Citation Nr: 21073749 Decision Date: 12/10/21 Archive Date: 12/10/21 DOCKET NO. 18-29 911 DATE: December 10, 2021 REMANDED Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for a bilateral hearing loss disability is remanded. Entitlement to service connection for a skin condition is remanded. Entitlement to service connection for high blood pressure is remanded. Entitlement to service connection for a prostate condition is remanded. Entitlement to an evaluation greater than 10 percent for coronary artery disease is remanded. REASONS FOR REMAND The Veteran had active service in the United States Marines Corps from July 1967 to May 1970. He had active service in the Vietnam from January 1969 to January 1970. These matters are on appeal from an August 2015 rating decision. In January 2020, the Veteran testified at a hearing before the undersigned. A transcript of the proceeding is associated with the record. 1. Entitlement to service connection for tinnitus is remanded. 2. Entitlement to service connection for a bilateral hearing loss disability is remanded. The Veteran testified that his bilateral hearing loss disability and tinnitus were caused by in-service noise exposure. He worked on the flight line during his active service. The Veteran's service treatment records indicate that he sustained a ruptured left tympanic membrane during his active service. In July 2015, the Veteran was afforded a VA hearing loss and tinnitus examination. The VA examiner indicated that she was unable to give an etiological opinion regarding the Veteran's bilateral hearing loss disability without resorting to speculation. The VA examiner indicated that the Veteran had hearing loss in the right ear at 6,000 hertz and left ear hearing loss at 4,000 hertz. She concluded that she was unable to determine if there was aggravation, because the Veteran was not afforded an audiological examination at separation. The Board finds that this opinion is inadequate because the Veteran did not meet the criteria for a bilateral hearing loss disability when he entered service. Therefore, he is presumed sound. Finally, the VA examiner indicated that the Veteran did not have tinnitus. However, in January 2020, the Veteran testified that he had tinnitus. A remand is required to afford the Veteran a VA examination to determine whether he has tinnitus and to obtain adequate etiological opinions related to his bilateral hearing loss disability and tinnitus. 3. Entitlement to service connection for a skin condition is remanded. 4. Entitlement to service connection for high blood pressure is remanded. 5. Entitlement to service connection for a prostate condition is remanded. The Veteran has not been afforded VA examinations to determine etiology of his skin condition, high blood pressure, or prostate condition. The Veteran testified that he experienced a rash on his arms that developed in service and has persisted. He attributed his rash to his conceded in-service exposure to herbicide agents. With regard to high blood pressure, the Veteran testified that his high blood pressure may be caused by his conceded in-service exposure to herbicide agents or may be proximately due to or aggravated by his service-connected coronary artery disease. Finally, the Veteran has a current diagnosis for hypertrophy of the prostate with urinary obstruction, which he claims is related to his presumed in-service exposure to herbicide agents. While these conditions may not be granted on a presumptive basis, the Veteran is not precluded from being awarded service connection on a direct basis. Therefore, a remand is required to afford the Veteran VA examinations and to obtain etiological opinions. 6. Entitlement to an evaluation greater than 10 percent for coronary artery disease is remanded. The Veteran underwent his most recent VA heart examination in May 2019. Since his examination, the Veteran underwent a procedure and had stents placed after his examination. In January 2020, the Veteran testified that he fatigues more easily. The evidence indicates that the Veteran's coronary artery disease has worsened since his May 2019 examination. A remand is required to afford the Veteran a VA examination to determine the current severity of his coronary artery disease. The matters are REMANDED for the following actions: 1. Schedule the Veteran for a VA examination for his bilateral hearing loss disability and tinnitus. The examiner must review the claims file. The examiner is asked to provide a response to the following: Are the Veteran's bilateral hearing loss disability and tinnitus at least as likely as not related to his in-service noise exposure? In rendering the opinion, the VA examiner is asked to address the Veteran's January 1968 ruptured tympanic membrane and his conceded in-service noise exposure. 2. Schedule the Veteran for a VA examination for his skin condition. The examiner must review the claims file. The examiner is asked to provide a response to the following: Is the Veteran's skin condition at least as likely as not related to his in-service exposure to herbicide agents and/or the rash he experienced during active service? The Veteran is competent to report the presence of a rash during active service. A rationale must be provided for the opinion. The examiner is advised that a negative opinion cannot be based solely on the fact that the disability is not on the list of diseases that are presumptively associated with exposure to herbicide agents. 3. Schedule the Veteran for a VA examination for his high blood pressure. The examiner must review the claims file. The examiner is asked to provide a response to the following: Is the Veteran's high blood pressure at least as likely as not related to his in-service exposure to herbicide agents? Is the Veteran's high blood pressure at least as likely as not proximately due to or aggravated by his service-connected coronary artery disease? A rationale must be provided for the opinions. The examiner is advised that a negative opinion cannot be based solely on the fact that the disability is not on the list of diseases that are presumptively associated with exposure to herbicide agents. 4. Schedule the Veteran for a VA examination for his hypertrophy of the prostate with urinary obstruction. The examiner must review the claims file. The examiner is asked to provide a response to the following: Is the Veteran's hypertrophy of the prostate with urinary obstruction at least as likely as not related to his in-service exposure to herbicide agents? A rationale must be provided for the opinion. The examiner is advised that a negative opinion cannot be based solely on the fact that the disability is not on the list of diseases that are presumptively associated with exposure to herbicide agents. 5. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected coronary artery disease. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. 6. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal. If the benefits sought are not granted to the Veteran's satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. DAVID L. WIGHT Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R.R. Watkins, 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.