Citation Nr: 21005141 Decision Date: 01/29/21 Archive Date: 01/29/21 DOCKET NO. 20-07 007 DATE: January 29, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from August 1965 to January 1969. The case originally came before the Board of Veterans’ Appeals (Board) on appeal from a July 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office. In April 2020, the Board remanded this case for additional development. The Board’s previous remand directives have been substantially complied with, and the matter is properly before the Board. See Stegall v. West, 11 Vet. App. 268 (1998). 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends that service connection for bilateral hearing loss is warranted as the condition was caused while he served on active duty. The Board remanded this issue for additional development because the Veteran’s lay statements were previously not considered by the RO and his contentions regarding a private audiological examination were not considered. Post remand, the Veteran was afforded an addendum opinion based on the Acceptable Clinical Evidence (ACE) process. The examiner issued a positive opinion after reviewing the evidence of record that it is at least as likely as not that the Veteran’s hearing loss resulted from cochlear damage due to military noise exposure. However, the RO denied the claim once again after observing that the Veteran does not have hearing loss for VA purposes as the private audiological examination conducted in May 2018 that showed left ear hearing loss was based on Central Institute for the Deaf (CID)W-22 List 1A criteria, and not on the Maryland consonant-vowel nucleus-consonant (CNC) Test, and therefore not valid for VA purposes. Impaired hearing will be considered a disability for VA purposes when the auditory thresholds in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz (Hz) are 40 decibels or more; or when the thresholds for at least three of these frequencies are 26decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. §3.385. The Board observes that in addition to an in-service incurrence and nexus to service, audiometric findings that show hearing loss for VA purposes based on the Maryland CNC Test are needed in order to grant service connection for a hearing loss claim. However, as the previous VA audiological in-person examinations that measured the Veteran’s audiometric threshold are now over two years old during the pendency of the appeal, a new in-person VA examination is needed to assess whether the Veteran has hearing loss for VA purposes. Although a mere passage of time does not render an audiological examination inadequate, there are conflicting medical opinions in the record. Thus, the Board affords the Veteran another opportunity for an in-person VA audiological examination to assess whether there is current hearing loss for VA purposes. Accordingly, the matter is REMANDED for the following action: 1. Schedule the Veteran for a new VA audiological examination for his claimed bilateral haring loss. The examiner must review the claims file, review the conflicting medical evidence, and respond to the following based on the audiometric thresholds recorded during the examination and the evidence of record: a. Is it as least as likely as not (50 percent probability or greater) that the Veteran’s claimed bilateral hearing loss had its onset in, or is otherwise etiologically related to active duty service? b. In rendering the requested opinion, the examiner should review the March 2008, July 2018 VA audiological examinations, May 2018 private audiological examination and August 2020 VA addendum opinion, and discuss the Veteran’s lay statements of record, noting his MOS as a jet engine mechanic and the contentions raised by the Veteran’s representative in the April 2020 Informal Hearing Presentation regarding the National Institutes of Health study titled ‘Impact of noise on hearing in the military’ (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455974), and that hearing protection in-service was inadequate as raised in the Veteran’s February 2020 lay statement, while also discussing his noise exposure post-service in civilian positions. 2. The examination report must include a complete rationale for all opinions expressed. If the examiner feels that a requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e., additional facts are required, or the examiner does not have the needed knowledge or training). 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran’s claim should be readjudicated based on the entirety of the evidence. If the benefit sought remains denied, furnish the Veteran and his representative a supplemental statement of the case (SSOC) and return the case to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Khan, 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.