Citation Nr: 21077624 Decision Date: 12/30/21 Archive Date: 12/30/21 DOCKET NO. 18-15 518 DATE: December 30, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1967 to July 1970. A remand is necessary to obtain clarification as to the etiology of the Veteran's bilateral hearing loss disability. Initially, the evidence demonstrates that the Veteran has bilateral hearing loss for VA compensation purposes, as evidenced by a September 2015 VA examination report. See C&P Examination, VBMS entry dated September 16, 2015. In the March 2018 substantive appeal, the Veteran asserts that he was exposed to acoustic trauma while serving as a Navy radarman due to rocket and mortar attacks while stationed in Vietnam, to include the 100 days after Ho Chi Mihn died. He also asserts that he worked TCL in the corner of the flight deck with no hearing protection during Vietnam while abord the USS Bennington. See Form 9, VBMS entry dated March 20, 2018. At the hearing in July 2021, the Veteran added that he could not hear for hours after the rocket attacks hit his bunker, that most of the time they were around him, twice on top of him, and another time, he was in the middle of an asphalt parking lot while they were all around him and he could not hear himself or others talking after that incident. He thought he raised his voice when younger and later connected it to the inservice rocket and mortar attacks. See Hearing Transcript, VMBS entry dated July 2, 2021, pp. 3-4. According to his DD 214, the Veteran's Military Occupational Specialty (MOS) was equivalent to a radio operator. The Veteran's DD 214 shows that he trained as a radarman 3. As such, based on the responsibilities and duties of the Veteran, the Board concedes that the Veteran was exposed to acoustic trauma in service. The Veteran was afforded a VA hearing examination in September 2015. The examiner opined that he could not determine a medical opinion without resorting to speculation. The examiner reasoned that the whispered voice test conducted at separation was not a valid measure of hearing acuity and could not be used to determine whether there was a significant high frequency hearing loss or aggravation of the pre-existing mild hearing loss shown at entrance. However, the Board finds this opinion inadequate as it does not address the Veteran's competent lay statements or conceded acoustic trauma. Second, the VA opinion does not consider more recent research cited below, involving hearing loss. Finally, the examiner notes that he is unable to provide an opinion without speculation. At the Board hearing in July 2021, the Veteran's representative referenced two medical articles in support of the Veteran's claim for bilateral hearing loss: medical article "Adding Insult to Injury: Cochlear Nerve Degeneration After Temporary Noise-Induced Hearing Loss" by Dr. Sharon Kujawa and M.C. Lieberman, and a 2011 article "Tinnitus with a Normal Audiogram: Physiological Evidence for Hidden Hearing Loss and Computational Model" by Roland Schaette and David McAlpine. See Hearing Transcript, VBMS entry, dated July 2, 2021, page 6. This evidence raises medical issues that the Board is not competent to address. See Colvin v. Derwinski, 1 Vet. App. 171 (1991). Thus, the Board finds that a remand is required for an addendum VA opinion that considers the medical evidence presented by the Veteran's representative. Accordingly, the case is REMANDED for the following action: 1. Associate with the electronic claims file updated VA treatment records, if any. 2. Obtain an addendum medical opinion from an appropriate VA examiner with regard to the likely etiology of the Veteran's bilateral hearing loss. The claims file and a copy of this remand must be made available to the reviewing examiner, who will acknowledge receipt and review of these materials. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. After a review of the claims file, the examiner is asked to address the following: (a) Address the findings of the audiometric testing conducted during service, which, with respect to the September 1966 enlistment examination audiometric results, should be converted to ISO-ANSI units. (b) Then, provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's bilateral hearing loss had its onset during active service or is otherwise related to it, to include exposure to conceded in-service acoustic trauma. (c) In doing so, address whether the conceded acoustic noise trauma of exposure in service could result in or aggravate the Veteran's current hearing loss. Regarding the basis for that opinion, please comment on the likelihood that the loud noises experienced during service resulted in damage to auditory hair cells even though findings may or may not suggest a recovered temporary threshold shift (TTS) in service. In providing the requested opinion, the examiner must specifically consider the relevance if any, of the following medical evidence cited by the Veteran's representative: (i) Sharon G. Kujawa and M. Charles Liberman, Adding Insult to Injury: Cochlear Nerve Degeneration After Temporary Noise-Induced Hearing Loss, J Neurosci. 2009 Nov 11; 29(45):14077-85, available at https://www.jneurosci.org/content/29/45/14077. (ii) Roland Schaette and David McAlpine, Tinnitus with a Normal Audiogram: Physiological Evidence for Hidden Hearing Loss and Computational Model, J Neurosci. 2011 Nov 21; 31(38): 13452-13457, available at https://www.jneurosci.org/content/31/38/13452. Note: The lack of hearing loss during service is not a bar for a claim for service connection. Hensley v. Brown, 5 Vet. App. 155, 160 (1993). (Continued on the next page) The examiner must set forth a complete rationale for any conclusion reached, citing to the examiner's own expertise, medical literature, and/or evidence in the Veteran's claims file as necessary. If an opinion cannot be reached without resorting to speculation, the examiner must fully explain why that is so 3. Thereafter, readjudicate the claim on appeal. S. B. MAYS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Beach, Julia M. 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.