Citation Nr: 21005556 Decision Date: 02/01/21 Archive Date: 02/01/21 DOCKET NO. 15-13 546 DATE: February 1, 2021 REMANDED Entitlement to service connection for left ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1986 to March 1989. The Veteran testified at a Travel Board hearing before the undersigned in November 2017; a transcript of the hearing is of record. This matter is before the Board of Veterans’ Appeals (Board) following Board remands in June 2018 and October 2019. Unfortunately, another remand is required in this case. A left ear hearing loss disability was noted at the time of the Veteran’s October 1985 entrance examination. The August 2013 and April 2019 VA medical opinions concluded that there was no worsening of the Veteran’s left ear hearing loss during service based on audiometric testing results at the time. However, current audiometric testing results, including those recorded in the April 2019 VA examination report, showed left ear hearing loss much more severe than what was recorded during service. The issue of whether or not a disability will be considered to have been aggravated by active service requires a determination of whether the disability underwent an increase in severity during service “on the basis of all the evidence of record pertaining to the manifestations of the disability prior to, during and subsequent to service.” 38C.F.R. §3.306(b) (emphasis added). Accordingly, in the October 2019 Remand the Board instructed that a VA medical opinion be obtained as to “Whether it is at least as likely as not (50% probability or more) that the Veteran’s subsequent worsening of his left ear hearing loss since service separation is due to aggravation of his pre-existing hearing loss caused by his established military noise exposure as a launch rocket crewmember.” The Veteran underwent VA examination in January 2020 at which time the examiner found that there was a pre-existing left ear hearing loss that was not aggravated beyond normal progression during active military service. The examiner concluded that the Veteran’s hearing loss did not worsen over the course of his enlistment. The examiner noted that the Veteran entered the Army with a moderately severe to severe left ear hearing loss and he separated with the same degree of left ear hearing loss. The examiner did not address the question posed by the Board as to whether subsequent worsening of his left ear hearing loss since service separation is due to aggravation of his pre-existing hearing loss caused by his established military noise exposure as a launch rocket crewmember, with consideration of the fact that the April 2019 VA medical opinion addressing the Veteran’s right ear hearing loss found that it was caused by in-service noise exposure even though his right ear hearing was normal during service. Therefore, an addendum medical opinion must be obtained on remand. The matter is REMANDED for the following action: 1. Obtain a VA medical opinion as to whether it is at least as likely as not (50% probability or more) that the Veteran’s subsequent worsening of his left ear hearing loss after his separation from service is due to aggravation of his pre-existing hearing loss caused by his established military noise exposure as a launch rocket crewmember. In making this determination, the examiner must consider the fact that the April 2019 VA medical opinion addressing the Veteran’s right ear hearing loss found that it was caused by in-service noise exposure even though his right ear hearing was normal during service. This raises the issue of whether subsequent worsening of the Veteran’s left ear hearing loss was similarly caused by in-service noise exposure even though there were no significant changes in his left ear hearing during service. P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. Olson, 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.