Citation Nr: 18156785 Decision Date: 12/11/18 Archive Date: 12/10/18 DOCKET NO. 12-29 033 DATE: December 11, 2018 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty with the US Navy from January 1969 to April 1971. His awards and decorations include a Combat Action Ribbon. In April 2016, the Board remanded this case for further development. A July 2017 Board decision denied service connection for bilateral hearing loss. The Veteran appealed to the United States Court of Appeals for Veterans Claims (Court), which remanded that decision in a May 2018 order, based upon a Joint Motion for Remand (JMR). As per the May 2018 JMR, remand is necessary to afford the Veteran an adequate audiology examination. Specifically, the June 2016 VA examination audiologist based her conclusion that the Veteran’s hearing loss was not as likely as not the result of military service on the fact that the Veteran’s hearing levels did not shift significantly greater than normal measurement variability during military service. The Veteran’s separation examination from 1971 showed hearing in the normal range, but did not contain any value or notation at 4000 Hz. The audiologist did not address this missing value in her opinion; therefore, because it is not clear how the audiologist determined that the Veteran’s hearing did not worsen in service, the opinion is found to be inadequate for rating purposes. Mitchell v. Shinseki, 25 Vet. App. 32 (2011); Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Further, the April 2016 Board remand expressly directed the audiologist to consider the Veteran’s lay statements to be credible evidence of in-service and post-service symptoms. However, in the August 2016 VA examination the audiologist relied on the absence of a significant shift in hearing levels during service, and the absence of documented complaints or relevant treatment in service treatment records without reference to the Veteran’s lay statements. Therefore, the audiologist’s opinion did not satisfy the terms of the 2016 remand as the examiner did not consider lay statements and the second rationale is an implicit rejection of the Veteran’s testimony of in-service and post-service symptoms. In light of what have been determined to be inadequate VA opinions, the Board agrees that sufficient rationale is necessary to adjudicate the claim and that the Veteran should be afforded a VA examination. Entitlement to service connection for bilateral hearing loss is remanded. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate examiner regarding the etiology of his bilateral sensorineural hearing loss. The examiner should review this Remand and the claims file. Following the examination, the examiner must opine as to whether it is at least as likely as not (50 percent or greater possibility) that any diagnosed hearing loss is etiologically related to or aggravated by service. If a hearing loss disability is not shown, that should also be noted. A complete rationale must be provided for these opinions, and the examiner must address the objective audiometric testing results. The examiner should fully explain significance of the missing 4000 Hz value from the Veteran’s 1971 separation examination, if any, and its impact on the determination of whether the Veteran’s hearing worsened in service. The examiner should consider the Veteran’s lay statements to be credible evidence of in-service and post-service symptoms. Please provide the basis for any medical determination and a rationale or medical explanation for the opinion. If medical literature is used, please provide a citation. If the examiner finds that an opinion cannot be rendered regarding which medical evidence best reflects the severity of the Veteran’s hearing loss or a comment cannot be made regarding a possible functional effect without resorting to speculation, the examiner should state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or by the examiner (does not have the knowledge or training).   2, Review the record and ascertain that all appropriate development was accomplished. If not, take corrective action. MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Scanlan, Associate Counsel