Citation Nr: 18151965 Decision Date: 11/20/18 Archive Date: 11/20/18 DOCKET NO. 17-08 848 DATE: November 20, 2018 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1954 to December 1956. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in San Juan, Puerto Rico, which determined that new and material evidence had not been received to reopen a previously denied final claim of service connection for bilateral hearing loss. In a November 2017 decision, the Board found that new and material evidence had been received to warrant reopening of claim of service connection for bilateral hearing loss. The Board remanded the underlying claim for additional evidentiary development. As detailed below, the Board finds that another remand is unfortunately required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board notes that in October 2018, the RO received the Veteran’s notice of disagreement (NOD) with a March 2018 rating decision which denied service connection for right knee degenerative changes, lumbar degenerative joint and disc disease, and right shoulder pain claimed as shoulder arthritis. The Board notes that the RO has not issued a statement of the case (SOC) with respect to these matters. However, the record currently available to the Board reflects that the RO has acknowledged the NOD and that additional action on the claims is pending at the RO. See October 29, 2019, RO letter. Thus, this situation is distinguishable from Manlincon v. West, 12 Vet. App. 238 (1999), where a NOD had not been recognized. Thus, a remand for the issuance of a SOC is not necessary at this time. 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran seeks entitlement to service connection for bilateral hearing loss. He contends that his current bilateral hearing loss disability is causally related to in-service noise exposure. In a November 2018 informal hearing presentation, the Veteran, through his representative, contends that there has been incomplete compliance with the Board’s previous remand order to provide an adequate examination. Specifically, the Veteran contends that the December 2017 VA examiner improperly considered the Veteran’s separation examination whisper voice test, as it is neither empirically valid or reliable. The Board’s November 2017 remand instructions requested that the RO obtain a new hearing loss examination to ascertain the nature and etiology of the Veteran’s current bilateral hearing loss. The examiner was to address all of the Veteran’s lay statements, including his contention noted in his November 2017 VA Form 9 that he was exposed to daily artillery and gunfire. The examiner was also to consider the Veteran’s MOS, which was “Flight AAA Fire Control Crewman,” and the relevant evidence of record. A VA examination was afforded to the Veteran in December 2017. The examiner opined that the Veteran’s current bilateral hearing loss was not due to service. In so finding, she noted that the Veteran’s separation hearing examination indicated normal whisper voice tests at 15 feet for both ears. The examiner also observed that based on the evidence of record, the Veteran did not complain of hearing loss or receive treatment for hearing loss during service or soon after release from duty. She further noted that the Veteran’s reports of progressive decrease in hearing occurred over the past 10 years and that medical records did not show evaluation or treatment for hearing loss until 2011. Therefore, she determined that the Veteran’s hearing loss, which was reported 55 years after separation from service, was not causally related to service. Notwithstanding the foregoing, the Board finds that the examiner failed to discuss the Veteran’s lay statement contending that he was exposed to daily artillery and gunfire. The examiner also failed to consider the Veteran’s particular MOS. Additionally, the examiner considered the Veteran’s separation hearing examination whisper voice test as medical evidence that the Veteran had normal hearing acuity at separation. The Board notes that whisper voice tests are not sensitive to high frequency hearing loss, which is the type of hearing loss most commonly caused by noise exposure. Therefore, the Veteran’s separation results are not considered reliable evidence of normal hearing or hearing impairment. More importantly, the absence of in-service evidence of a hearing disability is not fatal to a claim of service connection for hearing loss. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Rather, 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, as here, 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. See Hensley v. Brown, 5 Vet. App. 155, 159 (1993). As such, the Board finds that this examiner’s rationale is inadequate as she solely relied on the absence a hearing loss disability at separation from service. In light of the foregoing, remand for full compliance with the Board’s prior remand is warranted. Stegall v. West, 11 Vet. App. 268, 270-71 (1998).   Accordingly, the matter is REMANDED for the following action: 1. Afford the appellant an addendum opinion for the purpose of ascertaining the nature and etiology of his current bilateral hearing loss. The entire claims file should be made available to and be reviewed by the examiner, and it should be confirmed that such records were available for review. After reviewing the record, the examiner should provide an opinion as to whether it is at least as likely as not that the appellant’s current bilateral hearing loss is causally related to his active service or any incident therein, including established acoustic trauma. The examiner must address all the appellant’s lay statements, including his contention in his VA Form 9 dated February 2017 that he was exposed to daily artillery and gunfire, and the relevant medical evidence of record. The appellant’s MOS was “Flight AAA Fire Control Crewman” and his December 1956 military separation examination indicates that only whisper voice testing was performed. The Board notes that whisper voice testing is not reliable for determining high frequency hearing loss. The examiner should also discuss the Veteran’s contention that his hearing loss was of delayed onset years after his exposure to in-service acoustic trauma.   Clearly-stated, fully-reasoned rationale for all opinions rendered must be provided. K. Conner Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Ruddy, Associate Counsel