Citation Nr: 20021826 Decision Date: 03/27/20 Archive Date: 03/27/20 DOCKET NO. 16-21 835 DATE: March 27, 2020 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 United States Navy from July 1959 to July 1963. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Manchester, New Hampshire. Jurisdiction was subsequently transferred to the RO in Los Angeles, California. This case was previously before the Board in April 2018, when it was remanded to the agency of original jurisdiction (AOJ) for additional development. After taking further action, the AOJ confirmed and continued the prior denial and returned the case to the Board. 1. Service connection for bilateral hearing loss is remanded. In September 2019, a VA examiner concluded that it was unlikely that the Veteran’s bilateral hearing loss was related to service. In so doing, the examiner relied, in part, on a study by the Institute of Medicine, cited for the proposition that “there is no scientific basis for delayed or late onset noise induced hearing loss . . . .” The United States Court of Appeals for Veterans Claims (Court) recently observed that the study cited by the September 2019 VA examiner contains apparent qualifiers or contradictions that may impact the probative value of medical opinions that rely upon it. See McCray v. Wilkie, 31 Vet. App. 243 (2019). In light of the Court’s observation, the Board will remand this matter for an addendum opinion. 2. Service connection for tinnitus is remanded. Because the September 2019 VA examiner attributed the Veteran’s tinnitus to his hearing loss, the tinnitus claim is inextricably intertwined with the hearing loss claim. See, e.g., Parker v. Brown, 7 Vet. App. 116 (1994); Harris v. Derwinski, 2 Vet. App. 180, 183 (1991) (issues are “inextricably intertwined” when a decision on one issue would have a “significant impact” on an appellant’s claim for another issue). As such, the Board will remand the tinnitus claim was well. These matters are REMANDED for the following action: 1. Ask the Veteran to identify, and provide appropriate releases for, any care providers who may possess new or additional evidence pertinent to the issues on appeal. If he provides the necessary release(s), assist him in obtaining the records identified, following the procedures set forth in 38 C.F.R. § 3.159. Any new or additional (i.e., non-duplicative) evidence received should be associated with the record. If any of the records sought are not available, the record should be annotated to reflect that fact and the Veteran and his representative should be notified. 2. Obtain copies of records pertaining to any VA treatment the Veteran may have received since these records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 3. Arrange for the claims file to be reviewed by the VA examiner who prepared the September 2019 VA audiology examination report (or a suitable substitute if that VA examiner is unavailable) for the purpose of preparing an addendum opinion. If the examiner finds that another examination of the Veteran is required, one should be undertaken. The examiner is requested to opine as to whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that the Veteran’s bilateral hearing loss had its onset in, or is otherwise attributable to, his period of active service, to include in-service exposure to noise. In so doing, the examiner should refrain from placing any reliance on the 2005 study from the Institute of Medicine, pertaining to delayed onset of hearing loss, which the Court has determined contains apparent qualifiers or contradictions that may impact the probative value of medical opinions that rely upon it. A complete medical rationale for all opinions expressed must be provided. 4. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issues on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Ragheb, 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.