Citation Nr: 21006276 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 17-09 779 DATE: February 3, 2021 REMANDED Entitlement to service connection for a right ear hearing loss disability is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1969 to September 1973. This appeal to the Board of Veterans’ Appeals (Board) is from a January 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Veteran and his wife testified during a video conference hearing before the undersigned; a transcript of this hearing is of record. It was agreed at the hearing that the record would remain open for 30 days to allow the submission of additional evidence. In September 2019, the Veteran requested an additional 90 days to submit evidence; the Board granted the motion in December 2019. Additional evidence and the Veteran’s statements were received in November 2019. In March 2020, the Board remanded this matter. Following the remand, the RO granted service connection for left ear hearing loss and tinnitus, resolving those issues. Entitlement to service connection for a right ear hearing loss disability is remanded. In the March 2020 remand, the Board noted that there was evidence that indicated the Veteran’s hearing loss may be related to service and that the Veteran submitted an article in November 2019 from the Center for Disease Control that states loud noises are harmful to the inner ear and that long time exposure can overwork the hair cells and cause them to die. These cells allow the brain to detect sound and up to 30 to 50 percent can be damaged or destroyed before changes in hearing can be measured by a hearing test. By the time hearing loss is noticed, many hairy cells have been destroyed and cannot be repaired. Noise can also damage the auditory nerve and early damage may not show up on hearing tests, but it can create a “hidden hearing loss” that will make it difficult to understand speech in noisy environments. The cumulative effect of noise affects how well a person might hear later in life and how quickly hearing problems may develop even after the exposure has stopped. See November 2019 Medical Treatment Record –Government Facility. The examiner was instructed to discuss this article in relation to the Veteran’s hearing loss. The July 2020 examiner offered an unfavorable opinion but did not address the article. It is necessary to address the article regarding delayed onset hearing loss not only to comply with the Board’s remand but because it is relevant given that the VA examiner based the opinion, in part, on the absence of a hearing problem for many years after service. The matter is REMANDED for the following action: Make the claims file available to the audiologist who offered the July 2020 opinion regarding the etiology of the Veteran’s right ear hearing loss. Based on a review of the narrative portion of this remand, the clinician must address the following: Is it at least as likely as not (50 percent or greater probability) that the Veteran’s diagnosed right ear hearing loss is etiologically related to his period of service, to include his in-service noise exposure? A complete rationale is needed that supports all opinions expressed. In rendering the opinions, the clinician is advised to consider the following: a. The Veteran had acoustic trauma in service due to exposure to jet engines without hearing protection in service. b. All in-service hearing evaluations as shown, to include the July 1969 enlistment examination, April 1971 hearing conservation reference examination, and April 1973 separation examination, are to be considered as ISO findings, so no conversion is needed. c. Consider the October 2014 VA audiology consult that notes the results are consistent with functional/non-organic hearing loss. d. Consider and discuss the article from the Center for Disease Control concerning hearing loss that was submitted in November 2019. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Bredehorst 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.