Citation Nr: 18157304
Decision Date: 12/12/18	Archive Date: 12/12/18

DOCKET NO. 17-14 229
DATE:	December 12, 2018
REMANDED
Entitlement to service connection of bilateral hearing loss is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Marine Corps from December 1959 to April 1964.  This matter comes before the Board of Veterans’ Appeals (Board) from a March 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).
1. Entitlement to service connection of bilateral hearing loss is remanded.
The Veteran states he has military acoustic damage due to his tank unit assignment and as a rifleman.  See July 2015 VA 21-526EZ, Fully Developed Claim; April 2016 VA Form 21-0958, Notice of Disagreement.  The Veteran’s November 1959 enlistment report of medical examination reflects his hearing was normal upon entry to service.  However, he was involved in motorcycle accident in June 1963 and was discharged from the Navy in April 1964 without a medical exam.  See November 1963 Veteran’s Physical Evaluation Board Clinic Summary; April 1964 Discharge Health Record.
The Veteran was afforded a VA-contracted bilateral hearing loss examination in February 2016.  The examiner opined that the Veteran’s hearing loss is less likely than not caused by or a result of an in-service event in the military service, noting that partial hearing loss was showing a conductive component.  This opinion is inadequate, as the examiner’s statement implies that a portion of his hearing was sensorineural hearing loss, yet he provided no etiological opinion as to the same.  Moreover, subsequent VA treatment records note that the Veteran’s hearing loss is sensorineural.  See February 2017 and October 2017 VA Audiology Notes.  Given these conflicting findings and the inadequate rationale from the February 2016 examiner, a new examination is necessary and updated VA treatment records should also be secured.
The matter is REMANDED for the following action:
1. Obtain all outstanding VA treatment records.
2. Then schedule the Veteran for an audiology examination with an examiner other than the February 2016 VA examiner to determine the nature and etiology of any current hearing loss disability.  The claims file, including a copy of the remand, must be provided to the examiner in conjunction with the requested opinion.  All indicated tests and studies should be conducted, to include any otoacoustic emissions, and auditory brainstem response testing, if necessary.  After reviewing the claims file, eliciting a history directly from the Veteran and conducting a thorough examination, the examiner should address the following:
(a)	The February 2016 VA-contract examiner determined that there was a partial conductive component to the Veteran’s hearing loss, while subsequent VA audiologists determined that the Veteran’s hearing loss is sensorineural.  See February 2017 and October 2017 VA Audiology Notes.  Please reconcile these contradictory findings.
(b)	Please offer an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any currently diagnosed hearing loss had its onset in service or is otherwise related to service, to include conceded in-service acoustic trauma therein. 
In addressing this question, please concede in-service acoustic trauma, and note that it cannot be concluded that the Veteran did not have hearing loss at the time of his exit from service, given the lack of a separation examination.  Please do not rely solely on the lack of separation findings to support your opinion, as this will render the opinion inadequate.
A complete rationale should be given for all opinions and conclusions expressed.  If unable to opine without speculation, please provide a rationale for this conclusion.
 
S. BUSH
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Victoria L. Stephens, Associate Counsel