Citation Nr: 18153516
Decision Date: 11/28/18	Archive Date: 11/27/18

DOCKET NO. 16-48 839
DATE:	November 28, 2018
REMANDED
The issue of entitlement to service connection for tinnitus is remanded.
The issue of entitlement to a compensable rating for bilateral hearing loss disability is remanded.
REASONS FOR REMAND
The Veteran served on active duty from July 1969 to May 1977 and from June 1986 to May 1990.  This case comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision of a U.S. Department of Veterans Affairs (VA) Regional Office (RO).
Tinnitus 
An October 2014 VA examination report indicates that the Veteran did not have tinnitus.  But the Veteran has indicated that the VA examiner did not assess him for tinnitus.    
A March 2015 otolaryngology medical treatment note documented that the Veteran had ringing in his ears and needed his hearing checked. Thus, certain evidence indicates that the Veteran has tinnitus. Further, service treatment records indicate that the Veteran may have been exposed to acoustic trauma during service from working near laundry equipment and machinery in warehouses. Based on the foregoing, he should be provided a comprehensive VA examination into his claim.  See McLendon v. Nicholson, 20 Vet. App. 79 (2006).
Hearing Loss 
The Veteran was most recently afforded a VA examination with respect to his bilateral hearing loss disability in October 2014. In April 2015, the Veteran submitted a copy of a March 2015 private audiometric test results. Applicable regulations state that an examination for hearing impairment for VA purposes must include a controlled speech discrimination test (Maryland CNC) and a puretone audiometry test. See 38 C.F.R. § 4.85 (a) (2018). The March 2015 audiometric test results noted that the speech recognition test was performed, however, it was not noted whether the Maryland CNC test, was used. As such, these tests results are inadequate for VA rating purposes. When comparing the audiometric test results from March 2015 to the October 2014 VA examination report, however, worsening was documented at each frequency tested on both tests. In light of this evidence suggesting an increase in severity of the Veteran’s bilateral hearing loss disability since the last VA examination, remand is required to afford the Veteran a new VA examination.
The matters are REMANDED for the following action:
1. Obtain updated VA treatment records from the VA medical center in Orlando, FL and all associated clinics, as well as any other VA facility identified by the Veteran or in the record, for the period of July 2016 to the present.
2. Schedule the Veteran for a VA audiology examination to determine the nature and etiology of the Veteran’s tinnitus and the current severity of his bilateral hearing loss. The claims file should be made available to the examiner. All indicated tests and studies should be completed. The examiner must describe all pertinent symptomatology.
The examiner should then provide an opinion as to whether it is at least as likely as not that any tinnitus had its onset during service or within one year of separation, or is otherwise related to an in-service injury, event, or disease, including in-service noise exposure.
The examiner should also comment on whether it is at least as likely as not that tinnitus is due to, caused by, or aggravated by service-connected bilateral hearing loss disability.  
 
CHRISTOPHER MCENTEE
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	S. Baxter, Associate Counsel