Citation Nr: 18146852
Decision Date: 11/01/18	Archive Date: 11/01/18

DOCKET NO. 15-15 722
DATE:	November 1, 2018
REMANDED
Entitlement to service connection for left ear hearing loss is remanded.
REASONS FOR REMAND
The Veteran had active military service from January 1967 to January 1969.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) located in Huntington, West Virginia.
1. Entitlement to service connection for left ear hearing loss is remanded.
The Veteran asserts that service connection for left ear hearing loss is warranted.  He contends that the condition is due to noise exposure during active service.
The Veteran underwent a VA examination in May 2013 at which time left ear sensorineural hearing loss was assessed.  The examiner opined that the claimed disability is not related to military service.  In support of this finding, she noted that Veteran’s military separation examination indicated that hearing was within normal limits.
Similarly, in an August 2015 VA examination report, the examiner opined that the Veteran’s left ear hearing loss disability was not caused by or a result of an event in military service.  In so finding, she noted that the Veteran had normal hearing at all tested frequencies in the left ear at his military discharge in 1969.  Further, there were no significant threshold shifts when compared to the enlistment examination.
In correspondence from the Veteran’s representative received in October 2018, she reported that according to the National Institute of Health, National Institute on Deafness and Other Communication Disorders, noise-induced hearing loss can be immediate or it can take a long time to be noticeable.  She asserted that the Veteran’s hearing loss took longer to manifest.  The Veteran’s representative indicated that remand is necessary.
The Board observes that delayed onset hearing loss has not been addressed by the VA examiner.  Thus, remand for an additional medical opinion is required.
The matter is REMANDED for the following action:
1. Schedule the Veteran for a VA examination to determine the nature and etiology of his left ear hearing loss.  Access to records in the Veteran’s electronic claims file should be made available to the examiner for review in connection with his or her opinion.
After examining the Veteran and reviewing the record, the examiner should provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s left ear hearing loss disability was incurred in service or is otherwise causally related to his active service.
A clear explanation for the VA medical opinion is required.  In rendering the requested opinion, the examiner must discuss the assertion regarding delayed onset hearing loss. 
Additionally, the examiner is asked to discuss the impact of in-service and post-service noise exposure on the current hearing loss disability. 
The examiner is advised that the mere absence of evidence of a hearing loss disability during service is not fatal to a service connection claim.  See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992).  Evidence of a current hearing loss disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting the regulatory requirements for hearing loss disability for VA purposes, and a medically sound basis upon which to attribute the post-service findings to the injury in service.
 
K. Conner
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	C. Jones, Counsel