Citation Nr: 19123776 Decision Date: 03/29/19 Archive Date: 03/29/19 DOCKET NO. 17-58 312 DATE: March 29, 2019 REMANDED ISSUES 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 United States Navy from June 1972 to July 1975. This matter is before the Board of Veterans’ Appeals (Board) on appeal of a March 2016 rating decision of the St. Louis, Missouri, Regional Office (RO) of the Department of Veterans Affairs (VA). Entitlement to service connection for bilateral hearing loss and entitlement to service connection for tinnitus are remanded. The Veteran contends that he is entitled to service connection for bilateral hearing loss and tinnitus due to noise exposure during military service. Specifically, the Veteran states that during service, he worked with gun mounts and was on a small arms security team which required him to oversee the firing range once per month. He notes that he was not issued hearing protection. The Veteran has also noted that he experienced ringing in his ears after shooting several rounds of ammunition while in service. The Veteran’s DD-214 shows that his military occupation specialty was ordinance mechanic. The Veteran was afforded a VA audiological examination in February 2016. A diagnosis of bilateral sensorineural hearing loss was provided. The VA examiner opined that the Veteran’s right and left ear hearing loss was not at least as likely as not caused by or a result of an event in military service. For the Veteran’s right ear, the VA examiner stated that hearing sensitivity thresholds were within normal limits at entrance and exit. For the Veteran’s left ear, the VA examiner noted an exception of mild hearing loss at 500Hz at separation which would be more likely to be related to environmental testing conditions or a temporary medical condition. The VA examiner stated that literature on noise-induced hearing loss did not support the concept of delayed onset years following exposure to noise. Specifically, the VA examiner noted that the Institute of Medicine’s 2006 report entitled “Noise and Military Service: Implications for Hearing Loss and Tinnitus” addressed this issue. The VA examiner also opined that the Veteran’s tinnitus was less likely than not a symptom associated with the Veteran’s hearing loss and less likely than not caused by or a result of military noise exposure. The VA examiner stated that the Veteran’s service treatment records revealed no reports of tinnitus and that the Veteran was unsure of the onset date for claimed disability. Following the February 2016 VA examination and in support of his claim, in his Notice of Disagreement dated in September 2016, the Veteran submitted an excerpt from the Institute of Medicine’s 2006 report, in addition to the names of other medical publications that had issued articles regarding noise-induced hearing loss, which contradicted the information noted in the VA examiner’s opinion. That same month, the Veteran’s wife submitted a statement indicating that she noticed that the Veteran had an issue with his hearing “early on after” and “during the years since” the Veteran was discharged. Based on the foregoing, the Board finds that a remand is necessary in order to obtain an addendum opinion from the February 2016 VA examiner that considers the medical article and publications and lay statements by the Veteran and his spouse regarding the claimed bilateral hearing loss and tinnitus disabilities. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Furthermore, additional service treatment records added to the file reflect that the Veteran had extensive service with the Navy Reserves following his active service. Included with these service treatment records is an audiogram from January 1996 showing that, at that time, the Veteran had hearing loss for VA purposes in his left ear, with diminished hearing at two frequencies in his right. On remand, VA must attempt to verify the Veteran’s reserve service, and this service must be considered as well in determining whether his claimed conditions should be service connected. The matters are REMANDED for the following action: 1. Contact all indicated sources to confirm the dates of the Veteran’s service with the Navy Reserves following his period of active service. 2. Following the above ordered development, return the claims file to the February 2016 hearing loss and tinnitus VA examiner, if available, for an addendum opinion. If the original examiner is not available, the file should be reviewed by another examiner of similar qualifications to obtain the opinion. The need for a new examination is left to the discretion of the examiner. After review of the entire record, the examiner is asked to specifically address the following questions: (a.) Is it at least as likely as not (50 percent or greater probability) that the diagnosed hearing loss and tinnitus is related to his active service? (b.) Is it at least as likely as not that the diagnosed hearing loss and tinnitus are related to the Veteran’s noise exposure during periods of active duty for training or inactive duty for training with the Navy Reserves? In rendering the opinion, the examiner must address the lay statements of record and medical article and publications submitted by the Veteran suggesting a relationship between his claimed disabilities and service. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A-L Evans, Counsel