Citation Nr: 21008245 Decision Date: 02/12/21 Archive Date: 02/12/21 DOCKET NO. 16-26 921 DATE: February 12, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from October 1959 to August 1963 and from February 1965 to February 1967. A hearing was held before the undersigned Veterans Law Judge in January 2019 and a transcript of the hearing is part of the record. The Board previously remanded these matters in April 2019. The April 2019 remand directed that the Veteran be afforded an appropriate VA examination with respect to his hearing loss and tinnitus. It was noted the examiner “must address whether the Veteran’s hearing loss and tinnitus symptoms onset during active duty service and have been chronic since his discharge from service.” This question was not addressed. Additionally, the prior remand noted review of the entire claims folder was required. However, it appears this was not completed. Unfortunately, another remand is necessary considering there was not substantial compliance with the earlier remand. See Stegall v. West, 11 Vet. App. 268 (1998). 1. Entitlement to service connection for bilateral hearing loss Service personnel records show that the Veteran’s rating was radarman and that he served at sea on several ships. Although standing watch as a radar operator may have a low exposure to noise, the Veteran was also a radar maintenance technician and sailors aboard small ships such as destroyers are exposed to higher levels of noise when topside during gunfire exercises or when visiting in the engineering spaces. As noted below, the Veteran also credibly reported an incident while working aloft on an antenna when the ship sounded its foghorn. The January 2020 VA examiner found, “[t]he onset of his hearing loss was reported to be on active duty, in 1960-61; however, on his exit exams in 1963/1967 and re-enlistment exam from 1965, he did not report any hearing loss and/or other ear-related dysfunction. His hearing was found to be within normal limits in 1965, which suggests that he did not experience any acoustic trauma during his first enlistment period from 1959-63. Furthermore, his naval rating had a low probability of noise exposure. Based upon the available evidence (i.e., a lack of complaints of hearing loss at any point during service), it is less likely as not that his current hearing loss is due to exposure to noise from a foghorn during his service.” It is unclear how the examiner determined from a medical standpoint that it is less likely than not that the Veteran’s hearing loss is due to exposure to noise from a foghorn during service. The examiner relied on the lack of complaints of hearing loss in the Veteran’s service treatment records to conclude that it is less likely as not that his current hearing loss is due to exposure to noise from a foghorn during his service. However, he has not explained why he has discounted the Veteran’s present account of the incident. Also, the January 2020 VA examiner indicated he reviewed “military exams from 1959-67…as well as testing from 2013.” The examiner must review the record in its entirety. Remand is also necessary to obtain an addendum opinion that addresses the Veteran’s contentions and considers the record as a whole, including the information discussed below. In his November 2011 application for compensation, the Veteran reported his hearing loss and tinnitus began in February 1960 and were untreated. Service treatment records reflect the Veteran was seen in May 1961 for an infection of his left ear. An August 1963 exit examination indicates a normal whisper test and the clinical evaluation for “ears” is noted as normal. A February 1965 enlistment examination indicates a normal hearing exam and normal audiometer results. The clinical evaluation for “ears” is noted as normal. The February 1967 report of medical examination includes a normal hearing whisper test, but no audiometer results. The clinical evaluation for “ears” is noted as normal. In a January 2019 statement, the Veteran explained that a foghorn went off around 15 feet from him for five minutes. He was completely deaf for several hours and his ears rang for days. His hearing loss and tinnitus have never gone away since that day. At the time of the hearing, the Veteran explained that his hearing came back to the extent that he had hearing. Additionally, he explained the sound of the tinnitus initially sounded like the foghorn. That sound has not stayed with him, but he has a “ringing -type thing” that has stayed with him. He explained that when he mustered out of service, there was not a hearing test and he did not remember a whisper test. He stated there was a quota that had to be met and he was part of that quota. The record reflects, after service, the Veteran was enrolled in commercial flight school training beginning in March of 1969 and obtained a pilot’s license. During his March 2013 VA examination, the Veteran complained of constant tinnitus bilaterally and stated the rustling sound began years ago, but he could not be