Citation Nr: 21062323 Decision Date: 10/07/21 Archive Date: 10/07/21 DOCKET NO. 16-36 735 DATE: October 7, 2021 REMANDED Entitlement to service connection for right ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from July 1971 to February 1979. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in November 2018 and May 2021 when it was remanded for additional development. 1. Entitlement to service connection for right ear hearing loss is remanded. At the outset, the Board notes that the record reflects right ear hearing loss for VA purposes, satisfying the first element of service connection. 38 C.F.R. § 3.385. See January 2016, August 2021 VA examinations. The RO has also conceded exposure to acoustic trauma consistent with his service. See February 2016 rating decision (awarding service connection for tinnitus). In May 2021, the Board remanded this matter for additional development, to include affording the Veteran a new audiological examination to determine the etiology of the Veteran's right ear hearing loss disability. On August 2021 VA audiological examination, the examiner noted normal enlistment and separation audiogram that showed no shift compared to enlistment. The examiner opined that it was not at least as likely as not the Veteran's right ear hearing loss was caused by or a result of an event in military service. Inasmuch as the August 2021 VA examiner relied on the Veteran's normal hearing at separation to provide a negative etiological opinion, the Board finds the examination and opinion provided to be inadequate. Furthermore, inasmuch as the examiner stated that there was no threshold shift from enlistment to separation, the Board finds that the examiner's opinion was based on an inaccurate factual premise as the evidence shows the Veteran's right ear auditory threshold worsened at 500 and 1000 Hertz on separation when compared to his enlistment audiogram. Cf. May 1971 audiogram (reflecting auditory thresholds of 15 and 5 at 500 and 1000 Hertz respectively); December 1978 audiogram (reflecting auditory thresholds of 20 and 10 Hertz respectively); see Reonal v. Brown, 5 Vet. App. 548 (1993). The Board notes that even if disabling hearing loss is not demonstrated at separation, a veteran may still establish service connection for a current hearing disability by submitting evidence that a current disability is causally related to service. See Hensley v. Brown, 5 Vet. App. 155, 160 (1993). In addition, the examiner did not consider delayed-onset hearing loss. Therefore, the Board finds that a remand is necessary to afford the Veteran a new VA examination. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. Notify the Veteran that he may submit lay statements from himself and from other individuals who have first-hand knowledge, and/or were contemporaneously informed of his in-service and post-service right ear hearing loss, to include the onset of the condition. The Veteran should be provided an appropriate amount of time to submit this lay evidence. 3. Schedule a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible). Whether an in-person examination is necessary should be determined by the examiner. After review of the Veteran's claims file, the examiner should then opine as to whether it is at least as likely as not: (a) The Veteran's right ear hearing loss is had its onset in service or is otherwise related to service, to include as a result of conceded noise exposure during service. In addressing this question, the examiner must accept as true that the Veteran was exposed to noise exposure in conjunction with his service duties, and please do not rely solely on the fact that the Veteran had "normal" hearing at separation from service to support the opinion. It is not sufficient to base an opinion on a mere lack of documentation of complaints in service or post-service treatment records. The examiner must also address the likelihood the Veteran has delayed-onset hearing loss. (b) The Veteran's right ear hearing loss is proximately due to his service-connected type II diabetes mellitus; or, (c) The Veteran's right ear hearing loss has been aggravated by his service-connected type II diabetes mellitus. A complete rationale for all opinions must be provided. If unable to provide a medical opinion, provide a statement as to whether there is any additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Marley, 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.