Citation Nr: 18154482 Decision Date: 11/30/18 Archive Date: 11/29/18 DOCKET NO. 15-07 328 DATE: November 30, 2018 REMANDED 1. Entitlement to service connection for a bilateral hearing loss disability is remanded. 2. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1967 to June 1970, including service in Vietnam. 1. Entitlement to Service Connection for a Bilateral Hearing Loss Disability Upon review, remand is required for a new VA examination and opinion, as outlined further in the remand directives below. The evidence of record indicated that the Veteran has a current bilateral hearing loss disability for VA purposes. See August 2013 Audio Examination Report; 38 C.F.R. § 3.385 (defining when impaired hearing is a disability for VA purposes). The Agency of Original Jurisdiction (AOJ) conceded the Veteran’s noise exposure during his active service. See February 2015 Statement of the Case (stating that “military discharge document notes [the Veteran] served as a basic telegraphic teletype [repairman], exposure to acoustic trauma is conceded.” As such, the crucial issue in this case is whether the Veteran’s current bilateral hearing loss disability is caused by his active service and the conceded noise exposure. A VA opinion was obtained in August 2013. The provided opinion concluded that the Veteran entered and exited the service with clinically normal hearing bilaterally per enlistment and separation audiograms, and no significant threshold shifts were noted. Therefore, there was insufficient evidence of acoustic trauma in service, and Veteran’s hearing loss was not a result of his military noise exposure but rather attributable to civilian noise exposure, presbycusis, or some other etiology. The rationale relied, at least in part, on a lack of in-service documentation of a bilateral hearing loss disability and conflicting assessments of whether the Veteran was exposed to acoustic trauma in service. The absence of in-service evidence of a hearing disability during service (i.e., one meeting the requirements of 38 C.F.R. § 3.385), however, is not always fatal to a service connection claim. See Ledford v. Derwinski, 3 Vet. App. 87 (1992). The Court stated in Hensley v. Brown, 5 Vet. App. 155 (1993) that “when audiometric test results at a veteran’s separation from service do not meet the regulatory requirements for establishing a ‘disability’ at that time, he or she may nevertheless establish service connection for a current hearing disability by submitting evidence that the current disability is causally related to service.” The August 2013 VA opinion is accordingly insufficient and remand is therefore required for a new VA examination and opinion. See Barr v. Nicholson, 21 Vet. App. 303 (2007). 2. Entitlement to Service Connection for Tinnitus The Veteran contends service connection is warranted for tinnitus. Because a decision on the remanded issue of service connection for bilateral hearing loss could significantly impact a decision on the issue of service connection for tinnitus, these issues are inextricably intertwined. As such a remand is warranted. The matter is REMANDED for the following action: Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any bilateral hearing loss disability and tinnitus. The examiner must provide an opinion addressing the following: Whether it is at least as likely as not (i.e. 50 percent probability or greater) that a bilateral hearing loss disability and tinnitus had its onset during active service or is caused or aggravated by any in-service disease, event, or injury, to include conceded in-service noise exposure. While review of the entire claims folder is required, the examiner’s attention is invited to the April 1970 discharge examination questionnaire in which the Veteran denied hearing loss and the private July 2012 treatment records in which the Veteran reported hearing loss and tinnitus since separation. In rendering the above opinion, the examiner is advised that the absence of in-service evidence of a hearing loss disability during service is not always fatal to a service connection claim, so long as a medically sound basis upon which to attribute the post-service findings to the injury in service is found (in this case noise exposure). For all opinions provided, the examiner must include the underlying reasons for any conclusions reached. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Fitzgerald, Associate Counsel