Citation Nr: 21001553 Decision Date: 01/08/21 Archive Date: 01/08/21 DOCKET NO. 17-59 908 DATE: January 8, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served in the United States Army from May 1965 until his honorable discharge in May 1967. The Veteran served as an artillery scout for approximately six months, from October 1965 until April 1966, when his military occupational specialty (MOS) changed to personnel specialist. This matter comes before the Board of Veterans’ Appeals (Board) from a March 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this matter in February 2019 and October 2020 for additional development, which has not been substantially completed. See Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for bilateral hearing loss is remanded. The Veteran asserts that his bilateral hearing loss disability is related to in-service artillery noise exposure. As noted in the February 2019 remand order, the Veteran attended examinations in December 2016 and February 2017; however, the Board found those opinions were inadequate for rating purposes. Specifically, the Board stated that the December 2016 opinion was incomplete and failed to provide a factually accurate, fully articulated, sound reasoning for the conclusion and failed to provide a probative value to the medical opinion. The February 2017 opinion was inadequate because the examiner based the opinion on the Veteran’s lack of a hearing loss disability upon separation from service. The absence of hearing loss disability in service is not in and of itself fatal to a claim for service connection for a hearing loss disability. Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Service connection may be awarded when there is sufficient evidence to otherwise demonstrate a relationship between the Veteran’s service and his current disability. Hensley v. Brown, 5 Vet. App. 155, 159-60 (1993). In light of the above, the Board ordered a new VA examination to address the etiology of the Veteran’s hearing loss disability and directed the examiner to consider the Veteran’s lay reports describing his symptoms. As addressed in the October 2020 remand order, the Veteran had a VA examination in February 2020, but the Board found the opinion inadequate because the examiner did not address the Veteran’s reports of exposure to artillery fire. The Board remanded the matter for an addendum opinion and again directed the examiner to consider the Veteran’s lay reports describing his symptoms. In October 2020, an addendum opinion was received; however, this opinion is also inadequate for rating purposes. Similar to the February 2017 opinion, the examiner based the opinion on the Veteran’s lack of a hearing loss disability at separation from service. The examiner did not discuss the Veteran’s report of exposure to artillery fire during service. Further, the examiner failed to consider American Standards Association (ASA) to International Standards Organization (ISO) unit conversion when discussing in-service threshold shift. The Veteran’s separation audiological examination was conducted in January 1967 and it does not indicate which standard was used. Between January 1, 1967 and December 31, 1970, when the test does not indicate which standard is used, the examiner should consider the data under both ASA and ISO-ANSI standards. Accordingly, an opinion with a complete rationale that considers ASA-ISO unit conversion and does not rely on the lack of documented in-service bilateral hearing loss is needed and must be obtained on remand. The matter is REMANDED for the following actions: 1. Associate with the electronic claims file updated VA treatment records, if any. 2. Ask the October 2020 examiner, or another qualified clinician, to provide an addendum opinion addressing the etiology of the Veteran’s bilateral hearing loss. The examiner must be provided access to the electronic claims file and indicate review of the claims file in the opinion report. The examiner should be notified that the Veteran served as a Field Artillery Surveyor from October 1965 to April 1966. The examiner must consider the conversion from ASA standards to ISO standards for all in-service audiometric testing, including the test completed at separation in January 1967. After reviewing the claims file, the examiner must opine whether it is at least as likely as not (50 percent probability or greater) that hearing loss is related to an in-service injury, event, or disease, including in-service noise exposure. In providing the opinion, the examiner is advised that the absence of in-service evidence of a hearing disability is not always fatal to a service connection claim. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). 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. See Hensley v. Brown, 5 Vet. App. 155, 159 (1993) The examiner is advised that the Veteran is competent to report his symptoms and history, such as his report of exposure to artillery fire, and such reports must be considered in the rationale. If the examiner rejects the Veteran’s reports, the examiner must provide a reason for doing so. A complete rationale for the opinion must be provided. 3. Then, readjudicate the Veteran’s claim on appeal. If the benefit sought on appeal remains denied, provide the Veteran and his representative a supplemental statement of the case and allow an appropriate period for response. L. CHU Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Amanda G. Alderman 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.