Citation Nr: 21068647 Decision Date: 11/12/21 Archive Date: 11/12/21 DOCKET NO. 20-06 972 DATE: November 12, 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 served on active duty from May 1982 to November 1984. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2019 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). Here, the June 2019 VA audiological examination confirmed the Veteran has a ratable bilateral hearing loss disability as defined by 38 C.F.R. § 3.385; but the medical opinion regarding the etiology of this disability is inadequate. The examiner points to normal hearing acuity at separation as the rationale for why the Veteran's hearing loss is unrelated to his service but does not discuss why that is significant or identify an alternative, i.e., non-service-related etiology ("intercurrent cause") considered more likely the source of this present-day impairment. Further, the examiner did not address the Veteran's lay statements, conceded in-service noise exposure, or the possibility of delayed-onset hearing loss. It is well-established in caselaw that a finding of normal hearing acuity at separation does not preclude a finding of entitlement to service connection for hearing loss. Hensley v. Brown, 5 Vet. App. 155, 159 (1993). This legal authority provides that normal audiometric results in separation examination alone are NOT an adequate basis for a negative audiological opinion. The Board reiterates that the absence of in-service evidence of a hearing loss disability is not always fatal to a service connection claim, as the laws and regulations do not require in-service complaints of, or treatment for, hearing loss in order to establish service connection. Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Evidence of a current hearing disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service. Hensley, 5 Vet. App. 155, 159. Again, the Board reiterates the fact the Veteran's hearing loss was normal at discharge does not preclude service connection being granted for post-service hearing loss if it is, in fact, due to his conceded in-service noise exposure. As such, a remand is required for an addendum medical opinion. If, essentially, the VA examiner is disputing the notion of "delayed-onset" hearing loss, hence, the reason for finding it significant the Veteran did not have indication of hearing loss when separating from service, there must be more explanation for this conclusion. The matters are REMANDED for the following action: Obtain an addendum opinion from an examiner to address the etiology of the Veteran's bilateral hearing loss and tinnitus. No additional examination of the Veteran is necessary, unless the examiner determines otherwise. The claims file, including a copy of this remand, must be provided to the examiner in conjunction with the requested opinion. Then, the examiner must opine whether: a) is at least as likely as not (50 percent probability or greater) that the Veteran's bilateral hearing loss was caused by or otherwise etiologically related to his service, to include conceded in-service noise exposure? b) is at least as likely as not (50 percent probability or greater) that the Veteran's tinnitus was caused by or otherwise etiologically related to his service, to include conceded in-service noise exposure? Further, the examiner must discuss the possibility of delayed-onset hearing loss and may not rely solely on normal audiometric findings at separation to support the opinion. The examiner should also consider the Veteran's reports of continuous hearing loss since service separation and that he did not report his hearing loss in service as it was frowned upon to go to sick call, and he was unaware he could go to VA after service until other veterans encouraged him to file a claim. The Board reminds the examiner that the Veteran's noise exposure during service has been conceded, and legal authority providing that normal audiometric results in separation examination alone are NOT adequate basis for negative audiological opinion. Specifically, the examiner is cautioned against focusing an opinion solely on the evidence showing the Veteran experienced normal hearing during separation audiometer testing; and she or he must explain whether hearing loss can be related to service despite delayed manifestation. If, like the prior 2019 VA examiner concluded, the hearing loss disability is determined to be unrelated to the Veteran's service, please identify the etiology for the hearing loss considered more likely, if medically possible to do so. A complete rationale for all opinions must be provided. If unable to provide a medical opinion, provide a statement as to whether there is any 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. MICHELLE L. KANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G.Hoy, 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.