Citation Nr: 20037580 Decision Date: 06/02/20 Archive Date: 06/02/20 DOCKET NO. 17-16 876 DATE: June 2, 2020 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1960 to September 1964. The appeal arose to the Board of Veterans’ Appeals (Board) from a February 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri. In March 2018, the Veteran participated in a hearing with the undersigned Veterans Law Judge (VLJ). A transcript of the hearing is of record. In June 2018, the Board remanded the issue on appeal for further evidentiary development. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends his bilateral hearing loss is related to service. In support of his claim, he submitted a July 2018 letter from a private audiologist noting that the Veteran had a history of noise exposure in the military and opining that the Veteran’s current hearing loss “can be consistent with noise exposure.” No substantive rationale was provided, however. In October 2019, the Veteran underwent a VA Compensation and Pension (C&P) examination in which he reported experiencing excessive noise in service and stated he was not provided hearing protection. However, the examiner opined that it was not at least as likely as not that the Veteran’s current hearing loss was related to service. By way of rationale, the examiner explained that the Veteran’s entrance and exit exams showed whispered voice tests of 15/15, suggesting normal hearing. The examiner further stated the Veteran had “limited amounts of noise exposure” with “no documentation of hearing problems during his military service.” The Veteran argues the C&P examiner’s opinion is inadequate. Specifically, his representative noted in an April 2020 statement that the examiner did not address all relevant lay statements, particularly those detailing the nature of the Veteran’s noise exposure and his lack of ear protection in service (the examiner provided no explanation of her statement that the Veteran had “limited amounts of noise exposure” in service). The Board also notes that the C&P examiner failed to discuss the July 2018 positive opinion provided by the Veteran’s private audiologist. For these reasons, a remand is warranted for an updated VA examination and opinion. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide an examination or obtain a medical opinion, it must ensure that the examination or opinion is adequate). The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination, by an examiner who has not previously examined the Veteran, to determine the nature and etiology of the Veteran’s bilateral hearing loss. The examiner is asked to review the claims file and provide the following information: (a) State whether the criteria for a bilateral hearing loss diagnosis is met. (b) Opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral hearing loss disability was incurred in or otherwise related to in-service noise exposure. * Notably, the absence of documented evidence of hearing loss during service should not serve as the sole basis for a negative opinion. * In providing the above opinion the examiner must specifically discuss the relevant lay statements regarding noise exposure in service, to include the Veteran’s reports that he had inadequate ear protection in service. * The examiner must also discuss the July 2018 positive private nexus opinion provided by the Veteran’s audiologist. * Lastly, the examiner must discuss the article cited to the in the May 2020 representative’s brief from the Journal of Neuroscience in May of 2015 noted as stating that auditory damage can accelerate hearing loss in aging in some cases. Also, the examiner should address the theory of delayed onset as raised by the representative. (c) If it is determined that there is another likely etiology for the Veteran’s bilateral hearing loss, that should be stated. (Continued on the next page)   The examiner should set forth all examination findings, with a clear rationale for the conclusions reached. 2. Ensure that the medical opinion is in compliance with the above directives. If the report is deficient in any manner, it should be returned to the examiner for amendment. Stegall v. West, 11 Vet. App. 268 (1998). LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Ryan, 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.