Citation Nr: 21001746 Decision Date: 01/11/21 Archive Date: 01/11/21 DOCKET NO. 18-44 464 DATE: January 11, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for hyperacusis is remanded. Entitlement to service connection for a neck disability is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1965 to July 1971. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) via videoconference in November 2020; a transcript is of record. 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. 3. Entitlement to service connection for hyperacusis is remanded. Regarding the Veteran’s claims for bilateral hearing loss, tinnitus, and hyperacusis, the Board notes that the Veteran, through his representative, has submitted competent evidence of a relationship between hazardous noise exposure, such as the Veteran’s experience, and hearing disorders. The examiner who authored the September 2018 opinion did not address such evidence in his opinions regarding the natures and etiologies of the Veteran’s hearing loss, tinnitus, and hyperacusis. Thus, because the September 2018 examiner did not consider all the pertinent evidence of record, the Board requests an addendum opinion ascertaining the natures and etiologies of the Veteran’s current bilateral hearing loss, tinnitus, and hyperacusis. Because the Board finds that an addendum opinion is warranted, the Board requests that any outstanding medical records concerning the Veteran’s hearing loss, tinnitus, and hyperacusis, be affiliated with the claims file. 4. Entitlement to service connection for a neck disability is remanded. Concerning the Veteran’s claim for service connection for a neck disability, the Board recognizes that the Veteran has received treatment for this condition from a provider outside the VA. See March 2017 VA Primary Care Outpatient Note (reflecting that the Veteran sees a non-VA primary care provider). Accordingly, on remand, the Board requests that the Veteran’s private medical records related to his neck condition be obtained and associated with the claims file. The Veteran also identified an incident in service in which he injured his neck and claimed that he experienced excruciating pain. See November 2020 Hearing Transcript. The Veteran has not yet been examined for this condition. Therefore, the Board requests an examination and opinion determining the nature and etiology of the Veteran’s neck disability. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matters are REMANDED for the following action: 1. The RO should request the Veteran to identify any outstanding and/or updated VA and/or private medical records concerning his hearing loss, tinnitus, hyperacusis, and neck disability. Appropriate efforts must be made to obtain these records if he has adequately identified them and authorized their release (with respect to any private medical records). He should also be invited to submit these records himself. All actions to obtain the requested records should be fully documented in the claims file. If they cannot be located or no such records exist, the Veteran and his representative should be so notified in writing. 2. After completing the foregoing development, forward the claims file to the examiner who authored the September 2018 opinions regarding the Veteran’s hearing loss, tinnitus, and hyperacusis for an addendum opinion. If this examiner is not available, forward the claims file to another clinician with the appropriate expertise. If the examiner determines that a new examination (or telehealth interview, etc., if an in-person examination is not feasible) would be beneficial, one is to be obtained. The examiner should opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral hearing loss manifested during, or is the result of, his active service, to include conceded in-service noise exposure. The examiner should opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s tinnitus manifested during, or is the result of, his active service, to include conceded in-service noise exposure. The examiner should opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s hyperacusis manifested during, or is the result of, his active service, to include conceded in-service noise exposure. In formulating his or her opinions, the examiner should consider and address the competent medical and lay evidence of record, including, but not limited to: (a) The Veteran’s service treatment records; (b) The Veteran’s post-service VA medical records; (c) The Veteran’s post-service private medical records; (d) The evidence submitted by the Veteran, through his representative, in June 2017 and June 2020 reflecting a relationship between hazardous noise exposure and hearing disabilities; and (e) The Veteran’s competent lay statements, including his November 2020 hearing testimony, regarding the onset and continuity of symptomatology of his hearing loss, tinnitus, and hyperacusis. If the examiner determines that the Veteran’s bilateral hearing loss, tinnitus, and/or hyperacusis is/are less likely than not due to his active service, the examiner should discuss what other factor(s) caused the disorder(s). The examiner must provide a comprehensive report that includes a complete rationale for all opinions and conclusions reached. 3. Schedule the Veteran for an appropriate examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the nature and etiology of any and all neck disabilities attributable to the Veteran. The entire claims file, including a copy of this remand, must be made available to the examiner, who must note its review. The examiner should identify any and all neck conditions attributable to the Veteran throughout the appellate period. For each condition so identified, the examiner should opine as to whether it is at least as likely as not (50 percent or greater probability) that the condition manifested during, or is the result of, his active service. In formulating his or her opinion, the examiner should consider and address all competent medical and lay evidence of record, including, but not limited to: (a) The Veteran’s service treatment records; (b) The Veteran’s post-service VA medical records; (c) The Veteran’s post-service private medical records; and (d) The Veteran’s competent lay statements, including his November 2020 hearing testimony, regarding the onset and continuity of his neck symptomatology. If the examiner determines that the Veteran’s neck condition(s) is/are less likely than not due to his active service, the examiner should discuss what other factor(s) caused the disorder(s). The examiner must provide a comprehensive report that includes a complete rationale for all opinions and conclusions reached. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Seserman 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.