Citation Nr: 21074134 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 17-55 897 DATE: December 14, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1969 to August 1971, with subsequent services in the reserves. This matter is on appeal to the Board of Veterans' Appeals (Board) from an April 2017 rating decision. A hearing was held with the undersigned Veterans Law Judge in February 2020. In June 2021, the Board remanded the claim for a new VA examination and medical opinion. Although the Board regrets the delay, another remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. VA's duty to assist includes a duty to provide a medical examination or obtain a medical opinion where it is deemed necessary to make a decision on the claim. 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4); Duenas v. Principi, 18 Vet. App. 512 (2004); Robinette v. Brown, 8 Vet. App. 69 (1995); McLendon v. Nicholson, 20 Vet. App.79 (2006). In addition, once VA undertakes the effort to provide an examination when developing a service connection claim, even if not statutorily obligated to do so, it must provide an adequate one or, at a minimum, notify the claimant why one will not or cannot be provided. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). For below noted reasons, the Board finds that an additional VA examination is needed to determine the nature and etiology of the Veteran's claimed hearing loss. In the August 2021 VA examination, the Veteran had sensorineural hearing loss bilaterally. The examiner noted several past audiometric findings during active service and in the reserves, including the following: normal hearing at active duty separation in 1971, normal hearing at his enlistment in the reserves, normal hearing in 1980, mild high frequency hearing loss in the left ear at 4000 Hz in 1985, normal hearing in 1988, mild high frequency hearing loss bilaterally in 1992, mild high frequency hearing loss at 6000 Hz bilaterally in 1997, normal hearing in 2001, and mild high frequency hearing loss bilaterally in 2016. In finding that the Veteran's hearing loss was unrelated to service, the examiner rationalized that the Veteran's hearing was within normal limits at all frequencies 500-6000 Hz at separation and in 2001. She stated there was no evidence that hearing loss or significant threshold changes occurred during military service. The Board finds this opinion inadequate. First, the examiner erroneously based her opinion on the fact that hearing was within normal limits at separation. Service connection for hearing loss may be granted where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting regulatory requirements for hearing loss are met, and there is a medically sound basis to attribute post service hearing loss to service, irrespective of any intercurrent causes. See Hensley v. Brown, 5 Vet. App. 155, 157 (1993). Therefore, when the testing results at separation from service do not meet the requirements for hearing loss under C.F.R. § 3.385, service connection may still be established by evidence that the current disability is causally related to service. Second, the examiner also specifically noted hearing within normal limits in 2001 but failed to account for audiometric findings of hearing loss in 1985, 1992, and 1997, rendering the opinion of low probative value. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (the probative value of a medical opinion comes from its being factually accurate, fully articulated, and having a sound reasoning for the conclusion). Third, the examiner failed to address the Veteran's contentions in the record that his hearing loss was caused by exposure to weapons fire to include 81mm mortar rounds, artillery, Howitzers, 155s, small arms fire and grenades during active service. As in-service noise exposure has been conceded, the examiner must consider whether such exposure caused delayed onset hearing loss. The matter is REMANDED for the following action: Obtain a new VA examination to determine the nature and etiology of the Veteran's hearing loss. The examiner must opine whether it is at least as likely as not (approximately 50 percent or greater probability) that the hearing loss is related to in-service noise exposure, to include through delayed onset. The examiner must consider and address all relevant evidence of record, specifically the 1985, 1992, and 1997 findings of hearing loss, as well as the Veteran's lay statements pertaining to his conceded in-service noise exposure and onset of hearing loss. The examiner is asked to provide a complete rationale for all opinions and conclusions reached. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Carroll, 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.