Citation Nr: 18154584
Decision Date: 11/30/18	Archive Date: 11/30/18

DOCKET NO. 16-60 069
DATE:	November 30, 2018
REMANDED
Entitlement to service connection for bilateral hearing loss is remanded.
REASONS FOR REMAND
The Veteran served on active duty from January 1980 to January 1983. 
1. Entitlement to service connection for bilateral hearing loss is remanded.
The Veteran was afforded a VA examination in March 2016. However, the Board finds that the VA examination is inadequate for adjudication purposes. Although the examiner opined that the Veteran’s bilateral 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 rationalized that since both the entrance and separation examinations showed normal hearing thresholds, the Veteran’s bilateral 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 why the Veteran’s change in hearing (he had four audiological evaluations during the course of service) did not constitute a significant shift or address his military occupational specialty (MOS) as an ammunition specialist.
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 bilateral 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 physical 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 bilateral 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.
The Board notes that the Veteran has indicated exposure to acoustic trauma during his military service as an ammunition specialist.
In providing an opinion, the examiner should consider the August 1979, June 1980, April 1981, and December 1982 audiograms.
The examiner must provide a rationale for all medical opinions provided. The absence of evidence of treatment for a bilateral 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