Citation Nr: 18154229 Decision Date: 11/29/18 Archive Date: 11/29/18 DOCKET NO. 16-58 700A DATE: November 29, 2018 REMANDED Entitlement to service connection for left ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1976 to September 1979. The Board notes the Regional Office (RO) granted service connection for right ear hearing loss and tinnitus in an August 2016 rating decision. As this represents a full grant of the benefits sought, these issues are no longer before the Board. 1. Entitlement to service connection for left ear hearing loss is remanded. The Veteran was afforded a VA examination in August 2016. However, the Board finds that the VA examination is inadequate for adjudication purposes. Although the examiner opined that the Veteran’s left ear hearing loss was not at least as likely as not incurred in or caused by service, the examiner did not adequately explain his conclusions or provide a sufficient rationale. The examiner stated that since both the entrance and separation examinations showed normal hearing thresholds, the Veteran’s left ear hearing loss was unlikely caused by in-service exposure to noise. The Board finds that not only did the examiner fail explain why this is so, but this examiner also merely relied only on the absence of diagnoses, treatment, or symptoms in the Veteran’s service treatment records (STRs) in making his determination. In addition, the examiner did not discuss the Veteran’s change in his left ear hearing test results between his entrance and separation examinations, and why such change did not constitute a significant shift. In order to properly adjudicate this issue, a factually accurate, fully articulated, and soundly reasoned medical opinion is needed. As such, a remand for a new VA examination is required. 38 C.F.R. § 3.159(c)(4). The matter is REMANDED for the following action: 1. Contact the Veteran and request authorization to obtain any outstanding records pertinent to his claims, including any private treatment records following proper VA procedures (38 C.F.R. § 3.159(c)). 2. After completing the requested development, afford the Veteran a VA audiological examination to evaluate the nature and etiology of his left ear hearing loss. A copy of this remand and all relevant medical records should be made available to the examiner. The examiner should review the pertinent evidence, including the Veteran’s lay assertions, and undertake any indicated studies. The examiner must provide a rationale for the medical opinion provided. Based on a review of the results of the Veteran’s examination, the Veteran’s statements regarding the development and treatment of his disability, and a thorough review of the claims file, the examiner should answer the following question: a. Is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s currently diagnosed left ear hearing loss disability began in service, is related to the Veteran’s in-service noise exposure, or is otherwise related to a disease, event, or injury in service? In providing an opinion, the examiner should consider the August 1976 and April 1979 examinations. The examiner is also reminded that service connection has been granted for right ear hearing loss and tinnitus, and the RO, in its August 2016 decision, conceded acoustic trauma. The examiner must provide a rationale for all medical opinions provided. The absence of evidence of treatment for a left ear hearing loss disability in the Veteran’s service treatment records cannot, standing alone, be a sufficient rationale for providing a negative opinion. The examiner is also advised that the Veteran is competent to report noise exposure and hearing problems in service, and such reports must be specifically considered in formulating any opinions. If the examiner rejects the Veteran’s reports, the examiner should provide a reason for doing so. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Mukherjee, Associate Counsel