Citation Nr: 18152437 Decision Date: 11/21/18 Archive Date: 11/21/18 DOCKET NO. 16-56 717 DATE: November 21, 2018 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1963 to September 1966. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. The Veteran asserts entitlement to service connection for bilateral hearing loss and tinnitus, which he contends were incurred during his active duty service. He has indicated that he was exposed to repetitive boiler room noise, as well as in-service noise exposure from artillery, engines, explosions, and generators during his service in the U.S. Navy from April 1963 to September 1966. See, e.g., the VA treatment records dated August 2014. As the Veteran’s contentions of in-service noise exposure are consistent with his MOS of boiler repairman, the Board finds that in-service acoustic trauma is conceded to this extent. The Veteran’s service treatment records do not document in-service complaints of hearing loss and/or tinnitus. However, as indicated by the Veteran’s representative, the August 1966 separation examination did not include any audiometric testing; only whispered voice testing was conducted. See the VA Form 646 dated January 2017. VA treatment records dated in June 2014 indicated that the Veteran suffers from “chronic hearing loss with history of working in engine rooms and lots of noise exposure during his time in the Navy.” An August 2014 VA audiology consultation indicated that the Veteran reported changes to his hearing and constant bilateral buzzing in his ears. The Veteran was diagnosed with bilateral hearing loss sufficient for VA compensation purposes at that time. The Veteran was afforded a VA audiology examination in October 2014 at which time the examiner confirmed diagnoses of tinnitus and bilateral hearing loss sufficient for VA compensation purposes. With respect to the diagnosed hearing loss, the examiner explained, “[g]iven that there were no significant changes in hearing sensitivity documented in the medical records and that hearing sensitivity was within normal limits at separation, it is less likely than not that the hearing loss was caused by or a result of an event in military service.” As to the diagnosed tinnitus, the examiner stated, “[g]iven that there were no significant changes in hearing sensitivity documented in the medical records, that hearing sensitivity was within normal limits at separation, and that there is no report of tinnitus in the medical records, it is less likely than not that the tinnitus was caused by or a result of military noise exposure.” Here, the October 2014 VA examiner’s opinion failed to consider the Veteran’s lay assertions of hearing loss and tinnitus symptoms during service and thereafter. To this end, the lack of evidence of treatment for the claimed disorder in the Veteran’s service treatment records cannot, standing alone, serve as the basis for a negative opinion. See Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). Moreover, VA regulations do not preclude service connection for a hearing loss, which first met VA’s definition of disability after service. See Hensley v. Brown, 5 Vet. App. 155, 157-59 (1993). Thus, the Board finds the evidence of record is insufficient to determine whether service connection is warranted for bilateral hearing loss and tinnitus. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (once VA undertakes the effort to provide an examination when developing a service connection claim, even if not statutorily obligated to do so, it must provide one that is adequate for purposes of the determination being made). These matters must therefore be remanded to obtain a new VA opinion as to the etiology of the claimed disabilities. The matters are REMANDED for the following action: 1. Arrange to obtain an addendum opinion addressing the etiology of the Veteran’s diagnosed bilateral hearing loss and tinnitus, based on claims file review, if possible. If an examination is deemed necessary in the judgment of the clinician designated to provide the addendum opinion, one should be arranged. The claims file must be made available to the examiner for review in connection with the examination. With respect to the diagnosed bilateral hearing loss and tinnitus, the examiner should render an opinion, consistent with sound medical judgment, addressing whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the disability had its onset in service or is otherwise medically related to in-service injury or disease, including the conceded acoustic trauma. In addressing the above, the examiner must consider and discuss all pertinent medical, periodical, and other objective in- and post-service evidence, and all lay assertions. In this regard, the examiner should note that the absence of evidence of treatment for bilateral hearing loss and tinnitus in the Veteran’s service treatment records should not serve as the sole basis for a negative opinion. The examiner is also advised that the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinions. If the Veteran’s assertions in any regard are discounted, the examiner should clearly so state and explain why. All examination findings/testing results (if any), along with complete, clearly-stated rationale for the conclusions reached, must be provided. K. CONNER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. K. Buckley, Counsel