Citation Nr: 18153210
Decision Date: 11/27/18	Archive Date: 11/27/18

DOCKET NO. 16-56 385
DATE:	November 27, 2018
REMANDED
Entitlement to service connection for tinnitus is remanded.

REASONS FOR REMAND
The Veteran served on active duty from June 1966 to June 1968.  
This matter is before the Board of Veterans’ Appeals (Board) on appeal of a February 2014 rating decision of the Cleveland, Ohio, Regional Office (RO) of the Department of Veterans Affairs (VA).
Entitlement to service connection for tinnitus is remanded.
The Veteran contends that he is entitled to service connection due to noise exposure during military service.
A July 2013 VA audiological consult note shows that the Veteran complained of tinnitus in his right ear.  He noted that it was a whistling sound.  He stated that he had experienced tinnitus for 10+ years.   He stated that while in service, he was exposed to gunfire and helicopter noise.  The Veteran was afforded an audiological examination in January 2014.  He reported recurrent tinnitus.  The VA examiner opined that the Veteran had a diagnosis of clinical hearing loss and his tinnitus was at least as likely as not a symptom associated with the hearing loss, as tinnitus is known to be a symptom associated with hearing loss.  The VA examiner also opined that the Veteran’s claimed tinnitus was less likely than not caused by or a result of military noise exposure.  The VA examiner stated that the Veteran’s separation physical showed hearing to be better than upon enlistment.  The VA examiner noted that flat configuration of hearing loss is not associated with hearing loss due to noise exposure.  
In the Veteran’s March 2014 Notice of Disagreement, he noted that he was exposed to bomb blasts.  He included excerpts from The Journal of Head Trauma and the American Tinnitus Association regarding tinnitus.  In his November 2016 Substantive Appeal, the Veteran noted that he had constant ringing in his ears.  He also described the sound as buzzing, hissing and whistling.  
When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).  While the January 2014 VA examiner provided an opinion as requested, it is not apparent that the VA examiner considered the Veteran’s lay statements regarding the onset of his claimed tinnitus as related to his service.  As such, a supplemental opinion is warranted.  Accordingly, remand is required for this issue.
 The matter is REMANDED for the following action:
Return the claims file to the January 2014 tinnitus VA examiner, if available, for an addendum opinion.  If the original examiner is not available, the file should be reviewed by another examiner of similar qualifications to obtain the opinion.  If an additional examination is deemed necessary by the examiner to respond to the question presented, one should be authorized.
After review of the entire record, the examiner is asked to specifically address the following question:
Is it at least as likely as not (50 percent or greater probability) that any current tinnitus is related to the Veteran’s active service? 
In rendering the opinion, the examiner must consider the Veteran’s lay statements regarding his in-service noise exposure. 
The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached.

 
A. C. MACKENZIE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A-L Evans, Counsel