Citation Nr: 18151200 Decision Date: 11/16/18 Archive Date: 11/16/18 DOCKET NO. 15-31 032A DATE: November 16, 2018 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran had active service from August 1965 to August 1969. At an August 2012 VA audiological examination, the examiner opined that the Veteran had current sensorineural hearing loss not related to his service, because in-service audiograms did not show that he had impaired hearing or that his hearing underwent a significant threshold shift in service. The examiner’s rationale was based on her finding that he did not have hearing loss in service. The examiner, however, did not address whether the noise to which the Veteran was exposed in service could have caused hearing loss that began after he had separated from service. Further, the Veteran’s service treatment records show that the Veteran sought treatment on more than one occasion for impacted cerumen (ear wax) in both ears. The VA examiner’s rationale did not discuss the Veteran’s in-service treatment for impacted cerumen. Thus, it is unclear whether the examiner specifically considered the Veteran’s impacted cerumen during service as a possible in-service event to which hearing loss could be medically linked. Accordingly, an addendum opinion must be obtained to clarify these matters. The matter is REMANDED for the following action: 1. Obtain an addendum opinion from the same examiner that provided the August 2012 VA audiological examination, if possible. If the August 2012 VA examiner is unavailable, this opinion request should be forwarded to another appropriate VA examiner. If an opinion cannot be provided without an examination, one should be provided. The examiner should respond to the following questions: (a.) Is it at least as likely as not (i.e., 50 percent probability or greater) that the Veteran’s current bilateral hearing loss, which did not manifest in service, was caused by acoustic trauma or noise exposure that he sustained in service? (b.) Is it at least as likely as not (i.e., 50 percent probability or greater) that the Veteran’s current bilateral hearing loss, which did not manifest in service, was caused by the recorded events of impacted cerumen in both ears in service? The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. No action is required of the Veteran until he is notified by VA. However, he is advised of his obligation to cooperate in ensuring the duty to assist is satisfied. Kowalski v. Nicholson, 19 Vet. App. 171 (2005). His failure to report for a VA medical examination, if requested, may impact the determination made. 38 C.F.R. § 3.655. The Veteran also is advised that he has the right to submit additional evidence and argument with respect to this matter. Kutscherousky v. West, 12 Vet. App. 369 (1999). This appeal must be afforded prompt treatment. THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Davidoski, Associate Counsel