Citation Nr: 18154462 Decision Date: 11/30/18 Archive Date: 11/29/18 DOCKET NO. 16-60 273 DATE: November 30, 2018 REMANDED Entitlement to service connection for a back disability is remanded. Entitlement to service connection for posterior vitreous detachment of the left eye is remanded. Entitlement to service connection for cataracts is remanded. Entitlement to service connection for pinguecula is remanded. Entitlement to service connection for a bilateral hearing loss disability is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for a breathing condition, to include as sleep apnea, as due to asbestos exposure is remanded. REASONS FOR REMAND The Veteran had active service from October 1967 to May 1969. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). While the Veteran originally filed as claim for “difficulty breathing” as secondary to asbestos exposure, private treatment records indicate that he is diagnosed with sleep apnea. Therefore, in consideration of the holdings in Brokowski and Clemons, the Board has recharacterized this claim as reflected on the title page. See Brokowski v. Shinseki, 23 Vet. App. 79 (2009) (holding that a claimant may satisfy the requirement to identify the benefit sought by referring to a body part or system that is disabled or by describing symptoms of the disability); Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009) (holding that when a claimant makes a claim, he is seeking service connection for symptoms regardless of how those symptoms are diagnosed or labeled). 1. Entitlement to service connection for a back disability is remanded. 2. Entitlement to service connection for posterior vitreous detachment of the left eye, cataracts, and pinguecula is remanded. 3. Entitlement to service connection for bilateral hearing loss disability is remanded is remanded. 4. Entitlement to service connection for tinnitus is remanded. 5. Entitlement to service connection for a breathing condition, to include sleep apnea, as due to asbestos exposure is remanded. A June 2015 Social Security Administration (SSA) inquiry indicates that the Veteran received SSA disability benefits. To date, the Veteran’s SSA records have not been requested or otherwise associated with the claims file. Accordingly, such records should be requested on remand. See Murincsak v. Derwinski, 2 Vet. App. 363, 369-70 (1992). The Veteran attended a VA examination in August 2013 to determine the nature and etiology of his back disability. The examiner opined that the Veteran’s current back disability was less likely than not incurred in or caused by service. The examiner’s rationale was that the examiner was unable to find service medical record evidence of a recurrent back complaint, and that there is no evidence to support the chronicity of the problem for over 30 years after discharge. The Board finds the examiner’s opinion inadequate for decision making purposes. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The Board notes that an opinion based upon an inaccurate factual premise has no probative value. Reonal v. Brown, 5 Vet. App. 458, 461 (1993). Here, the examiner failed to acknowledge the Veteran’s reports of back pain in service in January 1968. As such, an addendum opinion is needed to address his in-service complaints. At an August 2013 VA examination, the examiner opined that the Veteran’s eye conditions were at least as likely as not caused by service. However, the examiner’s rationale regarding all the claimed conditions directly contradicts the examiner’s conclusion. The Board finds the opinions inadequate for decision making purposes. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). An addendum opinion is necessary for the examiner to provide a consistent conclusion and rationale. An August 2013 VA examination found that the Veteran did not have a current hearing loss disability. Since that examination, the Veteran has submitted multiple audiological examinations that indicate the possibility of a current hearing loss disability, particularly in an April 2018 examination. As such, the Board finds that a new opinion and possible examination are necessary to determine whether the Veteran has a current hearing loss disability, and if so, whether it is etiologically related to service. Regarding the Veteran’s tinnitus, as tinnitus can be a symptom associated with sensorineural hearing loss, the Board finds that the claim is intertwined with the remanded claim for service connection for a bilateral hearing loss disability. Accordingly, a remand of the claim for tinnitus is required. The matters are REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for his claimed disabilities. After securing any necessary releases, the AOJ should request any relevant records identified. In addition, obtain updated VA treatment records. If any requested records are unavailable, the Veteran should be notified of such. 2. Request all documents pertaining to any application by the Veteran for SSA disability benefits, including the medical records considered in deciding the claim. If any requested records are unavailable, the Veteran should be notified of such. 3. Forward the record and a copy of this Remand to the clinician who provided the August 2013 back opinion, or, if that clinician is unavailable, to another suitably qualified clinician for completion of an addendum opinion. The clinician should perform a new examination if necessary for providing an adequate opinion. The clinician must opine as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s current back disability was incurred in or caused by military service. The clinician must specifically address the Veteran’s in-service reports of back pain. A complete rationale is necessary for all conclusions reached. 4. Forward the record and a copy of this Remand to the clinician who provided the August 2013 eye conditions opinions, or, if that clinician is unavailable, to another suitably qualified clinician for completion of an addendum opinion. The clinician should perform a new examination if necessary for providing an adequate opinion. The clinician must opine as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s three diagnosed ocular disabilities were incurred in or caused by military service. The clinician must ensure that the rationale is consistent with the conclusions found, and a complete rationale, beyond mere explanation of medical process, must accompany any conclusion reached. 5. Forward the record and a copy of this Remand to the clinician who provided the August 2013 hearing loss opinion, or, if that clinician is unavailable, to another suitably qualified clinician for completion of an addendum opinion. The clinician should perform a new examination if necessary for providing an adequate opinion. The clinician must opine: (a.) Whether it is at least as likely as not (50 percent probability or greater) that the Veteran any current hearing loss disability was incurred in or caused by military service. The examiner must specifically address audiological examinations of record dated after the last VA examination. (b.) If the Veteran is found to have a bilateral hearing loss disability that is related to his military service, state whether it is at least as likely as not (50 percent probability or greater) that his tinnitus is a symptom of, caused by, or aggravated by his bilateral hearing loss. A complete rationale is necessary for all conclusions reached. 6. After completion of the above, review the expanded record, including any evidence entered since the most recent statement of the case, and determine whether any benefit sought may be granted. If any benefit sought remains denied, furnish the Veteran and his representative with a supplemental statement of the case. A reasonable period should be allowed for response before the appeal is returned to the Board. J. A. Anderson Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Baker, Associate Counsel