Citation Nr: 18147079
Decision Date: 11/02/18	Archive Date: 11/02/18

DOCKET NO. 15-04 258A
DATE:	November 2, 2018
REMANDED
Entitlement to service connection for bilateral hearing loss is remanded.
REASONS FOR REMAND
The Veteran served on active duty from September 1966 to September 1968.  He received a Purple Heart award and a Combat Infantry Badge award for his service. 
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). 
1. Entitlement to service connection for bilateral hearing loss is remanded.
The Veteran asserts that his currently diagnosed bilateral hearing loss is related to in-service noise exposure without hearing protection.  As the Veteran’s DD Form 214, Certificate of Release or Discharge from Service, reflects that he served in the light weapons infantry and received combat awards, in-service noise exposure is conceded.  Alternatively, the Veteran stated that his hearing was “never the same” after his armored personnel carrier hit a roadside bomb.  The Veteran was afforded a VA examination in August 2013.  At that time, the examiner found that the Veteran’s hearing loss was less likely than not due to his period of active service.  However, the examiner did not address the Veteran’s in-service exposure to a roadside bomb.  Additionally, it is not clear whether the examiner considered conversion of the in-service audiograms to International Standards Organization-American National Standards Institute (ISO-ANSI) units.  
Further, during an August 2018 VA traumatic brain injury examination, the examiner noted that the Veteran was injured in a blast explosion that caused hearing loss residuals.  Service connection for a traumatic brain injury was granted in an August 2018 rating decision.  The Board finds that an additional opinion should be obtained addressing the etiology of the Veteran’s hearing loss disability, to include whether it is secondary to his service-connected traumatic brain injury.   
The matter is REMANDED for the following action:
1. After obtaining any necessary releases, obtain any outstanding VA or private treatment records related to the Veteran’s hearing loss claim.  
2. Schedule the Veteran for an examination by an audiologist to determine the nature and etiology of his bilateral hearing loss.  The claims file must be reviewed and the examiner must indicate that such review occurred.  The audiologist should consider conversion of in-service audiograms to ISO-ANSI units and note such in the examination report.
The audiologist must opine whether it is at least as likely as not (50 percent or greater probability), that the Veteran’s hearing loss is:
(a.) related to an in-service injury, event, or disease, including the Veteran’s conceded in-service exposure to acoustic noise without hearing protection and the roadside bomb resulting in a traumatic brain injury; or, 
(b.) caused by his service-connected traumatic brain injury; or,
(c.) aggravated by his service-connected traumatic brain injury.  
The term “aggravated” in the above context refers to a permanent worsening of the underlying condition, as contrasted to temporary or intermittent flare-ups of symptomatology which resolve with return to the baseline level of disability.
All opinions offered must be accompanied by a clear rationale consistent with the evidence of record.  If the examiner finds it impossible to provide any part of the requested opinions without resort to pure speculation, he or she should so indicate and provide a rationale as to why such a finding is made.
 
CAROLINE B. FLEMING
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Lindsey Connor