Citation Nr: 21073426 Decision Date: 12/08/21 Archive Date: 12/08/21 DOCKET NO. 16-59 593 DATE: December 8, 2021 REMANDED Service connection for bilateral hearing loss is remanded. Service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1973 to January 1978 in the United States Air Force, with subsequent service in the National Guard and the Reserves from approximately 1983 to 2002. These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In July 2021, the Veteran testified before the undersigned during a virtual hearing. A transcript of the hearing is included in the electronic claims file. 1. Service connection for bilateral hearing loss is remanded. 2. Service connection for tinnitus is remanded. The Veteran has current hearing loss for VA purposes, as well as tinnitus, documented on VA examination in July 2016. Additionally, as discussed by the RO in the July 2016 rating decision, there is a high probability that he was exposed to hazardous noise while working with F-5 jets and T-37 aircraft in the performance of his duties as an Aircraft Maintenance Specialist during military service. A July 2016 VA examiner provided negative nexus opinions as to both claims, but the opinions are limited to the period of service from 1973 to 1978 and the examiner did not consider whether the Veteran's exposure to excessive noise during his approximately twenty years of subsequent service in the Reserves and National Guard (either active duty for training (ACDUTRA) or inactive duty for training (INACDUTRA)) may be the source of his hearing loss and/or tinnitus. Indeed, his service records from his time in the Reserves and National Guard document that he was "routinely exposed to hazardous noise." See, e.g., December 1995 service treatment record. The term "active military, naval, or air service" includes: (1) active duty; (2) ACDUTRA during which the individual concerned was disabled or died from a disease or injury incurred or aggravated in the line of duty; and (3) any period of INACDUTRA during which the individual concerned was disabled or died from an injury incurred or aggravated in the line of duty. 38 U.S.C. § 101(24); 38 C.F.R. § 3.6(a) (emphasis added). VA General Counsel Opinions reflect that the term "injury" denotes harm from external trauma, while the term "disease" refers to some type of internal infection or degenerative process. VAOPGCPREC 4-2002; VAOPGCPREC 8-2001. Thus, it is possible for the Veteran to establish entitlement to service-connection for hearing loss or tinnitus based on external trauma, such as noise exposure, during ACDUTRA or INACDUTRA service. The dates and character of the Veteran's service in the Reserves and National Guard should thus be clarified for the record, and thereafter, a further VA medical opinion must be obtained. Barr v. Nicholson, 21 Vet. App. 303 (2007) (holding if VA provides an examination, the examination must be adequate.) On remand, the examiner should additionally address the private June 2021 opinion of Dr. D. and the medical literature recently submitted by the Veteran. In this regard, in his June 2021 opinion, Dr. D. opined that the Veteran's bilateral hearing loss is likely noise-induced, and stated that his "involvement in the military serving his country had some degree as causation." On remand, the Veteran is free to seek a supplemental opinion from Dr. D., or any other provider, that employs more decisive language than that contained in the June 2021 opinion. See, e.g., Tirpak v. Derwinski, 2 Vet. App. 609 (1992) (holding that medical evidence which merely indicates that the alleged disorder "may or may not" exist or "may or may not" be related, is too speculative to establish the presence of a claimed disorder or any such relationship). The matters are REMANDED for the following action: 1. Attempt to verify the Veteran's periods of ACDUTRA and/or INACDUTRA from 1983 to 2002. Please note that reports of retirement points reflected in discharge records do not contain sufficient information. 2. If possible, return the record to the VA examiner who conducted the Veteran's July 2016 audiological examination. The record, a copy of this remand, and a copy of any summary or memorandum prepared in response to the remand directive above must be made available to the examiner. If the July 2016 VA examiner is not available, the record should be provided to an appropriate medical professional to render the requested opinion. The need for an additional examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion; however, the Veteran should not be required to report for another examination as a matter of course, if it is not found to be necessary. Upon a review of the record, the examiner should provide an opinion as to whether it is at least as likely as not (i.e., 50 percent or greater probability) that the Veteran's bilateral hearing loss and/or tinnitus are related to his military service, including as due to his exposure to hazardous noise while working with F-5 jets and T-37 aircraft in the performance of his duties as an Aircraft Maintenance Specialist during both his active duty and during his subsequent service in the Reserves and National Guard. In offering any opinion, the examiner must consider the full record, to include the Veteran's lay statements. A rationale for any opinion offered should be provided. The examiner must also consider the following evidence: June 2021 private medical opinion of Dr. D. Medical literature submitted by the Veteran, entitled Delayed Effects of Noise on the Ear, and Noise and Military Service. Implications for Hearing Loss and Tinnitus. L.M. YASUI Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Smith, 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.