Citation Nr: 21072464 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 20-25 597A DATE: December 3, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from October 1968 to October 1971. The Veteran's claim was received in September 2017. The claim was previously remanded by the Board in March 2021 for an etiology opinion that specifically addressed the Veteran's contentions that she was exposed to acoustic trauma during service. She reports that, while her official duties in the mess hall did not expose her to acoustic trauma, she was exposed to weapons fire as a result of other requirements of active duty. The examiner who prepared the report of the August 2021 VA examination noted the Veteran's reported history. The examiner subsequently wrote that acoustic trauma is not conceded with no further explanation. This is not responsive to the Board's remand directives. The Veterans Law Judge who signed the prior remand directed that an opinion be obtained which addresses exposure to "any acoustic trauma from weapons fire" the Veteran was exposed to. The Board finds a restatement of the prior etiology question is required. There is no actual quantification of the extent of noise the Veteran was exposed to and whether this results in "acoustic trauma" during active duty. The Veteran has reported that she was exposed to loud noises during training. She is competent to do so and this is consistent with her service in the Marines. She is competent to report the source of noise exposure (shooting weapons with it not customary for the requirement for proper hearing protection being enforced) but she is not competent to be able to quantify the actual noise exposed to. She has not done so. An opinion is required to determine if the Veteran has current hearing loss as a result of shooting weapons with it not customary for the requirement for proper hearing protection being enforced. As the prior remand specifically requested an opinion as to whether the Veteran's current bilateral hearing loss has resulted from service, to include inservice weapons training, the Board finds this opinion does not comply with the Board's prior remand directives. Accordingly, a remand is needed for an addendum opinion that addresses these contentions. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (Board remand confers a right on a claimant to compliance with the remand order); Dyment v. West, 13 Vet. App. 141, 147 (1999) (clarifying that substantial compliance with Board remand is required). The Veteran has alleged that she has left ear hearing loss as a result of a dental procedure which was performed during active duty. This allegation should also be addressed. The matters are REMANDED for the following action: 1. In remanding this case, the Board makes no credibility determination, expressed or implied, at this juncture. 2. Return the file to the examiner who conducted the August 2021 VA examination and request that they prepare an addendum report which addresses the questions below. If this examiner is not available, arrange to obtain the requested opinion from a suitably qualified health care professional. The electronic claims file must be made available to the examiner. If the examiner determines that another VA examination is necessary, one should be scheduled. Based on a review of the record, and a new examination if necessary, the examiner must address the following: a.) Is it at least as likely as not that the Veteran has hearing loss in either ear which is related to or had its onset during the Veteran's active duty service, to include exposure to weapons training during active duty? b.) Is there objective evidence of acoustic trauma during active duty? c.) Is it at least as likely as not that the Veteran has left ear hearing loss as a result of any dental procedure conducted during active duty? For purposes of this opinion, the examiner should assume during active duty the Veteran fired military caliber weapons and the requirement to use proper hearing protection was not customarily enforced. The opinion and rationale should reflect such consideration. The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. If the medical professional cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the medical professional shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Wade 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.