Citation Nr: 21068126 Decision Date: 11/09/21 Archive Date: 11/09/21 DOCKET NO. 17-39 403 DATE: November 9, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to a rating in excess of 10 percent prior to September 14, 2015, for coronary artery disease (CAD) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from April 1969 to December 1971, including service in Vietnam from January 1970 to November 1970. These matters come before the Board of Veterans' Appeals (Board) on appeal from a September 2013 rating decision by the Roanoke, Virginia Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. The Veteran contends that current bilateral hearing loss and tinnitus are the result of exposure to hazardous noise during service, to include 11 months of combat service in Vietnam and aircraft noise while working daily on a very active flight line. See VA Forms 21-4138 dated February 2012 and August 2014; March 2013, VA examination. The Veteran's DD-214 confirms service in Vietnam for 10 months and his training as an avionic communications repairman. Thus, the Board concedes in-service acoustic trauma. Service treatment records (STRs) demonstrate that the Veteran's hearing acuity shifted during service, though all thresholds were still within normal limits. Upon entry into service, the Veteran's audiogram for the left and right ears ranged from -10 to 5 dB between 500 to 4000 Hz. See April 1969, STR. At the time of separation, pure tone thresholds were 20 dB at 500, 1000, 3000, and 4000 Hz for both ears. See December 1971, STR. The Board finds the September 2013 VA audiology medical opinion to be inadequate. Based on a review of the record which included a March 2013 audiology examination, the VA examiner, opined the Veteran's current hearing loss and tinnitus was less likely than not caused by military service because he had a normal audiogram upon separation and about 40 percent of people in the Veteran's age range have some hearing issues. The examiner failed to address the Veteran's lay statements of exposure hazardous noise during service or his limited exposure to noise post-service. Accordingly, remand is necessary to determine the current nature and etiology of bilateral hearing loss and tinnitus. See Miller v. Wilkie, 32 Vet. App. 249 (2020) (finding the proper remedy is to order a new examination when an examiner fails to address the veteran's lay statements and reports of symptoms). 3. Entitlement to a rating in excess of 10 percent prior to September 14, 2015, for coronary artery disease (CAD) is remanded. The Veteran filed a timely August 2014 notice of disagreement (NOD) in response to the September 2013 rating decision granting service connection for CAD and assigning a 10 percent rating effective February 22, 2012, the date his claim was received. In his NOD, the Veteran asserted entitlement to a 30 percent schedular rating for CAD. See August 2014, NOD. The RO issued a May 2017 rating decision granting a 60 percent rating for CAD effective September 14, 2015, and indicated that this was considered a full grant of the benefits sought on appeal as the Veteran was only seeking a 30 percent schedular rating. However, the Veteran filed his CAD claim on February 22, 2012, and the RO did not grant a rating of 30 percent prior to September 14, 2015. Therefore, that portion of the Veteran's claim remains on appeal. In light of the above, the RO must issue a statement of the case (SOC) regarding entitlement to a rating in excess of 10 percent prior September 14, 2015, on remand. See Manlincon v. West, 12 Vet. App. 238, 240-41 (1999). The matters are REMANDED for the following action: 1. Obtain any outstanding VA or relevant private treatment records that are not of record and associate them with the claims file. 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 problems hearing and ringing in his ears. The Veteran should be provided an appropriate amount of time to submit this lay evidence. 3. Issue an SOC addressing the Veteran's increased rating claim for CAD prior to September 14, 2015. 4. Schedule the Veteran for a VA examination (or telehealth interview, review of record, etc., if an in-person examination is not feasible) to determine the nature, onset and etiology of bilateral hearing loss and tinnitus. The examiner should review the file and address the following: Whether it is at least as likely as not that bilateral hearing loss had its onset in or is a result of active service, to include in-service exposure to hazardous noise while serving in Vietnam and/or working on the flight line as well as his report of serving in combat in Vietnam. As stated earlier, the Board has conceded in-service acoustic trauma. Whether it is at least as likely as not that current tinnitus had its onset in or is a result of active service, include in-service exposure to hazardous noise while serving in Vietnam and/or working on the flight line as well as his report of serving in combat in Vietnam. A comprehensive rationale for all opinions must be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be provided without resorting to speculation, the examiner must explain why this is so and 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), the record (additional facts are required), or the examiner (does not have the knowledge or training). STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Straughn, 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.