Citation Nr: 20023050 Decision Date: 04/02/20 Archive Date: 04/02/20 DOCKET NO. 19-20 108 DATE: April 2, 2020 REMANDED Entitlement to service connection for hearing loss disability is remanded. REASONS FOR REMAND Entitlement to service connection for hearing loss disability is remanded. The Veteran separated from active service in February 1981. His hearing was noted as normal at separation. He contends, however, that he has hearing loss due to his service, including additional service on active duty for training (ACDUTRA) and inactive duty training (INACDUTRA). In support of his claim, he has submitted a private 2016 audiological opinion indicating his hearing loss disability is from his service in the “Army National Guard for 22 years”. He also has reported that the onset of his hearing loss was “7-10 years ago” (meaning 7-10 years before 2016), so sometime from 2006-2009. He had separated from the National Guard in 1999, therefore, about 7-10 years earlier. The examiner did not explain the reason for the apparent delayed onset of noticeable hearing loss, so the basis of the opinion is unclear, including in terms of whether he considered all of the relevant evidence such as the service treatment records (STRs). Moreover, the Veteran’s service in the National Guard was limited to periods of training and never exceeded 43 days in a year; he also had no INACDUTRA or ACDUTRA for two years (November 1983-January 1986). For INACDUTRA, drill weekends consist of four drill periods (e.g. morning, afternoon, morning, afternoon. A typical Drill weekend is worth four points; for ACDUTRA, a day is worth one point. The Veteran’s STRs contain several audiograms noting the following: October 1972 HERTZ 500 1000 2000 3000 4000 RIGHT 10 05 10 10 15 LEFT 10 10 05 10 15 October 1975 HERTZ 500 1000 2000 3000 4000 RIGHT 10 10 0 05 10 LEFT 15 05 0 15 05 June 1976 HERTZ 500 1000 2000 3000 4000 RIGHT 15 10 0 5 10 LEFT 15 10 05 15 10 January 1981-Release from active duty HERTZ 500 1000 2000 3000 4000 RIGHT 15 05 05 05 10 LEFT 15 05 05 15 05 The Veteran had ACDUTRA and/or INACDTURA of approximately a total of 49 days between February 1982 and November 1983. As already mentioned, he had no ACDUTRA or INACDUTRA from November 1983 to January 1986. In approximately November 1986, he enlisted in the Oregon National Guard. At that time, he had abnormal hearing in his left ear. His audiological testing revealed the following: Nov 1986-Enlistment in Oregon NG (Dr. J.B.) HERTZ 500 1000 2000 3000 4000 RIGHT 20 10 05 10 15 LEFT 25 20 20 30 25 Between November 1986 and March 1991, he had approximately 120 total number of days of INACDUTRA and ACDUTRA over the four-year period. He had another examination in March 1991 which revealed the following thresholds: March 1991-quad-Idaho NG (CW3 F.W.B) HERTZ 500 1000 2000 3000 4000 RIGHT 20 10 0 10 15 LEFT 15 0 05 70 05 Four years later, after no ACDUTRA but approximately 10-12 days of INACDTURA per year, he had the following threshold findings in March 1995: March 1995 (periodic. Dr. Vania) HERTZ 500 1000 2000 3000 4000 RIGHT 20 10 05 20 25 LEFT 15 05 10 25 20 Four months later, he was examined again for “over age 40” purposes. In July 1995, his puretone thresholds were as follows: July 1995-over 40 exam (Dr. Parke) HERTZ 500 1000 2000 3000 4000 RIGHT 25 10 05 30 15 LEFT 15 05 05 30 20 “[M]ild high frequency hearing loss” was noted in block 74 of summary of defects and diagnoses for the July 1995 examination. The claims file includes an August 2019 VA Disability Benefits Questionnaire (DBQ) with an opinion by the examiner that it is less likely than not the Veteran’s hearing loss disability is due to his service. The examiner’s opinion was based, in part, on a 1996 audiogram. However, the Board has been unable to locate a 1996 audiogram in the claims file, and the local regional office (RO) did not cite to one either. The examiner also did not discuss the numerous audiogram findings in the STRs as noted above. Consequently, the Board finds that a supplemental opinion is warranted. The Veteran contends that, in 1986, he was part of a test fire rocket launcher and that, although he wore hearing protection, he noticed a decrease in the hearing in his right ear for several days following the event.   The Veteran’s Master Military Pay Account (MMPA) should be obtained and, thereafter, the examiner should consider the Veteran’s several audiograms in service, also his actual dates of service, and provide an addendum opinion regarding whether it is as likely as not that his current hearing loss is due to his service. Accordingly, this claim is REMANDED for the following action: 1. Request the Veteran's Master Military Pay Account (MMPA) report for the period from June 10, 1981 to July 1, 1991 to ascertain his exact dates of ACDUTRA and INACDUTRA. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s current hearing loss disability is at least as likely as not (50 percent or greater probability) related to his service. In making this important determination of causation, the designated clinician should consider: a) the several audiograms in the claims file from during the Veteran’s service (dated in October 1972, October 1975, June 1976, January 1981, November 1986, March 1991, March 1995, and July 1995); b) the November 1986 finding of abnormal hearing in the left ear; c) the March 1991 finding of abnormal hearing in the left ear; d) the July 1995 finding of mild high frequency hearing loss; e) the Veteran’s contention to the private 2016 examiner that, in 1986, he was part of a test fire rocket launcher and noticed a decrease in right ear hearing acuity for several days following the event; and f) the Veteran’s dates of ACDUTRA and INACDUTRA.   The commenting clinician should consider whether the Veteran’s abnormal hearing (i.e., the threshold for normal hearing is from 0 to 20 dB, and higher threshold levels indicate some degree of hearing loss above 20) noted in the National Guard STRs was before or after periods of training. If pertinent, the commenting clinician should also consider the number of days of ACDUTRA and INACDUTRA in comparison to the number of days when the Veteran was a civilian and not training. If an opinion cannot be provided without another actual examination, have the Veteran re-examined. KEITH W. ALLEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Wishard 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.