Citation Nr: 18123767 Decision Date: 08/03/18 Archive Date: 08/02/18 DOCKET NO. 17-13 943A DATE: August 3, 2018 REMANDED Service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Appellant in this case had active service from August 1964 to December 1964, followed by Reserve service until 1996. The Appellant contends that his current bilateral hearing loss disability is due to acoustic trauma during his military service, to include periods of active duty for training (ADT) and inactive duty for training (IADT) after his initial period of active service in 1964. In his November 2016 notice of disagreement, he stated that while in the Air Guard, he worked on the flight line installing cameras using minimal hearing protection. In the Army, he was an armor and infantry officer, and he ran many ranges for large and small-bore weapons firing. He stated that he recalled losing his hearing on several occasions after weapons were fired on armor ranges and tank tables. Further, he stated that in his civilian job, he worked in an office with little to no noise exposure. The evidence of record includes medical records from his National Guard and Reserve service, including several periodic medical evaluation reports. There is no specific documentation in these records of the Veteran complaining of, or being treated for, hearing impairment during a qualifying period of service (ADT and IADT) after his separation in 1964 until 1996. However, the periodic examinations do show hearing impairment by VA standards starting in 1983, which indicates that such hearing loss may be considered early onset in view of the Veteran’s relatively young age at that time. In this regard, the Board notes that the April 2016 VA examiner focused his opinion on whether the Appellant’s hearing loss is related to his active service in 1964, but did not appear to consider whether it could be related to the cumulative effect of qualifying periods of service (ADT and IADT) after his separation in 1964 until 1996, when his National Guard and/or Reserve service ended. Therefore, the Board finds that an addendum opinion is necessary addressing whether the current hearing loss was caused by noise exposure as may have been incurred as a result of intermittent National Guard and/or Reserve service from 1964 to 1996. The matter is REMANDED for the following action: Obtain an addendum opinion (or examination, if deemed necessary) from the April 2016 VA examiner, if available, or from another appropriate specialist, regarding whether it is at least as likely as not (i.e., to at least a 50/50 degree of probability) that the current bilateral hearing loss disability was incurred during or caused by the Appellant’s periods of ADT and/or IADT with the National Guard and/or Reserves from 1964 to 1996. Any and all indicated evaluations, studies, and tests deemed necessary by the examiner should be accomplished, and a rationale for any opinion expressed should be provided. The claims file must be made available to the examiner for review of the history in conjunction with the examination, and the examination report should reflect that such review was accomplished. Note: The term “at least as likely as not” does not mean merely within the realm of medical possibility, but rather that the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of causation as it is to find against it. All opinions are to be accompanied by a rationale consistent with the evidence of record. A discussion of the pertinent evidence, relevant medical treatises, and generally accepted medical principles is requested. If the examiner cannot provide an opinion without resorting to speculation, he or she shall provide complete explanations stating why this is so. In so doing, the examiner shall explain whether any inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. JONATHAN B. KRAMER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Sherrard, Counsel