Citation Nr: 21072204 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 17-19 221 DATE: December 2, 2021 REMANDED Entitlement to service connection for bilateral hearing loss, to include as secondary to service-connected tinnitus, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1963 to January 1969. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional (RO). The Board notes that the September 2014 rating decision included a denial of the issues of entitlement to service connection for a right hand finger disability, a bilateral eye condition, a residual hemorrhoid condition, a stomach condition, and a left knee condition. The Veteran's November 2014 Notice of Disagreement (NOD) specified that he desired to appeal the issues of entitlement to service connection for a right hand finger disability, stomach condition, and residual hemorrhoid condition. However, the Veteran's April 2017 VA Form 9 specified that he desired to appeal only the issue of entitlement to service connection for bilateral hearing loss to the Board. Consequently, the Board finds that it does not have jurisdiction to consider the issues of entitlement to service connection for right hand finger disability, stomach condition, and residual hemorrhoid condition adjudicated a February 2017 Statement of the Case (SOC) and those issues are not before the Board. Cf. Evans v. Shinseki, 25 Vet. App. 7 (2011). The Veteran and his son-in-law testified before the undersigned Veterans Law Judge at an October 2021 Board hearing. A transcript of the hearing is of record. At the October 2021 hearing, the Veteran, through his representative, requested a 30-day extension to submit additional evidence. The 30-day extension has expired. As such, the Board will proceed with adjudication of the pending claim. Entitlement to service connection for bilateral hearing loss, to include as secondary to service-connected tinnitus, is remanded. The Veteran seeks service connection for bilateral hearing loss. See April 2014 VA Form 526. The Veteran contends that his bilateral hearing loss is the result of exposure to loud noises, including gas turbine engines, mechanical hydraulics, and gun ship fire during service. See November 2014 Correspondence. The Veteran also testified that he worked in a hanger with jet noise, noticed a decrease in hearing three years into service, and did not wear hearing protection. See October 2021 Hearing Transcript. The Board finds that remand is necessary for further development. When VA undertakes the effort to provide an examination when developing a claim, the exam must be an adequate one. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). For a medical opinion to be adequate, it must be: (1) based upon sufficient facts or data; (2) be the product of reliable principles and methods; and (3) be the result of principles and methods reliably applied to the facts. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008). The Veteran was afforded a VA examination in September 2014. Upon examination, the Veteran demonstrated bilateral hearing loss for VA purposes. See September 2014 VA examination. The VA examiner opined that the Veteran's bilateral hearing loss was not as least as likely as not caused by or a result of an event in military service. Id. As rationale, the VA examiner noted the Veteran's hearing thresholds at the time of entrance and separation were within normal limits. Id. The VA examiner also noted, that according to the American College of Occupational Medicine Noise and Hearing Conservation Committee, "a noise induced hearing loss will not progress once it is stopped." Id. The VA examiner concluded that the Veteran's current bilateral hearing loss is less likely than not related to military noise exposure. Id. However, the Veteran contends that a February 2005 Department of Defense Statistical Analysis of Hearing Loss Among Navy Personnel determined that permanent hearing loss is one of the most common disabilities among sailors. See November 2014 Correspondence. As noted, the Veteran also provided testimony that he was exposed to loud noises from gas turbine engines, mechanical hydraulics, and gun ship fire. See October 2021 Hearing Transcript. In discussing the etiology of the Veteran's tinnitus, the VA examiner conceded the Veteran was exposed to hazardous noise. See September 2014 VA examination. However, the VA examiner did not address the Veteran's lay statements regarding exposure to hazardous noise during service. As such, the Board finds the September 2014 VA examination inadequate for decision making purposes. See Nieves-Rodrigues, 22 Vet. App. at 302. Additionally, the Veteran provided a September 2020 private audiological evaluation and an October 2021 private medical opinion. The private physician noted review of the September 2020 private audiological evaluation. See October 2021 private medical opinion. The private physician opined that the Veteran's current bilateral hearing loss is more likely than not a service-connected disability. Id. As rationale, the private physician noted that, in her personal experience and medical literature, it is known that permanent hearing loss is one of the most common disabilities among sailors. Id. However, the private physician did not further explain why, in the Veteran's particular case, his bilateral hearing loss is more likely related to his military service. As such, the Board finds remand for an addendum medical opinion is necessary. The Board notes that it is required to consider all theories of entitlement to service connection. See Szemraj v. Principi, 357 F.3d 1370, 1371 (Fed. Cir. 2004); Roberson v. Principi, 251 F.3d 1378, 1384 (Fed. Cir. 2001) (explaining that the Board must consider all potential theories of entitlement raised by the evidence.). The Veteran is currently service connected for tinnitus. The Veteran contends that tinnitus causes hearing loss. See April 2017 VA Form 9. As such, remand is necessary in order to obtain an addendum medical opinion addressing secondary service connection. The matter is REMANDED for the following action: 1. Forward the record and a copy of this Remand to the examiner who provided the September 2014 examination and medical opinion, or, if that examiner is unavailable, to another qualified clinician, for completion of an addendum opinion to determine the nature and etiology of the Veteran's bilateral hearing loss. If the examiner determines that another examination of the Veteran is necessary, such an examination should be scheduled. The examiner should address the following; (a.) Whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran's bilateral hearing loss is etiologically related to an in-service injury, event, or disease, to include acoustic trauma. A complete rationale should be given for all opinions and conclusions expressed. The examiner must address and consider the Veteran's lay statements regarding noise exposure in service, including that his hearing loss started three years into service and that he did not wear hearing protection, and the October 2021 private medical opinion. If the examiner cannot provide an opinion without resorting to speculation, he/she should explain why an opinion cannot be provided. (b.) Whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran's bilateral hearing loss is proximately due to, or the result of, the Veteran's service-connected tinnitus. (c.) Whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran's bilateral hearing loss is aggravated (worsened) by the Veteran's service-connected tinnitus. A complete rationale should be given for all opinions and conclusions expressed. If the examiner cannot provide an opinion without resorting to speculation, he/she should explain why an opinion cannot be provided. Tiffany Dawson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moore, Carlin 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.