Citation Nr: 18158978 Decision Date: 12/19/18 Archive Date: 12/18/18 DOCKET NO. 17-01 473 DATE: December 19, 2018 REMANDED The issues of entitlement to service connection for bilateral hearing loss and tinnitus are remanded. REASONS FOR REMAND The Veteran served on active duty from September 1978 to September 1981. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a May 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. Although the Board regrets the additional delay, further development is required prior to the adjudication of the Veteran’s appeal. 1. Service Connection for Bilateral Hearing Loss The Veteran underwent VA audiological examination in April 2014 and February 2017. The VA examiners each diagnosed the Veteran with bilateral sensorineural hearing loss and opined that it was less likely than not that the hearing loss was related to or caused by service. Both examiners indicated that the Veteran’s hearing loss preexisted service and was not aggravated during service. In McKinney v. McDonald, the United States Court of Appeals for Veterans Claims (Court) addressed when hearing loss noted on an enlistment examination constituted a preexisting disability for compensation purposes. 28 Vet. App. 15, 18-19 (2016). The Court held that when the level of hearing loss noted on an enlistment examination does not meet VA’s definition of a hearing disability under 38 C.F.R. § 3.385, a claimant is entitled to the presumption of soundness and, accordingly, the hearing loss noted on the enlistment examination may not be considered a preexisting disability. Id. at 28. Pursuant to 38 C.F.R. § 3.385, impaired hearing is considered a disability for VA purposes when the auditory threshold in any of the frequencies of 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; the thresholds for at least three of these frequencies are 26 or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. In this case, while the Veteran’s August 1978 enlistment examination did note impaired hearing in each ear, the impairment was not significant enough to qualify as impaired hearing under 38 C.F.R. § 3.385. Accordingly, applying the holding of McKinney, the Veteran did not have a preexisting hearing disability prior to enlistment for VA compensation purposes. As each VA medical opinion was premised upon classifying the Veteran’s hearing disability as a preexisting disability, an additional opinion is required prior to adjudication of the issue of service connection for bilateral hearing loss. 2. Service Connection for Tinnitus Following the above-mentioned April 2014 VA examination, the VA examiner commented that the Veteran’s tinnitus was at least as likely as not a symptom associated with the Veteran’s hearing loss. As the Board is remanding the issue of service connection for bilateral hearing loss for an additional medical opinion, a decision on service connection for tinnitus would be premature at this point. Where a pending claim is inextricably intertwined with a claim currently on appeal, the appropriate remedy is to remand the claim on appeal pending the adjudication of the inextricably intertwined claim. See Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Obtain updated VA treatment records and associate them with the claims file—particularly those dated since May 2018. If no such records exist, the claims file should be annotated to reflect as such and the Veteran notified as such. 2. After the above has been completed to the extent possible, send the Veteran’s claims file to an appropriate VA clinician to determine the nature and etiology of the Veteran’s hearing loss. If the clinician determines that an examination is necessary, one should be scheduled. Following a review of the claims file, the clinician should address whether it is at least as likely as not (50 percent probability or more) that the Veteran’s hearing loss is related to service, or that it manifested within a year of his separation from service. For the purpose of providing this opinion, it has already been determined that the Veteran did not have hearing loss as a disability for VA purposes that preexisted service. The clinician should specifically discuss the significance of any in-service or post-service noise exposure and should explain why any hearing loss was not merely a delayed response to in-service noise exposure. Additionally, the clinician should specifically comment upon a January 2017 opinion from Dr. Ratcliff at Austin ENT Associates. For the opinion requested above, a complete rationale must be provided. If the clinician cannot provide an opinion without resorting to speculation, he or she should explain why an opinion cannot be provided (e.g., lack of sufficient information or evidence, the limits of medical knowledge, etc.). S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N.S. Pettine, Associate Counsel