Citation Nr: 21007436 Decision Date: 02/09/21 Archive Date: 02/09/21 DOCKET NO. 16-24 746A DATE: February 9, 2021 ORDER Entitlement to service connection for tinnitus is granted. REMANDED Entitlement to service connection for bilateral hearing loss is remanded. FINDING OF FACT The Veteran’s tinnitus is related to exposure to loud noise in service. CONCLUSION OF LAW The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1966 to March 1969. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a March 2015 rating decision. These matters were previously remanded by the Board in September 2019. There has been substantial compliance with the remand in connection with claim decided here and the Board will proceed with adjudication. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for tinnitus The Veteran contends that his tinnitus is the result of exposure to loud noise in service. The Board concludes that the Veteran has a current disability that is related to in-service noise exposure. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). A September 2014 VA treatment record shows the Veteran has a current diagnosis of tinnitus. The Veteran’s military occupation specialty (MOS) is engineer equipment repairman and diesel mechanic, which is consistent with the Veteran’s testimony of exposure to loud equipment noise. He has also reported exposure to the sound of gunfire, which is consistent with military service, including the Veteran’s service in the Republic of Vietnam. The question is whether the Veteran’s current tinnitus is related to this exposure to loud noise in service. On this question there are probative opinions in favor of and against the claim. The evidence against the claim is a January 2020 VA examination finding no evidence of permanent auditory damage in the Veteran’s service treatment records (STRs), and no evidence of chronicity or continuity of care regarding tinnitus since service. This examination opinion is inadequate because it does not follow the September 2019 remand instruction to discuss the Veteran’s competent lay testimony in the March 2015 examination that his tinnitus started after his tour in Vietnam. Therefore, it has limited probative value. The evidence in favor of the claim is the March 2015 VA examination, in which the examiner noted on the final page that the Veteran’s tinnitus IS at least as likely as ot related to exposures encountered in Vietnam and was noted by the Veteran as longstanding and starting after his tour. Although this examiner inaccurately identifies the Veteran’s MOS as infantryman rather than engineer equipment repairman, both MOS are consistent with exposure to loud noise. Therefore, this error is a minor one, and the Board finds that the March 2015 opinion has more probative value than the January 2020 opinion. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current tinnitus is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for tinnitus is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. REASONS FOR REMAND Entitlement to service connection for bilateral hearing loss is remanded. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives for this issue. Specifically, the examiner did not discuss the medical evidence in support of a causal link between in-service noise exposure and developing hearing loss later in life, as was instructed by the September 2019 remand, nor did the examiner clearly indicate whether the Veteran’s March 1966 audiogram was converted to the ISO-ANSI standard. Another remand is required. Stegall, 11 Vet. App. at 271. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s bilateral hearing loss is at least as likely as not related to in-service noise exposure. The clinician must discuss the medical evidence cited by the September 2019 informal hearing presentation in favor of a causal link between in-service noise exposure and developing hearing loss later in life. The clinician must also indicate whether he or she has converted the March 1966 audiogram from ASA to ISO-ANSI standards. The opinion offered must be supported by a complete rationale. If an opinion cannot be offered, the examiner must indicate why. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Budd, 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.