Citation Nr: 21000290 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 15-34 361 DATE: January 5, 2021 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 from June 1962 to March 1965. He died in November 2020, and the appellant is continuing the appeal as his substitute claimant. See December 2020 substitution determination. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2011 rating decision. The Veteran testified at a hearing before the undersigned Veterans Law Judge in December 2018. A transcript is of record. In March 2019, the Board remanded the case for further development. The case has since been returned to the Board for appellate review. The Veteran was afforded a VA audiology examination in December 2019. However, the examiner concluded that hearing loss could not be ruled out or confirmed based on the audiometric findings obtained during the examination. As a result, she did not provide medical opinions regarding the etiology of the Veteran’s bilateral hearing loss and tinnitus. Notably, the Veteran was diagnosed with bilateral hearing loss for VA purposes during a November 2010 VA audiology examination. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007) (noting that a requirement of current disability is satisfied when claimant has a disability at the time a claim for VA disability compensation is filed or at any point during the pendency of that claim). Therefore, a remand is necessary to obtain a VA medical opinion. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. The agency of original jurisdiction (AOJ) should request that the appellant provide the names and addresses of any and all health care providers who have provided treatment for the Veteran’s bilateral hearing loss and tinnitus. After acquiring this information and obtaining any necessary authorization, the AOJ should obtain and associate these records with the claims file. The AOJ should also obtain any outstanding VA medical records. 2. After completing the foregoing development, the AOJ should refer the Veteran’s claims file to a suitably qualified VA examiner for a medical opinion regarding the nature and etiology of the Veteran’s bilateral hearing loss and tinnitus. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran’s service treatment records, post-service medical records, and assertions. The examiner should note that the Veteran is competent to attest to factual matters of which he has first-hand knowledge. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should state this with a fully reasoned explanation. It should also be noted that the absence of evidence of a hearing loss disability during service is not always fatal to a service connection claim. Evidence of a current hearing loss disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting the regulatory requirements for hearing loss disability for VA purposes, and a medically sound basis upon which to attribute the post-service findings to the injury in service. The examiner should convert any audiometric results using ASA standards to ISO-ANSI standards in order to facilitate data comparison. (The Board has historically considered that service departments changed ASA standards to ISO-ANSI standards as of November 1967. The revised policy provides that, for service department audiograms conducted between January 1, 1967, and December 31, 1970, in which the standard used is not clearly indicated, the data should be considered under both the ASA and ISO-ANSI standards). The examiner should provide an opinion as to whether it is at least as likely as not that the Veteran’s bilateral hearing loss and tinnitus manifested in or were otherwise causally or etiologically related to his military service, including any noise exposure therein. In rendering this opinion, the examiner should address whether there was a threshold shift during service and the significance, if any, of the existence or absence of such a shift. The examiner should further discuss medically known or theoretical causes of hearing loss and tinnitus and describe how hearing loss and tinnitus which result from noise exposure generally present or develop in most cases, as distinguished from how hearing loss and tinnitus develop from other causes, in determining the likelihood that current hearing loss and tinnitus were caused by noise exposure in service as opposed to some other cause. (The term “at least as likely as not” does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of conclusion as it is to find against it.) A clear rationale for all opinions would be helpful, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. J.W. ZISSIMOS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Wulff, 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.