Citation Nr: 18152614
Decision Date: 11/23/18	Archive Date: 11/23/18

DOCKET NO. 16-17 517
DATE:	November 23, 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 had active duty from June 1964 to February 1970.
1. Entitlement it service connection for hearing loss is remanded.
The Veteran’s complete service records are not associated with the claims file.  In addition, post-service treatment records, which could potentially show continuity of symptomatology, have not been associated with the record.  Thus, a remand is necessary.
Finally, the Veteran underwent a VA examination in February 2016.  The examiner opined that the Veteran’s hearing loss was not related to noise exposure in service.  The United States Court of Appeals for Veterans Claims (Court) has held that the threshold for normal hearing is from 0 to 20 decibels, and that higher threshold levels indicate some degree of hearing loss.  Hensley v. Brown, 5 Vet. App. 155, 157 (1993).

Prior to November 1967, audiometric results were reported in standards set forth by the American Standards Association (ASA).  Since November 1, 1967, those standards have been set by the International Standards Organization (ISO) - American National Standards Institute (ANSI). The Veteran’s November 1964 audiogram showed the following puretone thresholds:
			HERTZ		
	500	1000	2000	3000	4000
RIGHT	-5	-5	-10	-	5
LEFT	10	10	10	-	-5

As the audiogram was administered prior to November 1, 1967, it is presumed that ASA standards were used when testing the Veteran. Therefore, to facilitate data comparison, the ASA standards have been converted to ISO - ANSI in the preceding chart below.  For ISO conversion, the Board added 15 at 500 Hz, 10 at 1000 Hz, 10 at 2000 Hz, 10 at 3000 Hz and 5 at 4000 Hz.
			HERTZ		
	500	1000	2000	3000	4000
RIGHT	10	5	0	-	10
LEFT	25	20	20	-	0

As the Veteran noted, through his representative, the examiner failed to account for the different audiometric standards.  See November 2018 Appellate Brief.  An addendum medical opinion is warranted. 
2. Entitlement to service connection for tinnitus is remanded.
As explained above, remand in necessary to obtain the Veteran’s complete service treatment records, VA and private post-service medical records, and a new VA medical opinion.  
The matters are REMANDED for the following action:
1. Obtain the Veteran’s complete service treatment records and associated them with the claims file, if possible. 
2. Contact the Veteran and ask that he provide a release for VA to secure records of treatment he received from any private medical treatment providers not already associated with the record.  The Veteran is to be notified of any unsuccessful efforts in this regard, to allow him the opportunity to obtain and submit those records for VA review
3. Obtain the Veteran’s VA treatment records and associate them with the claims file.
4. After completion of the above development, send the claims file to the February 2016 VA examiner (or other examiner if unavailable), to issue medical opinions as to whether it is at least as likely as not (50 percent probability or higher) that the Veteran’s bilateral hearing loss and tinnitus had their onset in service or is related to noise exposure in service. 
The examiner must address the ASA versus ISO-ANSI standards.  The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached.  
5. Readjudicate the appeal. 
 
R. FEINBERG
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J.A. Williams, Associate Counsel