Citation Nr: A20007360 Decision Date: 04/30/20 Archive Date: 04/30/20 DOCKET NO. 191031-40517 DATE: April 30, 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 Army from May 1968 to August 1969. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a September 2019 rating decision by a Regional Office (RO) of the United States Department of Veterans Affairs. In October 2019, the Veteran field his notice of disagreement, electing the Direct Review docket. Under Direct Review, the Board considers the same record as that before the RO in rendering a decision. 38 C.F.R. § 20.301. Remand is permitted only to correct pre-decision errors of assistance or errors likely to affect the outcome of the claim. 38 C.F.R. § 20.802. The Board finds that under the AMA structure, a remand is required because VA committed a duty-to-assist error prior to issuing the decision on appeal. The Veteran was provided a VA hearing loss and tinnitus examination in August 2019. The VA examiner noted the Veteran’s military occupational specialty as an infantryman and the high probability of the Veteran’s in-service hazardous noise exposure. The VA examiner documented the Veteran’s mild pre-existing bilateral hearing loss at 6000Hz. The VA examiner determined that the Veteran’s bilateral hearing loss was not related to service because there was no significant positive threshold shifts in hearing in comparing his entrance and separation examinations. The VA examiner opined that it was less likely than not that the Veteran’s bilateral hearing loss was caused or aggravated beyond natural progression in service. The VA examiner noted no significant permanent shift in hearing thresholds greater than normal measurement variability from entrance to separation, evidence of no permanent auditory damage on active duty. The VA examiner stated that “Although noise exposure is conceded, and auditory damage and hearing loss are well-established, auditory damage and hearing loss are not conceded based on noise alone. There must be a nexus of auditory damage to relate current hearing loss to military noise and not another etiology. The evidence is against a nexus in this case, therefore it is less likely than not that the hearing loss is related to military noise exposure.” Yet, the examiner failed to offer a thorough rationale for this conclusion. The Board finds that this opinion is inadequate for adjudication purposes because service connection for hearing loss is not precluded where hearing was within normal limits on audiometric testing at separation from service. See Hensley v. Brown, 5 Vet. App. 155, 159-60 (1993). In other words, the examiner did not address the possibility of delayed onset, and simply offered a conclusory “no nexus” statement based on lack of onset in service. On remand, a new VA examination and opinion is required. The VA examiner determined that it is at least as likely as not that the Veteran’s tinnitus is related to his hearing loss. This issue is inextricably intertwined with the claim for entitlement to service connection for bilateral hearing loss which is being remanded for additional development. 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 a veteran’s claim for the second issue). The matters are REMANDED for the following action: Schedule the Veteran for a hearing loss examination. The claims file must be reviewed in conjunction with the examination. The examiner must state whether or not it is at least as likely as not (50 percent or greater probability) that any currently diagnosed hearing loss is caused or aggravated by service, to include as due to his established acoustic trauma. Delayed onset hearing loss must be specifically addressed. A full and complete rationale for all opinions expressed must be provided. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. M. Lunger, 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.