Citation Nr: 21065554 Decision Date: 10/26/21 Archive Date: 10/26/21 DOCKET NO. 19-22 622 DATE: October 26, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran, who is the Appellant in this case, had active service in the U.S. Army from October 1965 to July 1967, including service in Vietnam. This matter comes before the Board of Veterans' Appeals (BVA or Board) from a September 2018 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). By way of a Statement in Support of Claim received in September 2021, the Veteran revoked his appointment of the Illinois Department of Veterans Affairs as his representative, and he has not submitted a new VA Form 21-22; he remains unrepresented. On his July 2019 VA Form 9, the Veteran requested a videoconference hearing before the Board. Hearings were scheduled for July 31, 2020, and June 14, 2021, but the Veteran requested postponement. A virtual hearing was scheduled for September 22, 2021, and notice of the hearing date and place was provided to both the Veteran and his representative. However, the Veteran did not report for the hearing, and no request for postponement was received and granted prior to the hearing date. Under 38 C.F.R. § 20.704(d), when a veteran fails to appear for a scheduled hearing and no request for postponement is received, the claim is processed as though the request for hearing had been withdrawn. Therefore, this case will be processed as though the request for a hearing was withdrawn, and the Board can now proceed to appellate review. 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. As noted above, the Veteran served in Vietnam, and his Military Occupational Specialty (MOS) was Pioneer (which involves construction and engineering). Excessive noise exposure during active service is conceded. The Veteran has reported hearing difficulty ever since he was stationed in Vietnam, where he was exposed to the noise of weapons with the use of earplugs. Following service, he worked for over 30 years at a printing company where he used earmuffs for hearing protection. He has also reported recreational noise exposure when hunting/shooting with the use of ear plugs and motorcycles without hearing protection. At a December 1965 pre-induction examination, an audiogram revealed puretone thresholds of 10, 5, 5, and 10 decibels in the right ear, and 20, 15, 5, and 10 decibels in the left ear at the test frequencies of 500, 1000, 2000, and 4000 Hz, respectively. (Note: Prior to November 1, 1967, service department audiometric test results were reported in standards set forth by the American Standards Association (ASA). Since November 1, 1967, those standards have been set by the International Standards Organization (ISO)-American National Standards Institute (ANSI). In order to facilitate data comparison in this decision, for service department audiometric test results through October 31, 1967, the ASA standards have been converted to ISO-ANSI standards.) No audiogram or whispered voice test was conducted at the July 1967 separation examination. An August 2018 VA examiner opined that the Veteran's hearing loss disability and tinnitus were not caused by or a result of any event in active service, reasoning that there was evidence of intervening causes (occupational and recreational noise exposure) and no separation hearing examination. The Board finds that the August 2018 VA examination is inadequate. While the examiner did not rely solely on the absence of hearing loss or tinnitus at separation, it appears to be a significant basis for the opinion. See Hensley v. Brown, 5 Vet. App. 155 (1993). Moreover, while the Veteran did report post-service noise exposure, the examiner did not explain why such noise exposure contributed to his hearing loss and tinnitus but not his in-service noise exposure, which is conceded and was certainly significant. The matters are REMANDED for the following action: Afford the Veteran an opportunity to attend a VA examination with an appropriate specialist regarding the nature and etiology of his bilateral hearing loss and tinnitus. Any and all indicated evaluations, studies, and tests deemed necessary by the examiner should be accomplished, and a rationale for any opinion expressed should be provided. The claims file, including a copy of this decision, must be made available to the examiner for review of the history in conjunction with the examination, and the examination report should reflect that such review was accomplished. (a.) The examiner should offer the following opinion: Is it at least as likely as not (i.e., to at least a 50/50 degree of probability) that the Veteran's bilateral hearing loss disability was incurred during or caused by active service, to include the Veteran's conceded in-service acoustic trauma? The examiner is reminded that any opinion which relies exclusively upon a normal hearing test (or absence of a hearing test) upon separation will be deemed inadequate and returned for further explanation. The examiner must discuss and consider the Veteran's competent and credible statements that he began experiencing hearing difficulty after service separation. (b.) The examiner should offer the following opinion: Is it at least as likely as not (i.e., to at least a 50/50 degree of probability) that the Veteran's tinnitus was incurred during or caused by active service, to include the Veteran's conceded in-service acoustic trauma? The examiner is reminded that any opinion which relies exclusively upon a normal hearing test (or absence of a hearing test) upon separation will be deemed inadequate and returned for further explanation. The examiner must discuss and consider the Veteran's competent and credible statements that he began experiencing hearing difficulty after service separation. Note: The term "at least as likely as not" does not mean merely within the realm of medical possibility, but rather that the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of causation as it is to find against it. All opinions are to be accompanied by a rationale consistent with the evidence of record. A discussion of the pertinent evidence, relevant medical treatises, and generally accepted medical principles is requested. If the examiner cannot provide an opinion without resorting to speculation, he or she shall provide complete explanations stating why this is so. In so doing, the examiner shall explain whether any inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. Cynthia M. Bruce Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Sherrard, 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.