Citation Nr: 18158566 Decision Date: 12/18/18 Archive Date: 12/17/18 DOCKET NO. 16-51 806 DATE: December 18, 2018 ORDER Entitlement to service connection for bilateral hearing loss is denied. Entitlement to service connection for tinnitus is denied. REMANDED Entitlement to service connection for a lumbar spine disability is remanded. Entitlement to service connection for a neck disability is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for diabetes mellitus is remanded. Entitlement to service connection for the residuals of a stroke is remanded. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran’s bilateral hearing loss began during active service, or is otherwise related to an in-service injury, event, or disease. 2. The preponderance of the evidence is against finding that the Veteran’s tinnitus began during active service, or is otherwise related to an in-service injury, event, or disease. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss are not met. 38 U.S.C. §§ 1110, 1111, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a) (2017). 2. The criteria for service connection for tinnitus are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107 (2012); 38 C.F.R. §§3.303, 3.307, 3.309 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from March 1971 to February 1973. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. 1. Bilateral Hearing Loss and Tinnitus The Veteran asserts that he is entitled to service connection for bilateral hearing loss and tinnitus. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has diagnoses of bilateral sensorineural hearing loss and tinnitus, the preponderance of the evidence is against finding that the disorders began during active service, or are otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). In January 2014, a VA examiner gave the Veteran a diagnosis of bilateral hearing loss and tinnitus. In a March 2014 addendum opinion, the examiner opined that it was less likely than not that the Veteran's bilateral hearing loss was caused by or the result of military noise exposure, and was more likely the result of post-military noise exposure. The examiner explained that the Veteran's entrance audiogram was normal and his separation examination showed normal hearing with no significant threshold shift since the entrance examination. The examiner also noted that Veteran reported that he used had hearing protection and hearing conservation methods while shooting on the range while in service, but his post-service noise exposure was extensive, as he reported he worked in manufacturing for 28 plus years and also had recreational noise exposure. Likewise, the March 2014 examiner opined that it was less likely than not that the Veteran's tinnitus was caused by or the result of military noise exposure, and was more likely the result of post-military noise exposure, as described above. While the Veteran believes his bilateral hearing loss and tinnitus are related to his service, he is not competent to provide a nexus opinion in this case. This issue is medically complex, as it requires knowledge of audiological testing and interpretation. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the March 2014 VA examiner’s opinion. Upon careful review and weighing of the evidence, with reasoning as detailed above, the Board finds that the preponderance of the evidence is against the claims for service connection for bilateral hearing loss and tinnitus, and the benefit of the doubt doctrine is not for application. See generally Gilbert v. Derwinski, 1 Vet. App. 49 (1990); Ortiz v. Principi, 274 F.3d 1361 (Fed Cir. 2001). The appeals must therefore be denied. REASONS FOR REMAND 1. Neck Disability, Lumbar Spine Disability, Diabetes Mellitus, Hypertension, and Residuals of a Stroke. The Veteran has asserted that his neck disability, lumbar spine disability, diabetes mellitus, hypertension, and the residuals of a stroke are related to his service. The Veteran was afforded a VA examination for each of the claimed disabilities in May 2011. And while the examiner confirmed the Veteran's various diagnoses and reported that there was no indication that the any of the conditions existed during the Veteran's service, the examiner failed to provide an opinion as to whether any of the claimed conditions were at least as likely not etiologically related to his active service. The examinations are therefore inadequate. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007), citing Daves v. Nicholson, 21 Vet. App. 46, 52 (2007). Thus, the claims must be remanded for an addendum VA medical opinion. The matters are REMANDED for the following action: 1. Contact the Veteran, and, with his assistance, identify any outstanding records of pertinent medical treatment from private or VA health care providers and associate them with the claims file. 2. Obtain an addendum opinion from an appropriate clinician as to whether any diagnosed neck disability is at least as likely as not (50 percent or greater probability) related to the Veteran’s active duty service. If, and only if, determined necessary by the reviewing clinician, the Veteran should be scheduled for another VA examination. 3. Obtain an addendum opinion from an appropriate clinician as to whether any diagnosed lumbar spine disability is at least as likely as not (50 percent or greater probability) related to the Veteran’s active duty service. If, and only if, determined necessary by the reviewing clinician, the Veteran should be scheduled for another VA examination. 4. Obtain an addendum opinion from an appropriate clinician as to whether the Veteran's diabetes mellitus is at least as likely as not (50 percent or greater probability) related to the Veteran’s active duty service. If, and only if, determined necessary by the reviewing clinician, the Veteran should be scheduled for another VA examination. 5. Obtain an addendum opinion from an appropriate clinician as to whether the Veteran's hypertension is at least as likely as not (50 percent or greater probability) related to the Veteran’s active duty service. If, and only if, determined necessary by the reviewing clinician, the Veteran should be scheduled for another VA examination. 6. Obtain an addendum opinion from an appropriate clinician as to whether any diagnosed residuals of a stroke are at least as likely as not (50 percent or greater probability) related to the Veteran’s active duty service. If, and only if, determined necessary by the reviewing clinician, the Veteran should be scheduled for another VA examination. 7. Then readjudicate the claim. If any benefit sought is not granted, the Veteran and his representative should be furnished an SSOC and given the requisite opportunity to respond before the case is returned to the Board. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Mine, Associate Counsel