Citation Nr: 18159652 Decision Date: 12/19/18 Archive Date: 12/19/18 DOCKET NO. 16-45 794 DATE: December 19, 2018 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 1966 to February 1969. The Veteran contends that his bilateral hearing loss is due to his period of service. The Board finds the September 2014 VA examination to be inadequate. In particular, the September 2014 VA examination of the Veteran did not weigh the Veteran’s competent lay statements. Accordingly, a subsequent VA examination is necessary to weigh the Veteran’s competent lay statements regarding in-service occurrence of his hearing loss and the post-service progression of such symptoms. See February 2014 Statement in Support of Claim; see also Dalton v. Nicholson, 21 Vet. App. 23 (2007) (examination inadequate where the examiner did not comment on Veteran’s report of in-service injury and relied on lack of evidence in service medical records to provide negative opinion). Further, the September 2014 VA examination stated that the Veteran’s hearing was within normal limits at the time of separation, yet the separation audiogram shows that two of the Veteran’s recorded decibel thresholds were above normal levels, indicating some degree of hearing loss. This is evident when comparing the Veteran’s enlistment and separation audiograms. The Veteran’s enlistment audiogram was performed in January 1966. No recordings were made at 250, 3000, 6000 and 9000 hertz. As this test occurred prior to January 1, 1967, it is assumed to have used American Standards Association (ASA) standards. When converted from ASA to ISO-ANSI units, the entrance audiogram reflects the following thresholds: HERTZ 500 1000 2000 4000 RIGHT 15 10 10 10 LEFT 15 10 10 5 An audiogram was also performed at separation in January 1969. It is not clear whether the thresholds were recorded using ASA units or ISO-ANSI units. Therefore, the Board will consider the recorded metrics under both standards, relying on the unit of measurement most favorable to the Veteran. The conversion to ISO units is shown in parentheses. Again, no recordings were made at 250, 3000, 6000 and 9000 hertz. HERTZ 500 1000 2000 4000 RIGHT 10 (25) 5 (15) 5 (15) 5 (10) LEFT 10 (25) 5 (15) 5 (15) 5 (10) The conversion to ISO units in the January 1969 separation audiogram indicates that the Veteran’s hearing was at twenty-five decibels at 500 hertz. This is an indication of some bilateral hearing loss, and it was not addressed by the examiner. A higher threshold than twenty decibels shows some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). The entrance and separation audiograms also show a bilateral threshold shift from fifteen to twenty-five decibels at 500 hertz, and a bilateral threshold shift from ten to fifteen decibels at 1000 and 2000 hertz. The examiner, however, stated in the September 2014 VA Examination that there was no bilateral threshold shift. The examiner did not provide any rationale for this apparent discrepancy. In light of the foregoing, a remand is required in order to obtain a medical examination and opinion reconciling these findings and addressing the nature and etiology of the Veteran’s bilateral hearing loss. The matter is REMANDED for the following action: 1. Obtain and associate with the claims file any outstanding VA treatment records. 2. After obtaining the necessary authorization from the Veteran, obtain and associate with the claims file any identified relevant private medical records. All attempts to secure these records must be documented in the record. If any requested records are unavailable, the Veteran should be notified of such in accordance with 38 C.F.R. § 3.159(e). 3. After steps one and two are completed, schedule the Veteran for an audiological examination by an appropriate clinician to determine the nature and etiology of any bilateral hearing loss. (a.) The examiner must opine whether any bilateral hearing loss is at least as likely as not (a 50% or better probability) related to an in-service injury, event, or disease. (b.) The examiner must also opine as to whether it is at least as likely as not that any bilateral hearing loss: (1) began during active service; (2) manifested within one year after discharge from service; or (3) was noted during service with continuity of the same symptomatology since service. (c.) The examiner should consider the audiometric thresholds at entrance in January 1966 under the ASA standards and the audiometric thresholds at separation in January 1969 under both the ASA and ISO-ANSI standards. The examiner should opine whether the frequencies shown at the separation examination are a significant threshold shift to reflect a hearing loss disability. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Voight, Associate Counsel