Citation Nr: 21062800 Decision Date: 10/12/21 Archive Date: 10/12/21 DOCKET NO. 17-55 258 DATE: October 12, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for bilateral tinnitus is remanded. Entitlement to a disability rating in excess of 10 percent for pseudofolliculitis barbae (PFB) is remanded. REASONS FOR REMAND The Veteran had active service from May 1977 to October 1983. This matter comes before the Board of Veterans' Appeals (Board) on appeal from January 2015 and September 2017 rating decisions of a VA Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a July 2021 hearing before the Board of Veterans' Appeals (Board). 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran asserts that he experiences bilateral hearing loss as a result of his active service. During the Veteran's VA examination for hearing loss and tinnitus, the Veteran reported that his hearing loss and tinnitus began during service after a grenade detonated near his head. The VA examiner opined that his hearing loss was less likely than not due to service. Their rationale was very brief, did not discuss his lay statements, and relied on the Veteran's military occupational specialty (MOS) being noted for low probability for noise exposure, as well as there being no documentation to confirm significant threshold shifts while in service. The Board finds this opinion inadequate for adjudication purposes. Where VA provides the Veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). A medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Generally, a medical opinion should address the appropriate theories of entitlement. Id. at 123-24 (2007). Where the Veteran has provided competent and credible lay testimony, an examiner cannot ignore that lay evidence. Dalton v. Nicholson, 21 Vet. App. 23, 39-40 (2007). Accordingly, this claim must be remanded for a VA addendum opinion. 2. Entitlement to service connection for bilateral tinnitus is remanded. The Veteran asserts that he experiences bilateral tinnitus as a result of his active service. During the Veteran's May 2016 VA examination for hearing loss and tinnitus, the VA examiner opined that his tinnitus was less likely than not related to service and at least as likely as not secondary to his hearing loss. Accordingly, this claim is inextricably intertwined with the remanded service connection claim for hearing loss and must also be remanded. See Harris v. Derwinski, 1 Vet. App. 180 (1991). 3. Entitlement to a disability rating in excess of 10 percent for PFB is remanded. The Veteran asserts that his PFB is more severe than is reflected by his current evaluation. The Veteran was last afforded a VA examination for this claim in May 2016. During his July 2021 Board hearing, the Veteran testified that his condition had worsened since his last VA examination, his back had also been treated skin problems during service, and his last VA examination did not adequately assess the skin on his back. Additionally, his VA treatment records reflect increased treatment for the skin on his back, including application an ointment twice per day. See, e.g., June 2021 and January 2017 VA treatment records. They also reflect treatment for cysts in November 2017 VA treatment records. Overall, the evidence reflects a need for a more contemporaneous VA examination. The matters are REMANDED for the following action: 1. Forward the Veteran's claims file to a qualified medical professional for a VA addendum opinion to determine the nature and etiology of the Veteran's hearing loss and tinnitus. The examiner should be asked to address the following, with a complete rationale for all opinions expressed: (a) Provide an opinion as to whether hearing loss at least as likely as not (at least an approximate balance of positive and negative evidence) had its onset during or is otherwise related to any event or injury during active service. The examiner must consider and discuss the Veteran's lay statements and Board testimony regarding noise exposure during service, including a grenade detonating near his head during service. (b) Provide an opinion as to whether tinnitus at least as likely as not had its onset during or is otherwise related to any event or injury during active service. The examiner must consider the lay statements of record. The examiner is advised that the Veteran is competent to report symptoms and treatment, and that his reports must be taken into account in formulating the requested opinion. 2. Schedule the Veteran for a VA examination by an appropriate examiner to assist in determining the current severity of the service-connected pseudofolliculitis barbae. The electronic claims file should be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished, and all clinical findings must be reported. The examiner must consider and address the Veteran's lay statements and Board testimony and should include the Veteran's back and neck in the examination. The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic, and requests flexibility and understanding in affording the Veteran an opportunity to report for an examination. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Hicks, 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.