Citation Nr: 21070947 Decision Date: 11/27/21 Archive Date: 11/27/21 DOCKET NO. 19-03 741 DATE: November 27, 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 September 1966 to September 1970. The Department of Veterans Affairs is grateful for his service. 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. The Veteran contends, in effect, that he has bilateral hearing loss and tinnitus are due to excess noise exposure with acoustic trauma in service. The Veteran was afforded two examination by different examiners in October 2017 addressing claimed hearing loss and tinnitus. One examiner provided negative opinions about hearing loss and tinnitus based on normal hearing at separation, no threshold shift in service, and a military occupational specialty (MOS) of signals intelligence analyst with an associated low probability of hazardous noise exposure. However, Veteran alleged frequent exposure to "loud static" and being around artillery. The examiner discounted the Veteran's artillery exposure by noting that the Veteran was reportedly 200 to 300 yards away from artillery. The examiner also noted absence of records addressing tinnitus in service and concluded that his tinnitus is more likely related to his hearing loss. The second examiner also provided negative opinions with rationales. However, this examiner did find a threshold shift in each ear over the course of service. Additionally, at this examination the Veteran reported civilian noise exposure including ten years of construction work without use of hearing protection and target shooting with hearing protection. The Board notes that the two October 2017 examiners came to opposite conclusions on the question of a threshold shift in service. This is relevant as it may serve as evidence of acoustic trauma in service. At his hearing before the undersigned in November 2021, the Veteran testified to having served at fire bases in Vietnam and having to listen to signals eight hours per day every day with artillery in very close proximity. Such exposure would potentially result in acoustic trauma, yet is at odds with the history as noted by the second October 2017 VA examiner. The Board concludes, based on the more detailed history provided by the Veteran at his November 2021 hearing and the discrepant findings about threshold shifts in service, that the opinions of the October 2017 examinations are of questionable probity based on their reliance of potentially inaccurate factual bases. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993). Accordingly, the case must be returned for an addendum from either of the examiners, to resolve the discrepancy presented about a threshold shift in service and to consider the Veteran's testimony in November 2021 addressing exposures in service and following service. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The claim for service connection for tinnitus must also be again addressed by an examiner, based on the same questions of accurate factual bases, since the presence of acoustic trauma and whether hearing loss threshold shifts occurred in service are also relevant to the questions of tinnitus being related to service or to service-connected disability (if hearing loss is service connected). The matters are REMANDED for the following actions: 1. Obtain any unobtained VA and pertinent private records, with the Veteran's authorization and assistance, as appropriate. The Veteran and his representative should be informed of any records that cannot be obtained. 2. Thereafter, return the case file to either of the examiners who examined the Veteran for hearing loss and tinnitus in October 2017. If neither of these examiners are available, then a different qualified examiner should provide the addendum. The examiner should be advised that a discrepant finding about a threshold shift in service between the October 2017 examiners and additional relevant testimony by the Veteran in November 2021 necessitates an addendum. The examiner should carefully review the claims file including in particular records from service, both October 2017 examinations, and statements and testimony from the Veteran and his spouse concerning his exposures and symptoms in service and following service. The examiner should endeavor to address questions posed based on the record, but additional tests or studies should be conducted if deemed necessary. The examiner should attempt to resolve the question of the presence of an acoustic threshold shift in service, about which the two October 2017 examiners came to opposite conclusions. The examiner must also document and consider the Veteran's own statements regarding his disability since a layperson is competent to address symptoms as experienced and his recollections of past history and treatment. If the examiner has reason based on other evidence of record or medical knowledge to question the Veteran's self-reported history, the examiner should so state and provide a complete explanation why this is so. a. The examiner should address whether it is at least as likely as not (50 percent or greater probability) that the Veteran's hearing loss in each ear developed in service or is otherwise causally related to service. b. The examiner should address whether it is at least as likely as not (50 percent or greater probability) that the Veteran's hearing loss in each ear was present to a disabling degree within the first post-service year. c. The examiner should address whether it is at least as likely as not (50 percent or greater probability) that the Veteran's tinnitus developed in service or was otherwise causally related to service. d. The examiner should also address whether it is at least as likely as not (50 percent or greater probability) that the Veteran's tinnitus was present to a disabling degree within the first post-service year. e. The examiner should also address whether it is at least as likely as not (50 percent or greater probability) that the Veteran's tinnitus was caused or aggravated (worsened) by his hearing loss. Aggravation under 38 C.F.R. § 3.310 (b) does not require that there be "permanent" worsening of the nonservice connected disability. Separate opinions and rationales must be provided for causation and aggravation. In support of these opinions, the examiner should provide a complete rationale (explanation) supported by evidence and medical knowledge. 3. Thereafter, readjudicate the appealed claims. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Schechter 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.