Citation Nr: 21075952 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 16-51 710 DATE: December 22, 2021 REMANDED Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1968 to April 1970. His awards and decorations include the Combat Infantry Badge. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge in July 2019. A transcript of that hearing has been associated with the claims file. Upon review, the Board finds that additional development is needed prior to adjudication of the issue. The Veteran was afforded a VA audiological examination in January 2015. At that time, he was diagnosed with bilateral hearing loss, which the VA examiner found was more likely than not due to excessive noise in service, as significant threshold shifts were seen during service. Although the Veteran reported that he did not have tinnitus at the time of the examination, he later testified during a hearing that he was confused regarding the nature of the question. He clarified that he was trying to report that he has intermittent tinnitus, which he was not experiencing at the specific time of the January 2015 VA examination. Therefore, the Board finds that an additional medical opinion is needed. Accordingly, the case is REMANDED for the following action: 1. The agency of original jurisdiction (AOJ) should obtain a VA medical opinion to determine the nature and etiology of any tinnitus that may be present. A physical examination is only needed if deemed necessary by the individual providing the opinion. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran's service treatment records, post-service medical records, and assertions. The examiner should note that the Veteran is competent to attest to matters of which he has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the appellant, the examiner should provide a fully reasoned explanation. The examiner should opine as to whether it is at least as likely as not that the Veteran has tinnitus that is causally or etiologically related to his military service, to include his noise exposure therein. Although the Veteran reported that he did not have tinnitus during the January 2015 VA examination, the Veteran later testified during a July 2019 hearing that he was confused regarding the nature of the question. He clarified that he has intermittent tinnitus, which he was not experiencing at the specific time of the January 2015 VA examination. He could not recall the date of its onset. The examiner should also opine as to whether it is at least as likely as not that the Veteran has tinnitus that is either caused by or aggravated by his service-connected bilateral hearing loss. (The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of a certain conclusion as it is to find against it.) A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. Because it is important "that each disability be viewed in relation to its history [,]" 38 C.F.R. § 4.1, copies of all pertinent records in the appellant's claims file, or in the alternative, the claims file, must be made available to the examiner for review. 2. After completing these actions, the AOJ should conduct any other development as may be indicated. J.W. ZISSIMOS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Rideout-Davidson, 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.