Citation Nr: 18156157 Decision Date: 12/07/18 Archive Date: 12/07/18 DOCKET NO. 17-17 163 DATE: December 7, 2018 REMANDED Service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1960 to April 1962. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). 1. Service connection for bilateral hearing loss is remanded. Remand is necessary, as the February 2017 VA examiner’s opinion is inadequate. In determining that the Veteran’s bilateral sensorineural hearing loss was less likely than not the result of in-service noise exposure, the VA examiner explained that the Veteran’s hearing was within normal limits upon leaving the military, and indicated that the Veteran did not experience an in-service permanent positive threshold shift. Initially, the Board observes that the Veteran presented for his separation examination in February 1962, but his service was extended and he was not relieved from active duty until April 1962. Thus, the February 1962 audiogram results do not reflect a contemporaneous assessment of the Veteran’s hearing at separation, and the examiner must discuss this fact before making any determination that the Veteran’s hearing was within normal limits at separation. Moreover, the Veteran’s induction examination report does not include audiogram results and notes bilateral “15/15” hearing scores, while the Veteran’s February 1962 audiogram shows elevated hearing thresholds at certain frequencies. If the VA examiner concludes that the Veteran did not experience an in-service permanent positive threshold shift, the examiner must explain this conclusion in the context of this evidence. Finally, the Board notes that prior to November 1967, service department audiometric results were reported using standards set forth by the American Standard Association (ASA). Since November 1, 1967, those standards have been set by the International Standards Organization (ISO)-American National Standards Institute (ANSI). As VA’s current definition for a hearing loss disability, found at 38 C.F.R. § 3.385, is based on ISO-ANSI units, military audiograms dated before November 1967 must be converted from ASA to ISO-ANSI units prior to making findings related to a claimed hearing loss disability. As the Veteran’s in-service audiological examinations are dated prior to November 1967, and there are no indications that ISO-ANSI standards were used, the Board assumes that audiometric findings in the Veteran’s examination reports used the ASA standard and the examiner should convert all service audiogram results from ASA to ISO-ANSI units and address these converted results. Thus, the Board will remand the Veteran’s appeal for an addendum opinion that is responsive to these deficiencies. Updated VA and private treatment records should also be secured. The matter is REMANDED for the following action: 1. Obtain any outstanding VA medical records. 2. With any necessary assistance from the Veteran, obtain any outstanding records of private treatment for his hearing loss. 3. Then obtain an addendum opinion addressing the etiology of the Veteran’s bilateral hearing loss from an examiner other than the February 2017 examiner. The claims file should be made available to and be reviewed by the examiner. No additional examination of the Veteran is necessary, unless the examiner determines otherwise. The examiner should opine as to whether it is at least as likely as not (50 percent probability or higher) that the Veteran’s bilateral hearing loss had its onset in or is otherwise related to active service, including conceded acoustic trauma sustained therein. The examiner is advised that the absence of hearing loss pursuant to 38 C.F.R. § 3.385 during service cannot, standing alone, serve as a basis of a negative opinion, and any opinion that relies such absence will be returned as inadequate. The examiner must discuss Veteran’s in-service audiograms after converting those results from ASA to ISO-ANSI units. If the examiner concludes that the Veteran did not experience a permanent, positive threshold shift in-service, the examiner must explain that conclusion in the context of (i) the February 1960 induction examination report that indicates normal (“15/15”) hearing, (ii) the February 1962 audiogram results converted from ASA to ISO-ANSI units, and (iii) the Veteran’s April 1962 relief from active duty. A complete rationale must be provided for all opinions. If the requested opinion cannot be provided without resorting to speculation, the examiner should so state and explain why an opinion would be speculative (e.g. whether there is any additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge). S. BUSH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D.M. Badaczewski, Associate Counsel