Citation Nr: 21069257 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 18-43 738 DATE: November 18, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1971 to February 1973. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2016 rating decision issued by a Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ). The Veteran testified before the undersigned in November 2021. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran attended a VA examination in August 2016. The examiner found the Veteran's hearing loss was not at least as likely as not caused by or a result on an event in military service. The examiner stated that the Veteran had a low to moderate probability of hazardous noise exposure and records indicated a negative threshold shift during service between entrance and exit, indicating hearing loss existed prior to service and resolved during service. The examiner also stated current hearing loss was greater in the left ear than the right ear, which does not correlate to left-handed rifle shooting. However, the Board notes that the February 1973 separation examination has a line drawn through the audiometer boxes for 1000 hertz through 4000 hertz. At the hearing the representative stated that the validity of the separation examination was questionable for this reason, and the Veteran testified that he did not recall an examination at separation for his hearing. The examiner did not address the line through the audiometer boxes in the separation examination or explain what the line might mean. In addition, as noted above, the examiner based part of his rationale on the fact that the Veteran's current hearing loss was greater in the left ear than the right ear, which does not correlate to the Veteran's left-handed rifle shooting. However, as noted by the representative at the Board hearing, the Veteran's hearing was worse in his left ear at the February 1971 entrance examination. The VA examiner did not address this or discuss whether this could explain why the Veteran's left ear hearing loss is currently worse. Moreover, the Veteran testified that while he is left handed, he shoots with his right hand. Accordingly, the Board finds the VA examiner's opinion inadequate. Also, the examiner stated that the Veteran's right and left ear hearing loss pre existed service. While the February 1971 entrance examination showed left ear hearing loss that meets the definition for hearing loss under 38 C.F.R. § 3.385, the right ear did not. For pre-existing hearing loss to be "noted" upon entry, the entrance auditory examination must show hearing loss that rises to the level of a disability under VA law. See McKinney v. McDonald, 28 Vet. App. 15, 29 (2016). Additionally, if the Veteran's left ear hearing loss pre-existed service, an opinion is required on whether it was clearly and unmistakably not aggravated beyond its normal progression during service. Last, at the November 2021 Board hearing, the Veteran provided additional testimony regarding his in-service noise exposure, to include working as a medic at a range where both rifles and grenades were fired. The VA examiner should consider this testimony on remand. Therefore, the Board finds that a new opinion on whether the Veteran's bilateral hearing loss is related to his service is required. The matters are REMANDED for the following actions: 1. Obtain an addendum opinion from a VA examiner regarding the nature and etiology of the Veteran's bilateral hearing loss. The claims file, including a copy of this Remand, must be made available to the examiner for review. The decision for an in-person examination of the Veteran is left to the discretion of the examiner. Following a review of the record, the examiner is asked to provide a response to the following (the opinion must be supported by rationale): (a.) Is the Veteran's right or left ear hearing loss at least as likely as not (a 50 percent or greater probability) related to service? In answering this question, the examiner should consider and address the Veteran's testimony at the November 2021 Board hearing regarding his noise exposure in service, to specifically include his statements that he worked as a medic at the rifle and grenade range for approximately a year. The examiner should also consider and address the Veteran's testimony that after service he could not hear the same things as well as before service. Additionally, the examiner must address the line through the frequencies of 1000 to 4000 hertz on the February 1973 separation examination and explain what this line means. The examiner must also consider the Veteran's February 1971 entrance examination, which showed the Veteran's left ear hearing was worse than his right ear on entry. The examiner must address if this is a possible explanation as to why the Veteran's left ear hearing loss is currently worse than his right ear hearing loss. If the examiner finds that the Veteran's left ear hearing loss pre-existed service, he or she should answer the following questions. The Board notes that for hearing loss to pre-exist service, it must meet the definition for hearing loss under 38 C.F.R. § 3.385. See McKinney v. McDonald, 28 Vet. App. 15, 29 (2016) (pre existing hearing loss is "noted" upon entry into service only if the entrance auditory examination shows hearing loss that rises to the level of a disability under VA law). (a.) Is it clear and unmistakable (undebatable) that the Veteran's left ear hearing loss pre-existed service? If so, specify the evidence upon which this opinion is based. (b.) If the Veteran's left ear hearing loss clearly and unmistakably pre-existed service, is it clear and unmistakable (undebatable) that the pre-existing hearing loss was not aggravated beyond normal progression by service? Tiffany Dawson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Patrick, 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.