more specific. In his August 2013 notice of disagreement, the Veteran reported his tinnitus was related to serving on naval ships with gun fire. In a January 2019 statement from the Veteran’s wife, she explained that she married the Veteran about one year after his discharge from the Navy and his hearing has been poor ever since she has known him and it has gotten worse over the last 50 years. In a March 2020 statement, the Veteran’s representative indicated the Veteran claimed his hearing loss and tinnitus were due to a fog horn blast on the USS Arneb in late 1966, suggesting that the normal testing from February 1965, referenced by the examiner, would not have been relevant to the analysis because the Veteran’s hearing would have been affected after that date. 2. Entitlement to service connection for tinnitus The January 2020 VA examiner provided an addendum opinion in November 2020 in which he indicated that, during his exam, the Veteran reported the onset of his hearing loss and tinnitus was reported to be “on active duty, in 1960-61, after being exposed to noise from a fog horn; however, on his exit exams in 1963/1967 and re-enlistment exam from 1965, he did not report any tinnitus and/or other ear-related dysfunction. His hearing was found to be within normal limits in 1965, which suggests that he did not experience any acoustic trauma during his first enlistment period from 959-63. Furthermore, his MOS had a low probability of noise exposure, and he had a significant history of occupational noise exposure from pilot training post-service. Additionally, in March of 2004 he stated that his tinnitus had only begun a few weeks prior, decades after he was discharged from the military. Based upon the available evidence (i.e., a lack of complaints of tinnitus at any point during service), it is less likely as not that his current tinnitus is due to military exposure.” The explanation noted above in the section pertaining to hearing loss also applies to the Veteran’s claim for tinnitus. The matters are REMANDED for the following actions: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s bilateral hearing loss is at least as likely as not onset during service or was caused by his service, especially the reported exposure to a foghorn while repairing a radar. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s tinnitus is at least as likely as not onset during service or was caused by his service, especially the reported exposure to a foghorn while repairing a radar and exposure to gunfire. The examiner must address in both opinions whether the Veteran’s hearing loss and tinnitus symptoms onset during active duty service and have been chronic since his discharge from service. The examiner must also review the entire claims folder and consider the record as a whole, including the following: In his November 2011 application for compensation, the Veteran reported his hearing loss and tinnitus began in February 1960 and were untreated. Service treatment records reflect the Veteran was seen in May 1961 for an infection of his left ear. An August 1963 exit examination indicates a normal whisper test and the clinical evaluation for “ears” is noted as normal. A February 1965 enlistment examination indicates a normal hearing exam and normal audiometer results. The clinical evaluation for “ears” is noted as normal. The February 1967 report of medical examination includes a normal hearing whisper test, but no audiometer results. The clinical evaluation for “ears” is noted as normal. In a January 2019 statement, the Veteran explained that a foghorn went off around 15 feet from him for five minutes. He was completely deaf for several hours and his ears rang for days. His hearing loss and tinnitus have never gone away since that day. At the time of the hearing, the Veteran explained that his hearing came back to the extent that he had hearing. Additionally, he explained the sound of the tinnitus initially sounded like the foghorn. That sound has not stayed with him, but he has a “ringing -type thing” that has stayed with him. He explained that when he mustered out of service, there was not a hearing test and he did not remember a whisper test. The record reflects, after service, the Veteran was enrolled in commercial flight school training beginning in March of 1969 and obtained a pilot’s license. During his March 2013 VA examination, the Veteran complained of constant tinnitus bilaterally and stated the rustling sound began years ago, but he could not be more specific. In his August 2013 notice of disagreement, the Veteran reported his tinnitus was related to serving on naval ships with gun fire. In a January 2019 statement from the Veteran’s wife, she explained that she married the Veteran about one year after his discharge from the Navy and his hearing has been poor ever since she has known him and it has gotten worse over the last 50 years. J.W. FRANCIS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Vemulapalli, 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.