Citation Nr: 21005769 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 14-36 463 DATE: February 2, 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 January 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from the February 2013 rating decision of the St. Louis, Missouri, Regional Office (RO) of the Department of Veterans Affairs (VA). The Board remanded the claim in April 2018 and July 2020. Pursuant to the July 2020 remand, VA obtained another VA opinion dated in August 2020 and an October 2020 addendum. On review, the Board finds that additional development is still needed. The August 2020 VA examiner opined that the Veteran’s bilateral hearing loss is less likely as not related to service, reasoning that the absence of a hearing threshold shift in the service treatment records indicates that the Veteran had not experienced hearing loss in service. However, the examiner did not explain the significance of the Veteran not having a threshold shift in service. Again, the examiner relied on the absence of hearing loss in service in providing an unfavorable opinion, and in doing so, did not address the Veteran’s competent lay reports of noise exposure in service. See Dalton v. Nicholson, 21 Vet. App. 23 (2007). The RO obtained an addendum in October 2020, and that examiner also determined that the Veteran’s the bilateral hearing loss is less likely than not related to his military service. The examiner stated that the conceded noise trauma during the Veteran’s service did not result in or aggravate the Veteran’s current bilateral hearing loss. The examiner reasoned that although the Veteran had no history of occupational or recreational noise exposure after service, there was no change in hearing at separation from service. As such, the October 2020 VA addendum also reasoned that the Veteran’s hearing loss is not related to service based on the absence of hearing loss in the service treatment records. Lastly, the Board observes that neither opinion addressed stated why the conclusions of the 2006 IOM study apply to this Veteran, given its contradictory aspects noted by the Court in McCray v. Wilkie, 31 Vet. App. 243 (2019). The Board asked this question in its 2018 remand and it was not addressed in any of the subsequent opinions. For these reasons, the claim unfortunately must be remanded again. The matter is REMANDED for the following action: 1. Forward the Veteran’s claim file to a qualified audiologist preferably one that has NOT yet provided an opinion in this case for the purpose of obtaining an opinion as to the etiology of the Veteran’s current bilateral hearing loss disability. After a review of the claims file, the examiner is asked to respond to the following: CLARIFY whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s current bilateral hearing loss disability is a result of conceded in-service noise exposure. If this examiner finds no nexus, (i) Please explain why the absence of a significant threshold in service is relevant in determining the etiology of the Veteran’s hearing loss. (ii) Address the Veteran’s lay statements that he has had no significant history of occupational or recreational noise exposure after service. (iii) Indicate whether this examiner is relying on the 2006 IOM study, as prior examiners did, and if so, state why the conclusions of that study apply to this Veteran, given its contradictory aspects noted by the Court in McCray v. Wilkie, 31 Vet. App. 243 (2019). A complete rationale for all proffered opinions must be provided. 2. Thereafter, readjudicate the remanded claim. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Moldawer, 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.