Citation Nr: 21006284 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 16-59 101 DATE: February 3, 2021 REMANDED Service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1997 to June 2001 and from November 2001 to November 2002. These matters are before the Board of Veterans’ Appeals (Board) on appeal from May 2016 and August 2017 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO). A Board hearing was conducted in September 2019 before the undersigned Veterans Law Judge, a transcript of which is associated with the claims file. In January 2020, the Board remanded the Veteran’s claims of service connection for bilateral hearing loss and a right hip condition for further development. In a November 2020 rating decision, service connection for a right hip condition was granted and thus, that issue is considered closed and not on further appeal. Service connection for bilateral hearing loss is remanded. Despite the additional delay, a remand is required to obtain an addendum medical opinion. The Veteran attended an October 2020 VA examination for his bilateral hearing loss. the examiner diagnosed the Veteran with bilateral sensorineural hearing loss. The examiner opined that the Veteran’s hearing loss is less likely than not caused by or a result of an event in service. The October 2020 examiner opined that the Veteran’s hearing loss is less likely than not related to his military service. The only rationale provided for the opinion was that the Veteran did not have a hearing loss disability for VA compensation purposes. The Board notes that in the diagnosis portion of the examination, the examiner checked the box indicating the Veteran has a diagnosis of sensorineural hearing loss. Therefore, the Board must seek clarification on whether the Veteran has a hearing loss disability and, if so, whether that disability is at least as likely as not related to military service or his service-connected tinnitus. Additionally, regarding the secondary service connection rationale, the examiner did not provide a rationale for aggravation, but rather causation only. The Board greatly appreciates the RO’s efforts to ensure compliance with the remand directives below before issuing a supplemental statement of the case and returning the Veteran’s appeal to the Board. The matters are REMANDED for the following action: 1. Please note that, by law, ALL remanded claims must be processed expeditiously. 2. The RO should arrange for an addendum medical opinion from a qualified provider (to exclude the October 2020 examiner) that addresses the obvious conflicts within the October 2020 hearing loss examination. The examiner should review the entire record in conjunction with any examination deemed necessary by the examiner. Based on review of the record (including this remand) and interview and any examination of the Veteran, the examiner should provide opinions that respond to the following: The Board has found the Veteran was exposed to acoustic trauma in service, therefore the examiner must consider this fact as established in their analysis. (a.) Does the Veteran have bilateral hearing loss disability (as defined in 38 C.F.R. § 3.385)? The Board notes the October 2020 examiner checked the box indicating sensorineural hearing loss bilaterally. (b.) If a hearing loss disability is found, is it AT LEAST AS LIKELY AS NOT (A 50 PERCENT OR GREATER PROBABILITY) that it is related to his service, to include as due to his established exposure to acoustic trauma therein? If the October 2020 examination is found to be inaccurate, a new examination should be scheduled with the Veteran. (c.) If a hearing loss disability (in either the right and/or left ear) is found to be unrelated to the Veteran’s service, is it at least as likely as not (a 50 percent or greater probability) that this was caused by the Veteran’s (now) service-connected tinnitus? (d.) If the answer to (c) is no, is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s hearing loss was aggravated by the Veteran’s service-connected tinnitus? The opinion MUST address aggravation, which is defined as the disability increasing in severity beyond its natural progression. If aggravation is found, the examiner should indicate, to the extent possible, the approximate baseline level of disability before the onset of the aggravation. The examiner is reminded that the Veteran is competent to provide information about observable symptoms and events. The examiner should assume, for the purposes of the opinions, that the Veteran’s reports are both accurate and credible. A detailed explanation (rationale) is requested for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested.) VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Williams, 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.