Citation Nr: 21073716 Decision Date: 12/10/21 Archive Date: 12/10/21 DOCKET NO. 17-33 182 DATE: December 10, 2021 REMANDED The claim of entitlement to service connection for an acquired psychiatric disability is remanded. The claim of entitlement to service connection for left ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1980 to August 1983. This appeal is from a March 2015 rating decision. In August 2020, the Veteran had a personal hearing with the undersigned VLJ. 1. The claim of entitlement to service connection for an acquired psychiatric disability is remanded. The Veteran is diagnosed with anxiety with agoraphobia. He asserts that his disability is related to his service. He reports that he witnessed a fellow airman's injury when the front tire of a plane exploded. On remand, he shall be provided with a VA examination. 2. The claim of entitlement to service connection for left ear hearing loss is remanded. The Veteran is diagnosed with left ear hearing loss. He entered service with some hearing loss but not with hearing loss that is considered disabling for VA purposes. The October 1979 hearing test showed a 30 decibel loss at 2000 Hertz, but all other tested frequencies were below 20 decibels. See 38 C.F.R. § 3.385. He was not noted to have left ear hearing loss on his entrance examination. At his separation examination, in June 1983, he again was not diagnosed with left ear hearing loss. The February 2015 VA examiner noted that the Veteran's left ear did undergo a permanent positive threshold shift during service. However, the examiner continued that the Veteran entered service with hearing loss that was not aggravated beyond normal progression during service. This opinion is inadequate. As discussed above, he did not enter service with a hearing loss disability as per VA regulations, and he was not found by entrance examiners to have a hearing loss disability. The examiner should not have considered aggravation, but rather whether any current hearing loss is related to the permanent positive threshold shift that occurred during service. On remand, another VA examination opinion shall be obtained. The matters are REMANDED for the following action: 1. Update VA treatment records. 2. After completion of directive 1, schedule the Veteran for an appropriate examination for a diagnosis and opinion on whether it is as likely as not (50/50 probability or greater) that any diagnosed acquired psychiatric disability is related to his service. The examiner is asked to review the record and to elicit from the Veteran a detailed history of his symptoms in and since service prior to opining. The Veteran asserts he witnessed someone seriously injured when a tire exploded in their face, causing the skin to peel off and exposing the bone and eyeball. He reports that he has been unable to get that image out of his mind. He has been diagnosed with anxiety with agoraphobia. All opinions are to be supported with explanation. 3. After completion of directive 1, schedule the Veteran for an appropriate examination for an opinion on whether left ear hearing loss is as likely as not (50/50 probability or greater) related to service. The examiner is asked to review the record prior to the examination. The Veteran is diagnosed with a left ear hearing loss disability for VA purposes. The February 2015 VA examiner noted that the Veteran did have a permanent positive threshold shift during service. However, that examiner opined the Veteran entered service with hearing loss that was not permanently aggravated during service, which is an incorrect standard because the record does not show he had hearing loss for VA purposes on his entrance examination, and he was not diagnosed with a left ear hearing loss defect at that time. Accordingly, the issue is not whether hearing loss was permanently aggravated during service, but whether it was caused by the permanent positive threshold shift during service. Hearing loss need not be diagnosed during service to be related to service. The examiner is also asked to opine on whether left ear hearing loss is caused or aggravated by right ear hearing loss. "Aggravated" means to cause any increase in severity that is beyond the normal progression, and it need not be permanent in nature. All opinions must be supported with explanation. Nathaniel J. Doan Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Gibson 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.