Citation Nr: 21001832 Decision Date: 01/12/21 Archive Date: 01/12/21 DOCKET NO. 16-28 882 DATE: January 12, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran had active duty service from March 1979 to May 1983. This matter is on appeal before the Board of Veterans’ Appeals (Board) from a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) rating decision dated in March 2015. The Veteran testified at a Board hearing in July 2019, and a copy of the transcript has been associated with the record. This case was previously before the Board in October 2019, at which time it was remanded to the AOJ for additional development. Unfortunately, for the reasons explained below, another remand is necessary. 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran underwent a VA examination in October 2020. The examiner opined that the Veteran’s left ear hearing loss, which preexisted service, was not aggravated thereby. The examiner also opined that the Veteran’s right ear hearing loss was less likely than not caused by or the result of service. Regarding the right ear, the examiner explained that there was no evidence of threshold shift during service and no evidence of an in-service noise injury. This opinion is inadequate because it only addresses whether the Veteran’s hearing loss was incurred in service, and not whether it is otherwise attributable to service. Moreover, the Board found in its October 2019 decision granting service connection for tinnitus that there was evidence of acoustic trauma. Therefore, an adequate opinion must be obtained on remand. Additionally, after the October 2020 VA examination, the Veteran submitted additional evidence in support of his claim that needs to be addressed by an examiner. Specifically, the Veteran submitted a statement and argument in November 2020. The Veteran reported having been told by a medical professional that his hearing loss was due to noise-exposure in service because he had no post-service exposure, that he experienced ear pain in service when exposed to loud music, and a website purporting that noise-induced hearing loss can take a long to manifest and is not always immediate. These arguments and statements need to be addressed on remand. The matters are REMANDED for the following action: 1. Obtain a supplemental opinion from a qualified VA examiner regarding the etiology of the Veteran’s bilateral hearing loss. If the examiner determines that he or she cannot respond to the Board’s inquiries herein without examining the Veteran, then an examination must be afforded. If an in-person examination is not feasible, then the Veteran should be afforded an examination by other means. (a.) The examiner must review and address the statement and argument submitted in November 2020, including: the Department of Health and Human Services website that noise-induced hearing loss can take a long time to manifest (https://www.nidcd.nih.gov/health/noise-induced-hearing-loss); he was told by a medical professional that his hearing loss was due to noise-exposure in service because he had no post-service exposure; and that he experienced pain in his ears during service when exposed to loud music. (b.) The examiner is also advised that the Board has already resolved doubt in the Veteran’s favor that he experienced acoustic trauma during service. (c.) The examiner must provide an opinion as to whether it is at least as likely as not (50 percent or greater) that the Veteran’s right ear hearing loss is etiologically related to, incurred in, or caused by the Veteran’s military service, including noise exposure. (d.) The examiner must provide an opinion as to whether it is at least as likely as not (50 percent or greater) that the Veteran’s left ear hearing loss, which was noted at entrance into service, was aggravated beyond its natural progress during service. (Continued on the next page)   A complete rationale must be provided for all expressed opinions. A complete explanation for all opinions expressed must be provided. A clearly stated rationale must not be based solely on lack of documentation or records. The reasons for any opinion must include a discussion of the relevant evidence. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why. S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Smith, 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.