Citation Nr: 21066893 Decision Date: 11/02/21 Archive Date: 11/02/21 DOCKET NO. 17-13 008 DATE: November 2, 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 Army from April 1981 to June 1981. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2013 rating decision issued by a Department of Veterans Affairs Regional Office (RO). In a September 2020 submission, the Veteran's former Veterans Service Organization (VSO) representative indicated that they no longer wished to be a co-located VSO at the Board due to staffing and programming changes. The Veteran was informed that his prior VSO representative was no longer an accredited representative in an August 2021 letter from the Board. The August 2021 letter also provided instructions to the Veteran on how to appoint another representative and indicated that if the Veteran did not respond within 30 days, the Board would proceed with review of the appeal. The Veteran returned an Appointment of Veterans Service Organization as Claimant's Representative (VA Form 21-22) in September 2021 that contained his personal information but did not appoint a representative. Therefore, the Board is considering the Veteran to be pro se. 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends that his bilateral hearing loss is the result of his service, specifically noise exposure as a gunner and cannoneer. The Veteran's Form DD 214 lists his military occupational specialty (MOS) as cannon crewman. A February 2014 VA examiner opined that the Veteran's bilateral hearing loss was not at least as likely as not (50 percent probability or greater) caused by or a result of an event in service and reasoned that the Veteran's February 1981 service entrance examination and February 1985 service discharge examination were within normal limits bilaterally. The examiner notes that the comparison of examinations indicate no significant change in hearing sensitivity and documentation of OSHA-defined significant threshold shift (STS) during service cannot be established from this audiometric data. However, this opinion does not reflect an adequate rationale as the examiner did not explain the significance of OSHA-defined significant threshold shift. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A] medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions.") In addition, the examiner did not consider the Veteran's reports that his hearing loss symptoms began during service and relied on the absence of medical documentation in rendering the opinion. See, e.g., Dalton v. Nicholson, 21 Vet. App. 23 (2007) (an examination was inadequate where the examiner did not comment on a Veteran's reports of in-service injury and instead relied on the absence of evidence in a Veteran's service treatment records to provide a negative opinion). This opinion is therefore inadequate for adjudication purposes. Therefore, an addendum opinion is necessary. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). In addition, the Board notes that the Veteran's DD Form 214 indicates that he served on active duty for training from April 1981 to June 1981. The Record of Assignments indicates that the Veteran was released from active duty training in June 1981 and that he then served for several more years in B Battery 1/141 FA in New Orleans. On remand, the Veteran's complete service and personnel records related to his service in the Army National Guard should be obtained. In a June 2011 Application for Compensation and/or Pension (VA Form 21-526), the Veteran reported being in the Reserve and National Guard from April 1981 to February 1987. The matter is REMANDED for the following action: 1. The Veteran should be given the opportunity to identify any outstanding private or VA treatment records relevant to the claim on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained, to include updated VA treatment records. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and his representative and afford him an opportunity to submit any copies in their possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. Verify the Veteran's periods and locations of service, to include active duty for training, inactive duty for training, and other reserve duty in the Reserves and/or National Guard. Current records indicate that the Veteran was assigned to the B Battery 1/141 FA in New Orleans, Louisiana. Once all periods and locations of duty other than active duty have been verified, the Agency of Original Jurisdiction (AOJ) is directed to take reasonable efforts in associating respective records with the Veteran's claims file. If these records cannot be located despite a reasonable search, a notation memorializing a negative response should be provided. 3. Following the receipt of outstanding records, refer the claims file to an audiologist for preparation of an addendum opinion as to the etiology of the Veteran's claimed bilateral hearing loss. The entire claims file should be made available to and reviewed by the examiner, to include a copy of this Remand. The need for further in-person examination is left to the discretion of the examiner. Following a review of the claims file, the examiner should opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's current bilateral hearing loss had its onset in, or is otherwise related to service, to include as a result of noise exposure therein. A rationale should be provided for all opinions offered. If it is not possible to provide a specific opinion regarding the above questions, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). The medical opinion must support the conclusions reached with an analysis that is adequate to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is 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. KRISTY L. ZADORA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Kashif I. Ali, 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.