Citation Nr: 21073129 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 20-07 926 DATE: December 7, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1966 to August 1968. This matter is before the Board of Veterans' Appeals (Board) on appeal from an August 2018 rating decision by the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). In October 2020 the Board remanded the Veteran's claims for further development. The Board notes that on remand, entitlement to service connection for an acquired psychiatric disorder (including PTSD and major depression) and service connection for a right shoulder condition were granted. Therefore, those issues are no longer on appeal before the Board and will not be discussed further in this decision. 1. Entitlement to service connection for bilateral hearing loss is remanded. Despite the additional and regrettable delay, a remand is required because the May 2021 VA examination contained a medical opinion with an inadequate rationale. The VA medical opinion was inadequate because it relied on the lack of hearing loss or threshold shifts in the service enlistment and separation examinations. The Board notes hazardous noise exposure is conceded, and the lack of hearing loss documented in service cannot, standing alone, serve as the basis for a negative etiology opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (holding that most of the probative value of an opinion comes from its rationale or underlying reasoning). Accordingly, a remand is required in order to obtain a new VA medical opinion. The matters are REMANDED for the following action: 1. The AOJ should arrange for a VA medical opinion, with examination or telehealth interview of the Veteran ONLY if deemed necessary by a medical professional, to determine the nature and likely cause of the Veteran's bilateral hearing loss. The examiner should review the claim file (including this remand) and note such review was conducted. Based on review of the record, the examiner should provide an opinion with detailed rationale that responds to the following: 2. The Board notes the Veteran has bilateral hearing loss for VA compensation purposes and the examiner should assume the same for the opinion rendered. Further, exposure to hazardous noise in service is also established. 3. Is it at least as likely as not (50% or greater probability) that such disability was either incurred in or otherwise related to the Veteran's military service? Please explain why. 4. Is it at least as likely as not (50% or greater probability) that the disability was either 1) CAUSED or 2) AGGRAVATED by the Veteran's service-connected tinnitus? Please explain why. The opinion must address whether the disability increased in severity beyond its natural progression (i.e., was aggravated). If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation. The examiner is reminded that the Veteran is competent to provide information about observable symptoms and events. The examiner should assume, for the purposes of the opinions, that the Veteran's reports are both accurate and credible. A detailed explanation (rationale) is required for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested.) David Gratz Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Williams, Associate 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.