Citation Nr: 21006135 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 14-09 198A DATE: February 3, 2021 REMANDED Entitlement to service connection for right ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1967 to March 1974 and from September 1974 September 1987. The case is on appeal from a March 2012 rating decision. Subsequently, in a February 2015 rating decision, the regional office granted service connection for left ear hearing loss. Thus, only the matter of entitlement to service connection for right ear hearing loss remains on appeal. Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997). The Veteran was scheduled for a Board hearing, but the Veteran withdrew his request for a Board hearing in April 2018. 38 C.F.R. § 20.704 (e). In October 2019, the Board remanded the appeal for an addendum opinion in light of McCray v. Wilkie, 31 Vet. App. 243 (2019). That opinion was obtained in January 2020, with the examiner again finding that it was less likely than not that the Veteran’s right ear hearing loss was caused by in-service noise exposure. In December 2020, the Veteran’s representative submitted additional arguments, wherein they asserted that “prior auditory damage can aggravate and/or accelerate hearing loss as the veteran ages.” The representative added: An article published in the Journal of Neuroscience in May of 2015, shows that auditory damage can accelerate hearing loss in aging in some cases. Synapses are structures that permit neuron to pass an electrical or chemical signal to another neuron. Studies have shown that a single synaptopathic exposure (traumatic event) can accelerate cochlear aging. The fact that initially reversible noise damage can have dramatic long-term consequences in amplifying age-related sensorineural hearing loss is of great significance in the consideration of noise-risk assessments. http://www.jneurosci.org/content/jneuro/35/19/7509.full.pdf Accordingly, the Board finds that an addendum opinion is warranted to consider the above. The matter is REMANDED for the following action: 1. Forward the claims file to an appropriate medical professional to obtain an addendum opinion regarding the Veteran’s right ear hearing loss. The claims file must be reviewed, and such review should be noted in the opinion. An additional VA examination may be provided if deemed appropriate. Specifically, the examiner should opine on the following: Is it at least as likely as not that the Veteran’s right ear hearing loss is caused or aggravated by his in-service noise exposure? In rendering an opinion, the examiner must consider the May 2015 Journal of Neuroscience article, which the Veteran’s representative has argued supports a conclusion that “a single synaptopathic exposure (traumatic event) can accelerate cochlear aging,” and that “initially reversible noise damage can have dramatic long-term consequences in amplifying age-related sensorineural hearing loss.” If relying on the 2006 Institute of Medicine study, the examiner must state why the conclusions of that study apply to this particular Veteran, given its contradictory aspects noted by the United States Court of Appeals for Veterans Claims in McCray v. Wilkie, 31 Vet. App. 243 (2019), and the specific facts in this case. A complete rationale should be given for any opinion rendered. A medical opinion based solely on the absence of documentation of symptoms in the record is inadequate. If the needed opinion cannot be provided without resort to speculation, court cases require the examiner explain why the opinion cannot be offered, and state whether the inability is due to the absence of any evidence or to the limits of scientific or medical knowledge. 2. Readjudicate the appeal. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.Z., 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.