Citation Nr: 21068832 Decision Date: 11/15/21 Archive Date: 11/15/21 DOCKET NO. 17-24 938 DATE: November 15, 2021 REMANDED Entitlement to service connection for bilateral sensorineural hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1969 to June 1973. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). While the Board finds substantial compliance has been made with the previous Board remand instructions (Stegall v. West, 11 Vet. App. 268, 271 (1998))to the extent a new addendum opinion has been obtainedthe Board regrettably finds another remand necessary for the reasons addressed immediately below. Notably, the Veteran's VSO recently submitted an appellate brief, noting that the December 2019 addendum opinion failed to discuss a 1993 private medical opinion. However, upon a thorough review of the file, it does not appear that such record has been associated with the file. Since this is being remanded anyways, the Board will also request for a medical addendum opinion that addresses the aspect of the Institute of Medicine (IOM) raised by the VSO (see October 2021 appellate brief). With regards to the latter, the VSO cited to a non-precedential case (Lemmons v. McDonald, No. 15-3043, 2016 WL 6311289 (Vet. App. October 28, 2016) (non-precedential); Blackwood v. McDonald, No. 14-1148, 2015 WL 403642 (Vet. App. Jan. 29, 2015) (non-precedential)), and argued that to the extent that the December 2019 VA examiner cited to the IOM report in furnishing a negative nexus opinion, the examiner should contemplate all aspects of its pertinent findings. The VSO underlined that the IOM report not only includes "delayed onset hearing loss may be "unlikely,"" but also the conclusion that "an individual's awareness of the effects of noise on hearing may be delayed considerably after the noise exposure" (Lemmons at *6 (quoting Institute of Medicine report at 203-04)). In this case, the December 2019 VA examiner merely stated the IOM study without addressing any aspects of it. Since this is being remanded anyways, the Board will request for a medical addendum opinion that addresses both the private opinion, if submitted, and the IOM report. The matter is REMANDED for the following action: 1. Ask the Veteran to submit the 1993 private medical opinion identified by his representative. 2. Only after allowing him a period of time to respond, then obtain a medical addendum opinion from the December 2019 VA examiner, but if not available, from another VA examiner. The examiner must review the complete claims file, including this Remand. Then, the examiner must address, with full supporting rationale, the arguments raised in the October 2021 brief concerning the IOM report ("delayed onset hearing loss may be unlikely," but also "an individual's awareness of the effects of noise on hearing may be delayed considerably after the noise exposure"), and discuss points of agreement and/or disagreement with the 1993 private medical opinion, if it is submitted. MICHELLE L. KANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Lee, Catherine 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.