Citation Nr: 21068583 Decision Date: 11/10/21 Archive Date: 11/10/21 DOCKET NO. 17-62 770 DATE: November 10, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to an effective date earlier than April 29, 2015 for the award of basic eligibility for education benefits under Chapter 35, Title 38, United States Code (Dependents' Educational Assistance (DEA)) is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1992 to October 1993. These matters come before the Board of Veterans' Appeals (Board) from August 2015 and March 2016 rating decisions. These matters were previously remanded by the Board in September 2019, February 2021, and most recently in September 2021. Regrettably, remand is again warranted. VA opinions addressing the etiology of the Veteran's bilateral hearing loss and tinnitus were obtained most recently in September 2021. Unfortunately, the most recent, September 2021 opinion is not in compliance with the prior Remand instructions. Specifically, an examiner was asked to consider whether hearing loss and tinnitus are related either to service, or to medication taken for a service-connected disability, as the Veteran has asserted. The examiner opined that there was no service-connected condition that aggravated hearing loss, without any additional medical explanation or rationale for that opinion. Thus, the opinion is not adequate to decide the claim for service connection, and an addendum opinion is again necessary. The Board adds that a prior May 2021 examiner had indicated that the question of whether the Veteran's hearing loss and/or tinnitus was secondary to medications taken for his service-connected schizophrenia is outside the scope of practice for an audiologist; yet the most recent opinion obtained was from an audiologist. Thus, if necessary, an addendum opinion should be obtained from a clinician qualified to opine on such a question. The effective date of the Veteran's basic eligibility for education benefits under Chapter 35 (DEA) has been established from April 29, 2015, the date he satisfied the criteria of being permanently and totally disabled. Resolution of the claims remanded herein may affect whether the Veteran is entitled to an earlier effective date for his Chapter 35 benefits. See, e.g., Parker v. Brown, 7 Vet. App. 116 (1994); Harris v. Derwinski, 2 Vet. App. 180, 183 (1991) (issues are "inextricably intertwined" when a decision on one issue would have a "significant impact" on an appellant's claim for another issue). Thus, this issue must also be remanded. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from a qualified VA clinician regarding the etiology of the Veteran's hearing loss and tinnitus. After a complete review of the record, the examiner should answer the following questions: a) Is it at least as likely as not (approximately 50 percent probability) that the Veteran's hearing loss and/or tinnitus had onset in service, or is otherwise related to in-service noise exposure. Please consider the medical treatise evidence referenced by prior examiners and submitted by the Veteran. b) Is it at least as likely as not (approximately 50 percent probability) that the Veteran's hearing loss and/or tinnitus have been caused or aggravated by medication taken for the Veteran's schizophreniform disorder? If an audiologist does not have the expertise to address this specific question (as was suggested by the May 2021 examiner), ensure that the opinion is obtained from a clinician with specific expertise on pharmaceutical side effects. The examiner is advised that causation and aggravation are two separate inquiries, and both must be answered. A complete medical rationale must accompany any opinion offered. 2. Then, readjudicate the issues on appeal. V. Chiappetta Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Polly Johnson, 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.