Citation Nr: 19190861 Decision Date: 12/03/19 Archive Date: 12/03/19 DOCKET NO. 17-01 233 DATE: December 3, 2019 REMANDED The issue of entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1973 to October 1978. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in New Orleans, Louisiana. The Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ) in July 2019. A transcript of the hearing has been associated with the claims file. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran seeks service connection for bilateral hearing loss. Specifically, he contends that he has bilateral hearing loss as a result of acoustic trauma related to his military occupational specialty (MOS) as air traffic controller (exposed to loud plane engine noise (SACs, MP-52s, and KC-135s) without hearing protection). In this regard, the evidence of record includes a January 2016 VA hearing loss and tinnitus examination report in which the examiner opined that it was less likely than not that the Veteran’s bilateral hearing loss was caused by or a result of an event in military service. The examiner reasoned that the Veteran’s audiograms from November 1973, September 1974, July 1976, September 1977, and August 1978 all documented normal hearing bilaterally. There was no change or shift in hearing thresholds observed from induction to separation. The Board finds the January 2016 VA examination inadequate to decide the Veteran’s claim for service connection for bilateral hearing loss. The examiner improperly relied on the absence of an in-service hearing disability. The Board notes that the absence of in-service evidence of a hearing disability during service (i.e., one meeting the requirements of 38 C.F.R. § 3.385) is not always fatal to a service connection claim. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Evidence of a current hearing loss disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting the regulatory requirements for hearing loss disability for VA purposes, and a medically sound basis upon which to attribute the post-service findings to the injury in service (as opposed to intercurrent causes). See Hensley v. Brown, 5 Vet. App. 155, 159 (1993). Additionally, the examiner did not consider the Veteran’s contentions regarding his exposure to excessive noise during service as a result of his MOS as air traffic controller. In light of the aforementioned deficiencies of the January 2016 VA examination, the Board finds that an additional VA examiner opinion must be provided on remand. See Bar v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate.) The matters are REMANDED for the following action: 1. Request that the Veteran provide or authorize VA to obtain records of his relevant treatment that have not yet been associated with the claims file, and associate with the claims file any outstanding VA treatment records. The Board is particularly interested in the Veteran’s updated VA treatment records. 2. Return the claims file to the audiologist who conducted the Veteran's January 2016 audiological examination, if available. If that audiologist is not available, send the claims file to another audiologist. The claims file and this remand should be made available to the examiner and review of the file should be noted in the requested report. After reviewing the claims file the audiologist should respond to the following: (a.) Is it at least as likely as not (50 percent probability or greater) that any current hearing loss disability had its onset in, or is related to any in-service disease, event, or injury, including noise exposure, including on a delayed onset theory of causation? (b.) Is it at least as likely as not that any current sensorineural hearing loss manifested to a compensable degree within one year of service discharge? The audiologist should specifically address the Veteran's contention that he was exposed to acoustic trauma in relation to his MOS as air traffic controller (loud plane engine noise (SACs, MP-52s, and KC-135s) without hearing protection.) The audiologist should review the January 2016 VA examination report and the Veteran’s July 2019 hearing testimony. The Veteran testified during the July 2019 Board hearing that he was exposed to significant noise after service, but he wore hearing protection. He further testified that he did not seek treatment for hearing loss until it bothered him. The audiologist is advised the lack of a diagnosis of hearing loss in service is not, by itself, a sufficient reason to find there is no nexus to service. The salient question is whether any incident of service, including noise exposure, caused a current hearing loss disability even though it may have been initially diagnosed years after the Veteran's discharge from service (delayed on-set hearing loss). All findings and conclusions should be supported with a complete rationale and set forth in a legible report, which should reflect the examiner's consideration and analysis of both the medical and lay evidence of record. If it is not possible to provide an opinion without resort to speculation, the reason that is so should be explained, indicating whether there is additional evidence that could enable an opinion to be provided or whether the inability to provide an opinion is based on the limits of medical knowledge. S.C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Smith-Jennings, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.