressing this question, please accept as true that the Veteran was exposed to acoustic trauma during service in conjunction with her service duties, has had no significant noise exposure since service, and please do not rely solely on the fact that the Veteran had “normal” hearing at separation from service to support the opinion. The examiner must also discuss the possibility of delayed-onset hearing loss. A complete rationale for all opinions must be provided. If unable to provide a medical opinion, provide a statement as to whether there is any 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. C. CRAWFORD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Marley, Counsel