Citation Nr: 20043770 Decision Date: 06/29/20 Archive Date: 06/29/20 DOCKET NO. 14-31 189 DATE: June 29, 2020 REMANDED Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from April 1971 to December 1971. This matter is on appeal before the Board of Veterans Appeals (Board) from an October 2015 decision of a Department of Veterans Affairs (VA) Regional Office (RO) that in pertinent part denied service connection for tinnitus. In a May 2018 decision, the Board, in pertinent part, denied the instant claim. The Veteran appealed. In an August 2019 memorandum decision, the Court vacated the May 2018 decision and remanded the appeal back to the Board for action consistent with the memorandum decision. Entitlement to service connection for tinnitus is remanded. In the August 2019 memorandum decision, the Court noted that the Veteran underwent a VA audiological examination in August 2015. The Court indicated that at the examination, the examiner diagnosed the Veteran with bilateral hearing loss but found that the condition was not related to service because of a 40 year-gap between the Veteran’s service and the first diagnosis of the condition. The examiner also noted the Veteran’s reports of recurrent tinnitus from the previous year and found that the tinnitus was not related to service because “tinnitus is known to be related to hearing loss.” The Court concluded that the Board erred by failing to return the August 2015 VA examination for further clarification from the examiner. The Court noted that although the examiner attributed the Veteran’s tinnitus to hearing loss, she failed to explain how the condition was a symptom of hearing loss instead of delayed-onset tinnitus. The Court indicated that the examiner noted the Veteran’s reports that the tinnitus had begun a year prior to the examination but did not address when the hearing loss may have begun in relation to the tinnitus or provide any other information to explain her negative rationale. Given the Courts’ finding, a remand is required so that the VA examiner can provide an addendum opinion, which provides more detail concerning the underlying rationale. The matter is REMANDED for the following action: 1. Obtain copies of VA treatment records dated from April 2020. 2. Arrange for an addendum opinion to be provided by the August 2015 VA audiological examiner, if available. If the August 2015 VA audiological examiner is not available, the supplemental opinion should be provided by another qualified individual. If this is the case, an additional audiological examination (or telehealth interview, if an in-person examination is not feasible) may be necessary; however, this is left to the medical professional’s discretion. The claims file should be reviewed by the examiner in conjunction with the examination. This review should include the service treatment records, the August 2015 VA audiological examination report, any pertinent post-service treatment records and any other information of record deemed pertinent. A) The VA audiological examiner is advised that the Court of Appeals for Veterans Claims (Court), in an August 2019 decision, found inadequate her previous August 2015 opinion, which indicated that the Veteran’s tinnitus is less likely than not caused by or a result of military noise exposure. In this regard, the Court indicated that although the examiner attributed the Veteran’s tinnitus to hearing loss, she failed to explain how the condition was a symptom of hearing loss instead of delayed-onset tinnitus. The Court also indicated that the examiner noted the Veteran’s reports that the tinnitus had begun a year prior to the August 2015 examination but did not address when his hearing loss may have begun in relation to the tinnitus, and did not provide any other information to explain her finding that the tinnitus was a symptom of the hearing loss and less likely than not caused by or a result of military noise exposure. B) After claims file review and review of the summary of the Court finding above, the audiological examiner should then provide an opinion as to whether it is at least as likely as not that the Veteran’s current tinnitus is related to the noise exposure he experienced during service. (Continued on the next page)   In so doing, the examiner should address when the Veteran’s hearing loss may have begun in relation to his tinnitus; whether the Veteran’s tinnitus is likely a symptom of his hearing loss and if so, why this is the case; and/or whether the Veteran’s tinnitus is of a delayed onset, and likely related to his noise exposure during service. C) The audiological examiner should clearly explain the rationale for the opinion provided with citation to pertinent medical literature, if necessary and appropriate. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Dan Brook, 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.