Citation Nr: 21006606 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 17-65 390 DATE: February 4, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1977 to August 2002. The issue comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2002 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In a May 2019 Board decision, the Board denied the Veteran’s service connection for bilateral hearing loss claim. Thereafter, the Veteran appealed the Board decision to the United States Court of Appeals for Veterans' Claims (CAVC). In September 2020, a Joint Motion for Remand was granted by CAVC, vacating the May 2019 Board decision and remanding the issue back to the Board for additional development. The Board finds that additional development is needed before it can adjudicate the issue. Entitlement to service connection for bilateral hearing loss The Veteran contends that his current hearing loss is the result of hazardous noise exposure in service. In August 2017, a VA opinion for the Veteran’s hearing loss was completed. The examiner gave a negative opinion that the Veteran’s hearing loss was due to military service. The examiner noted that the entrance and separation audiograms were normal, with no evidence of a significant threshold shift. See August 2017 VA Examination. The examiner also stated that the Veteran’s exit audiograms were within normal hearing limits. Id. Additionally, the August 2017 examiner failed to consider the Veteran’s lay statements and pertinent medical notes in rendering his or her opinion. Notably, on the Veteran’s audiology treatment records shortly before his separation from service, the Veteran reported difficulty hearing over the phone and in background noise. See January 2002 STR-Medical. The Veteran also shared that his spouse complained about his hearing. Id. The physician noted that the Veteran had peripheral hearing sensitivity, within normal limits from 250 to 4000 Hz with a “drop-off” noted at higher frequencies. Id. The Board finds that the VA medical opinion is inadequate as it relies on a rationale that hearing was within normal limits during active duty with no significant threshold shifts during active service. According to 38 C.F.R. § 3.385, service connection for a current hearing disability is not precluded where hearing was within normal limits at separation. See Hensley v. Brown, 5 Vet. App. 155, 159-60 (1993). The VA medical opinion provider also failed to address the in-service complaints of difficulty hearing, which runs afoul of the Court’s recent holding in Miller v. Wilkie, 32 Vet. App. 249 (2020) (an “examiner must address the Veteran’s lay statements to provide the Board with an adequate medical opinion”). As such, a remand is necessary for an addendum opinion to discuss the nature and etiology of the Veteran's bilateral hearing loss. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (Once VA undertakes the effort to provide an examination, it must provide an adequate one). The matters are REMANDED for the following action: 1. In remanding this case, the Board makes no credibility determination, expressed or implied, at this juncture.” 2. Obtain an addendum medical opinion from a medical professional with appropriate expertise. The examiner should review the Veteran's claims file. If the examiner determines that an opinion cannot be provided without an examination, the Veteran should be scheduled for one. Based on a review of the record, and a new examination if necessary, the examiner must address the following: Whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's bilateral hearing loss is related to his active service or is caused by or aggravated by military service. The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. The examiner is advised that normal hearing at separation is not sufficient to serve as a rationale as 38 C.F.R. § 3.385 establishes that service connection for a current hearing disability is not precluded where hearing was within normal limits at separation In all opinions rendered, the examiner is advised that the Veteran is competent to report his symptoms of bilateral hearing loss from in-service injury to the present. The examiner must specifically consider and discuss the Veteran's in-service exposure to acoustic trauma and continuity of symptomology since service. The opinion and rationale should reflect such consideration. See January 2002 STR-Medical. The examiner must specifically address, and reconcile to the extent possible, his or her medical opinion with the August 2017 VA medical opinion. If the medical professional cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the medical professional shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board V. Schmidt 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.