Citation Nr: 21009031 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 13-01 467 DATE: February 18, 2021 REMANDED The claim of entitlement to service connection for right ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1963 to February 1967. This appeal is from an April 2012 rating decision. Most recently, in April 2020, the Board remanded this claim for additional development. Unfortunately, that development has not been substantially completed, and another VA examination opinion must be obtained, as explained below. The claim of entitlement to service connection for right ear hearing loss is remanded. The VA examiner was advised that the 2006 IOM study was inconclusive, and that the examiner must explain why the conclusions apply to the Veteran. The examiner said the results applied to him because his hearing was normal during service. The Board notes that the issue is whether noise exposure during ACDUTRA has caused his current hearing loss. His STRs from his period of ACDUTRA are not available, and therefore it is not established that his hearing loss was normal at that time. The examiner did not explain why normal hearing during active duty, which was immediately following ACDUTRA, precludes delayed-onset right ear hearing loss. In that regard, the Board notes that it is not clear the October 2020 VA examiner considered the Veteran’s in-service hearing tests under the correct standards. Neither the August 1963 test nor the February 1967 test indicate whether they are presented in ASA units or ISO/ANSI units. For the 1963 test, VA policy is to assume that this test is presented in ASA units, and so it must be converted to ISO/ANSI; for the 1967 test, one must consider the results under the standard that is most advantageous to the Veteran. The Veteran has reported that his hearing loss is related to an incident that happened during ACDUTRA prior to his active duty, therefore the examiner should consider the accurate (as converted) test results of the tests that are available from that time. Further, the Board observes that no opinion has been obtained as to whether the Veteran’s service-connected left ear hearing loss has caused or aggravated right ear hearing loss. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Forward the claims file to the October 2020 examiner for an addendum opinion on whether it is as likely as not (50/50 probability or greater) that any right ear hearing loss is related to his service. The examiner is also asked to provide an opinion on whether it is as likely as not that left ear hearing loss has caused or aggravated right ear hearing loss. “Aggravated” means to have caused any increase in severity that is beyond the normal progression of the disability which need not be permanent in nature. The examiner was asked, if relying on the 2006 IOM study, to explain why they applied to this Veteran. He is reporting hearing loss related to traumatic noise during ACDUTRA, which was just prior to his active duty. The examiner noted that his hearing was normal during active duty without any changes, which does not adequately explain why the IOM study should be relied upon, given the assertion is that exposure during ACDUTRA caused delayed onset after active duty. The examiner is advised that the Veteran’s 1963 hearing test is not labeled, and must be presumed to be presented in ASA units, and therefore converted to ISO/ANSI standards. The 1967 test is also not labeled, and must be considered under the standards that are most advantageous to him, which may require conversion. Upon conversion, it shows that he entered active service following ACDUTRA with a 20-decibel hearing loss at 500 Hertz. The examiner is asked to comment on whether these findings alter the opinion regarding whether right ear hearing loss is related to noise exposure during ACDUTRA. The Board notes that STRs for this time-frame are not available, and therefore a detailed rationale is requested if a negative opinion is rendered, as the Board has a heightened duty to explain its findings under such circumstances.   All opinions must be accompanied by explanation. It is up to the discretion of the examiner as to whether a physical examination must be completed to render the requested opinion. If so, the examiner is asked to notify the scheduling authority to make appropriate arrangements. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Gibson 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.