Citation Nr: 21067163 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 17-46 468 DATE: November 3, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for bilateral vision loss (claimed as a result of jet fuel in eyes) is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1971 to March 1976. 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends that he has bilateral hearing loss as a result of exposure to engine and jet noise while serving on the flight line during service. A review of his service treatment records reveals no complaints, treatment, or diagnosis of hearing loss of either ear. A March 1971 Report of Medical Examination upon entrance into service revealed his pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 0 0 0 X 0 LEFT 0 0 0 X 0 A March 1976 Report of Medical Examination upon separation from service revealed his pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 10 0 5 10 5 LEFT 5 5 5 20 10 His DD-214 form reflects that he served as an aerospace ground equipment repairman during service. Notably, service connection has already been granted for tinnitus as a result of in-service noise exposure. In an October 2016 Disability Benefits Questionnaire (DBQ), the Veteran was noted as meeting the criteria for bilateral hearing loss bilaterally, as auditory thresholds were noted at 40 decibels or greater at 3000 and 4000 Hertz. The examiner determined that bilateral hearing loss was not at least as likely as not caused by or a result of an event in military service. The examiner noted that the Veteran reported normal hearing upon entering military service. He reported exposure to noise while in service. Noise exposure is a known cause of hearing loss. Testing conducted at the time of leaving service noted no loss of hearing. Research has shown that hearing loss due to noise exposure does not continue once removed from the noise exposure. Therefore, the examiner opined that the hearing loss is less likely as not caused by or a result of an event in military service. In a January 2017 addendum opinion, the examiner noted that etiology regarding permanent positive thresholds shift should be marked "yes" for both right and left ears. The examiner noted that the Veteran reported normal hearing upon entering military service. He reports exposure to noise while in service. Noise exposure is a known cause of hearing loss. Testing conducted at the time of leaving service noted no loss of hearing per VA guidelines, although a permanent threshold shift was noted. Research has shown that a hearing loss due to noise exposure does not continue once removed from the noise exposure. Therefore, the examiner opined that hearing loss is less likely as not caused by or a result of an event in military service. The Board finds that this issue must be remanded in order to obtain a new medical opinion. Specifically, the Board notes that the January 2017 VA addendum opinion, which clarified the October 2016 VA opinion, appears to be based in part on the finding that the testing conducted at the time of the Veteran's leaving service noted no loss of hearing per VA guidelines. However, the United States Court of Appeals for Veterans Claims (Court) has held that VA regulations do not preclude service connection for a hearing loss which first met VA's definition of disability after service. Hensley v. Brown, 5 Vet. App. 155, 159 (1993). Therefore, in light of the fact that the January 2017 VA addendum acknowledges a permanent shift in hearing loss during service, the Board finds that a new medical opinion is required in order to determine whether this permanent shift is related to his service. 2. Entitlement to service connection for bilateral vision loss (claimed as a result of jet fuel in eyes) is remanded. The Veteran contends that his bilateral vision loss is related to exposure to jet fuel in his eyes during service. He testified at the hearing that he was hospitalized for 2 or 3 days following the incident, and his vision never completely recovered. He further testified that he had special prescription sunglass made as a result of this incident. A review of his service treatment records reveals that both eyes were sprayed with gasoline in September 1972. It was noted that his eyes were washed and stained. Stain revealed a burn to both eyes. Conjunctival congestion was also noted. The service treatment records document eyewear prescriptions from April 1971, February 1972, and January 1973. The March 1976 Report of Medical Examination upon separation service noted normal clinical evaluation of the eyes. The Veteran was noted as having impaired vision on both entrance and separation examinations. Notably, his visual acuity appears to have changed from his 1971 entrance examination to his 1976 separation examination. In an October 2016 DBQ, the Veteran was diagnosed with cataracts and keratitis sicca. In an October 2016 VA opinion, the examiner determined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner determined that the claimant has mild dry eye and normal age-related cataracts. There is no evidence to support an association with jet fuel exposure. While the 2016 VA examiner addressed the Veteran's dry eye and cataracts, he did not address the fact that the Veteran's visual acuity changed from his 1971 entrance examination to his 1976 separation examination. The Board observes that congenital or developmental defects and refractive error of the eye are not diseases or injuries within the meaning of the applicable legislation. 38 C.F.R. §§ 3.303 (c), 4.9. However, service connection may be granted for additional disability due to disease or injury superimposed upon a defect during service. VAOPGCPREC 82-90, 55 Fed. Reg. 45711 (1990). Therefore, as the Veteran is asserting that his vision loss is due to the specific in-service incident of fuel exposure to his eyes, the Board finds that an additional medical opinion must be obtained on this matter. The matters are REMANDED for the following action: 1. Associate with the claims file all outstanding medical records from the VA San Diego Healthcare System from August 2016 to the present. 2. Obtain a VA medical opinion regarding the etiology of the Veteran's bilateral hearing loss. After a review of the claims file, the examiner should opine as to whether it is at least as likely as not that the Veteran's bilateral hearing loss began during, or was caused or aggravated by, his active duty service. The examiner should specifically discuss the Veteran's shift in hearing acuity from his March 1971 entrance examination to his March 1976 separation examination. The examiner is advised that VA regulations do not preclude service connection for a hearing loss which first met VA's definition of disability after service. The examiner should provide a complete rationale for any opinions provided. If additional examination is needed to render the above-requested opinion, such should be provided. 3. Obtain a VA medical opinion regarding the etiology of the Veteran's bilateral vision loss. After a review of the claims file, the examiner should opine as to whether any refractive error of the eye was subject to a superimposed disease or injury during service which created additional disability. The examiner should specifically discuss the incident involving fuel spraying into the Veteran's eyes. The examiner should provide a complete rationale for any opinions provided. If additional examination is needed to render the above-requested opinion, such should be provided. MICHELLE L. KANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Durham, 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.