Citation Nr: 18106905 Decision Date: 06/01/18 Archive Date: 05/31/18 DOCKET NO. 15-09 234 DATE: June 1, 2018 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from April 1970 to April 1973. The Veteran testified before the undersigned at a Board hearing in March 2018. Entitlement to service connection for bilateral hearing loss and tinnitus is remanded. The Veteran contends that his bilateral hearing loss and tinnitus stem from acoustic trauma during military service. He has consistently reported an incident in which he was in a truck about 30 to 40 feet behind a tank when it fired. He stated that he had no noise protection at the time and, immediately following this incident, he noticed persistent humming in his ears. He believes this incident caused his current hearing loss and tinnitus. See Hearing Transcript. The Veteran was provided an audiological examination. Regarding the Veteran’s claim for bilateral hearing loss, the examiner stated given the Veteran’s normal hearing ability at enlistment and separation and low noise military occupational specialty (MOS), it was less than likely that any hearing difficulty experienced by the Veteran was due to military noise exposure. She indicated that there was little evidence to support the suggestion of delayed onset hearing loss, citing a 2005 Institute of Medicine report to bolster her reasoning. With respect to the Veteran’s claim for tinnitus, she similarly found that, given the Veteran’s normal hearing ability at enlistment and separation and low noise MOS, it was less than likely that any tinnitus experienced by the Veteran was due to hearing loss. Further, she opined that given the Veteran’s low noise MOS and a record silent for tinnitus/ringing, that it was less than likely that any tinnitus experienced by the Veteran was due to military noise exposure. She noted that the most common cause of tinnitus was damage to the cochlea due to age related hearing loss or exposure to loud noises. See December 2014 VA Examination. Remand is required regarding hearing loss and tinnitus for an adequate etiological opinion. Where VA provides the veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board finds that the aforementioned medical opinion is inadequate. The VA examiner focused on the absence of hearing loss at discharge, without further discussion to include explaining the effects of the Veteran’s in-service noise exposure, any post-service occupational/recreational noise exposure, or his competent and credible lay statements. Based on the foregoing, a new examination and opinions are needed. The matters are REMANDED for the following action: 1. Contact the appropriate VA Medical Center and obtain and associate with the claims file all outstanding records of treatment. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified and this should be documented for the record. Required notice must be provided to the Veteran and his or her representative. 2. Contact the Veteran and afford him the opportunity to identify by name, address and dates of treatment or examination any relevant medical records. Subsequently, and after securing the proper authorizations where necessary, make arrangements to obtain all the records of treatment or examination from all the sources listed by the Veteran which are not already on file. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file, and if, after making reasonable efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and his representative. 3. After any additional records are associated with the claims file, provide the Veteran with an appropriate examination to determine the etiology of his hearing loss and tinnitus. The entire claims file must be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that bilateral hearing loss had onset in, manifested within one year of service discharge, or is otherwise related to, active military service. The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that tinnitus had onset in, manifested within one year of service discharge, or is otherwise related to, active military service. The examiner must specifically address the Veteran’s lay statements regarding the onset of his hearing loss and tinnitus. 4. Notify the Veteran that it is his responsibility to report for any scheduled examination and to cooperate in the development of the claims, and that the consequences for failure to report for a VA examination without good cause may include denial of the claims. 38 C.F.R. §§ 3.158, 3.655 (2017). In the event that the Veteran does not report for any scheduled examination, documentation must be obtained which shows that notice scheduling the examination was sent to the last known address. It must also be indicated whether any notice that was sent was returned as undeliverable. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L. Bush