Citation Nr: 18153970 Decision Date: 11/28/18 Archive Date: 11/28/18 DOCKET NO. 15-01 701 DATE: November 28, 2018 REMANDED 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty from May 1972 to May 1975. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a July 2012 Department of Veterans’ Affairs (VA) rating decision. 1. Entitlement to service connection for bilateral hearing loss. The Veteran contends that he has bilateral hearing loss that resulted from exposure to noise in service. On July 2012 VA examination, audiometry revealed a bilateral sensorineural hearing loss (SNHL) disability. The examiner indicated that he reviewed the Veteran’s record, noted the Veteran reported exposure to noise in service and denied any postservice exposure to noise, and opined that the Veteran’s hearing loss was unrelated to his service. The rationale for the opinion cited to normal audiometry examiner found on service separation examination and on examination for enlistment in Navy Reserves about a year following separation. Under governing caselaw, the absence of a hearing loss in service is not fatal to a claim of service connection for hearing loss (see Hensley v. Brown, 5 Vet. App. 155, 159 (1993)). Notably, the examiner did not acknowledge (or comment on) the significance of the notation in the Veteran’s STRs that in December 1974 he was seen for complaints of impaired hearing acuity of 3 days duration (apparently associated with an ear infection). The examiner also did not identify the etiology for the hearing loss considered more likely. While the Veteran’s primary military occupational specialty (MOS) was clerk, he reported (and the record confirms) that his active service included duties as a plane captain (placing him in proximity to aircraft noise). Therefore, it may reasonably be conceded that he was exposed to substantial noise during service. An examination of the Veteran to obtain a fully adequate opinion in this matter is necessary. 2. Entitlement to service connection for tinnitus. The Veteran contends that he has tinnitus due to exposure to noise in service. As noted above, it may reasonably be conceded that he was exposed to significant noise in service. Tinnitus was not noted in service or clinically noted for decades after service. A February 1988 VA questionnaire (among VA treatment records) shows that the Veteran denied having tinnitus. He now reports he has tinnitus; as the diagnosis of tinnitus is established by self-reports, it may now reasonably be conceded that he has tinnitus. The etiology of tinnitus (without evidence of its presence in service or continuity) is a medical question. The medical opinion in the record that addresses this matter (on July 2012 examination) is limited to indicating that the tinnitus is not a manifestation of the Veteran’s hearing loss. It does not address whether it is related to his ear complaints noted in or his exposure to noise in service, and does not identify the likely etiology for the tinnitus. It is inadequate for rating purposes, and a medical opinion that addresses the unresolved medical question in this matter is necessary. The matters are REMANDED for the following: Arrange for the Veteran’s record to be forwarded to an audiologist or otologist for review and a medical advisory opinion regarding the etiology of his bilateral hearing loss and tinnitus. [If further examination or interview of the Veteran is deemed necessary, such should be arranged.] The consulting provider should respond to the following: (a) Identify the likely etiology for the Veteran’s bilateral hearing loss. Is it at least as likely as not that it is etiologically related to his service (to include as due to exposure to noise or the ear complaints noted therein)? (b) Identify the likely etiology for the Veteran’s tinnitus. Is it at least as likely as not that it is etiologically related to his exposure to noise or ear complaints noted therein? Include complete rationale with all opinions. If the disabilities are determined to be unrelated to service, identify the etiology considered more likely (and explain why that is so). GEORGE R. SENYK Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Robert Cordingley, Associate Counsel