Citation Nr: 21005782 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 17-09 129 DATE: February 2, 2021 REMANDED Entitlement to service connection for bilateral sensorineural hearing loss (SNHL) is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1966 to January 1968, including service in the Republic of Vietnam. This matter was last before the Board in June 2019, whereupon it was remanded to the Agency of Original Jurisdiction (AOJ) for further development of the record. Upon review of the record, the Board finds that it must remand this matter once again in order to secure an addendum opinion that sufficiently addresses the question of whether there is a nexus between the Veteran’s in-service noise exposure and his later development of bilateral SNHL. Specifically, pursuant to the Board’s prior remand instructions, the Veteran was afforded a VA examination in December 2019 to evaluate the nature and etiology of his claimed bilateral SNHL. After confirming that the Veteran had diagnosable sensorineural hearing loss for VA benefits purposes in both ears, the examiner opined that it was less likely than not that the bilateral hearing loss was incurred in or otherwise related to service. In support thereof, the examiner noted that the Veteran had normal hearing for VA purposes on his separation examination with no significant threshold shifts during service. Unfortunately, the Board cannot rely on this etiology opinion, as the December 2019 examiner did not provide a sufficient rationale to support the findings. To begin, the examiner did not explain why the presence of “normal” hearing at the time of separation, plus the lack of a threshold shift during service, is clinically significant in this inquiry-especially in light of the fact that service connection for a hearing loss disability may be awarded even if such disability did not manifest during service. See 38 C.F.R. § 3.303(d); see also Hensley v. Brown, 5 Vet. App. 155, 159 (1993). A new medical opinion that thoroughly explains why the Veteran’s current hearing loss disability is, or is not, related to in-service acoustic trauma is needed. The matters are REMANDED for the following action: Provide the claims file to the January 2020 examiner, or another qualified examiner if that individual is not available, in order to determine the etiology of the Veteran’s bilateral SNHL. A copy of the claims file should be made available to and reviewed by the examiner. Any clinical testing deemed necessary should be scheduled. After a review of the Veteran’s claims file, to include his service treatment records, the examiner should determine whether it is at least as likely as not (a 50 percent of greater probability) that the Veteran’s current bilateral hearing loss disability is related to his period of active duty service. If it is less likely than not that the Veteran’s current hearing loss disability is related to his period of service, the examiner should discuss why this is the case, to include the clinical significant of any “normal” in-service hearing test results, as well as the lack of permanent pure tone threshold shifts during service. The examiner must provide any and all opinions as to etiology in the form of a probability and must provide a complete rationale for any opinion express. The Veteran’s lay contentions as to acoustic trauma must be considered in full. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Christopher M. Collins, 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.