Citation Nr: 20045077 Decision Date: 07/07/20 Archive Date: 07/07/20 DOCKET NO. 19-35 965 DATE: July 7, 2020 REMANDED Entitlement to service connection for left ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from July 1967 to July 1970 as a Persian Missile Specialist and Crewchief. This matter comes before the Board of Veterans’ Appeals (Board) from an August 2018 rating decision from the Department of Veterans Affairs Regional Office (RO). Entitlement to service connection for left ear hearing loss is remanded. The Veteran asserts entitlement to service connection for left ear hearing loss. A November 2017 VA examination shows a diagnosis of sensorineural hearing loss in the left ear. See November 2017 VA Examination, p. 3. There are three in-service audiograms in the Veteran’s claims file: January 1967, September 1969, and April 1970. See November 2017 STR, pp. 16, 19; see also November 2017 Military Personnel Record #3, p. 2. In a February 2018 addendum opinion, a VA examiner opined that the Veteran’s hearing loss in both ears was not related to military noise exposure. See February 2018 VA Examination. In this addendum opinion, the examiner only considered the Veteran’s audiograms from 1967 and 1970, failing to consider the September 1969 examination that appeared to show worsened hearing acuity over all tested frequencies. The Board finds that the February 2018 addendum opinion is inadequate for adjudication purposes as the VA examiner did not address all in-service audiograms in the Veteran’s claims file and thus failed to address a potential threshold shift. Barr v. Nicholson, 21 Vet. App. 303 (2007) (when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). In addition, the Board notes that between the time of the Veteran’s induction examination and his separation examination, many military branches changed from using American Standards Association (ASA) standards to using International Standards Organization American National Standards Institute (ISO-ANSI) standards when providing audiograms. Thus, for all of the Veteran’s in-service audiograms between January 1, 1967 and December 31, 1970, data under both ASA and ISO-ANSI standards will be considered, and the measurement most favorable to the Veteran must be applied. Conversion from ASA to ISO-ANSI standard is accomplished by adding between 5 and 15 decibels to the recorded data as follows: HERTZ 500 1000 2000 3000 4000 ADD 15 10 10 10 5 Although the Veteran has been diagnosed with sensorineural hearing loss, the February 2018 negative addendum opinion was based solely on the lack of any significant threshold shift between induction and separation. Crucially, the examiner did not specify under which standard she considered the in-service audiograms. Thus, upon remand, the RO must obtain an adequate etiological opinion that considers all in-service examinations under both ASA and ISO-ANSI standards, whichever is most favorable to the Veteran. The matter is REMANDED for the following action: Obtain a VA opinion regarding the Veteran’s left ear hearing loss. After a review of the claims folder, please provide the following opinion: • Whether the Veteran’s left ear hearing loss is at least likely as not (50 percent or more probability) due to exposure to noise during service. In so opining, the examiner must consider the in-service audiograms in January 1967, September 1969, and April 1970 under both ASA and ISO-ANSI standards, whichever is most favorable to the Veteran. The examiner must also specifically address the September 1969 audiogram results that appear to show worsened hearing acuity under either standard. The examiner is also advised that the RO has determined that the Veteran’s military occupational specialty (MOS) of Persian Missile Specialist and Crewchief is consistent with acoustic trauma. The examiner is advised that the Veteran is competent to report symptoms and treatment, and that his reports must be taken into account, along with the other evidence of record, in formulating the requested opinion. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Watkins, 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.