Citation Nr: 21069512 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 16-22 455 DATE: November 18, 2021 REMANDED Entitlement to service connection for left ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from August 1965 to February 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2015 rating decision of an Agency of Original Jurisdiction (AOJ) of the United States Department of Veterans Affairs (VA). The issue has been before the Board previously, most recently in February 2021 at which time it was remanded for additional development. The Board finds that there was not substantial compliance with its February 2021 remand orders and another remand of these issues is necessary. See Stegall v. West, 11 Vet. App. 268 (1998). In its February 2021 remand directives, the Board requested a new etiology opinion because the VA examiner did not consider the Veteran's converted thresholds or consider the private opinions provided by Dr. DS and Dr. RC, as had been previously requested in its April 2020 remand directives. The Board had converted the Veteran's in-service audiometric results from ASA to ISO-ANSI units and indicated that the examiner should consider the converted thresholds. The VA examiner was specifically asked that if the Veteran's hearing loss was more likely than not related to post service noise exposure, he should explain why that is so. A VA opinion was provided in March 2021. The VA examiner determined that it was less likely than not that the Veteran's left ear hearing loss incurred in or caused by service. He stated that he was not able to find the private opinions of Dr. RC and Dr. DS and that no etiology for hearing loss was provided. Nevertheless, the VA examiner stated that neither of these practitioners would have had the complete military treatment records which would make their opinions for an etiology irrelevant. With regard to the audiograms, the VA examiner stated that in comparing the 1967 ANSI audiogram to the 1965 ANSI audiogram, showed no shift in hearing greater than 15 dB in the left ear. The VA examiner stated "although one can be exposed to noise, the development of hearing loss is based on the intensity of the noise and the duration of the exposure. The audiogram is the most sensitive test we have to evaluate for noise induced hearing loss. The fact the left ear hearing actually improved to a significant degree indicates there was no acoustic trauma. There are papers suggesting a delayed onset hearing loss in animal models but that has not been shown in humans. As such, it is less likely than not that the left ear hearing loss is related to military service." In an addendum, the VA examiner stated he reviewed the private records of Dr. RC and Dr. DS after the AOJ identified them with specificity in the file. The VA examiner stated that Dr. RC is a family medicine doctor who did not review the Veteran's records and indicated that the Veteran's hearing loss is possibly the result of his work in the Army and should be treated as such. The VA examiner found this opinion to be "irrelevant." The VA examiner also found the opinion of Dr. DS to be irrelevant because Dr. DS specifically noted he did not have audiometric testing before or after service. VA has previously conceded the Veteran's exposure to acoustic trauma in service during the course of the Veteran's military occupational specialty (MOS) duties as an automotive mechanic. The Veteran reported no post service noise exposure. However, the VA opinion provided does not address these facts and does not provide an etiology for the Veterans' hearing loss as was requested by the Board. The opinions of the private providers are indeed relevant, as they considered these facts. Accordingly, a remand is warranted to obtain a new opinion that complies with the Board's remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Obtain a VA medical opinion from a VA examiner other than he who provided the March 2021 opinion and addendum opinion. The claims file must be reviewed by the examiner. If the examiner determines another VA examination is necessary, one should be scheduled. The examiner must opine whether it is at least as likely as not (50 percent probability or greater) that the Veteran's left ear hearing loss is related to his active duty service, to include as due to his MOS duties as a general vehicle repairman/automotive mechanic. If the VA examiner determines the Veteran's hearing loss is not related to service, an opinion as to the etiology of his hearing loss should be provided. The examiner should consider the February 1965 audiological results in the Veteran's service treatment records under ISO units and the December 1967 audiological results under both ASA and ISO units. The examiner must also consider the October 2014 and May 2015 private opinions by Dr. RC and Dr DS, as they consider the competent and credible lay reports of noise exposure in service. A full and complete rationale for all opinions expressed is required. 2. Then, readjudicate the remanded issue. If the benefit sought remains denied, the Veteran and his representative should be provided with a supplemental statement of the case. The case should then be returned to the Board for appellate review if otherwise in order. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Margaret M. Lunger, 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.