Citation Nr: 21009283 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 15-13 058 DATE: February 22, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Army and the National Guard of Puerto Rico from January 1964 to August 1965, with a period of active duty for training from April 1964 to September 1964. The Board most recently remanded this case to the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) in January 2020 for additional development, and it now returns to the Board for appellate review. Entitlement to service connection for bilateral hearing loss is remanded Unfortunately, due to reasons that follow, an additional remand is required. Although the Board sincerely regrets this additional delay, it is necessary to ensure the Veteran is afforded adequate due process and every possible consideration. In October 2020 the Veteran underwent a VA examination for hearing loss. The VA audiogram revealed bilateral ear hearing loss per 38 C.F.R. § 3.385. The examiner diagnosed the Veteran with sensorineural hearing loss of the bilateral ears in the frequency range of 500 to 4000 Hertz. The VA examiner opined that the Veteran’s bilateral hearing loss was less likely not caused by or a result of military service as audiometric testing at the time of discharge revealed normal hearing of the bilateral ears. The rationale deficiency with the October 2020 VA audiological examination is that the examiner relied on the absence of hearing loss disability in service for the negative service connection opinion. The Board notes that the absence of hearing loss disability in service is not in and of itself fatal to a claim for service connection for a hearing loss disability. Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Rather, service connection is warranted if all of the evidence, including that pertinent to service, reflects that current hearing loss is related to in-service noise exposure or anything else in service. The negative opinion is inadequate because the examiner appeared to have relied solely on the lack of hearing loss during service. Notably, the VA examiner incorrectly stated that the September 1964 Report of Medical History reported no ear, nose, or throat (ENT) concerns, when the record shows that the Veteran identified an unspecified ENT concern in September 1964. Further, the Board finds that the October 2020 VA medical opinion is inadequate as the examiner did not address the Veteran’s lay contentions as required by the January 2020 Board remand. Based on the above, the Board finds that a medical addendum should be provided. The matters are REMANDED for the following action: 1. Obtain a VA addendum opinion pertaining to the Veteran’s bilateral hearing loss from the October 2020 examiner, or a similarly qualified individual. The examiner should review the record prior to providing an opinion. The examiner should provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s hearing loss had its onset in active service, is otherwise caused by active service, or had its onset within one year of the Veteran’s separation from active service. The examiner must address the Veteran’s assertions of diminished hearing loss since service, to include any post-service noise exposure; and, address the Veteran’s in-service military occupational specialty and the corresponding level of noise exposure. A complete rationale must be provided. As indicated above, the examiner must review the record in conjunction with rendering the requested opinion; however, his or her attention is drawn to the following: The Veteran’s January 1964 and September1964 medical history reports in which the Veteran responded affirmatively to the question of the ear, nose or throat trouble; and the Veteran’s numerous assertions of diminished hearing loss since service due to artillery fire, as well as the Veteran’s post-service occupational history of banking with no reported noise exposure. In rendering the above opinion, the examiner is advised that the absence of in-service evidence of a hearing disability during service is not always fatal to a service connection claim. Evidence of a current hearing loss disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting the regulatory requirements for hearing loss disability for VA purposes, and a medically sound basis upon which to attribute the post-service findings to the injury in service.   The examiner must provide a complete rationale for all proffered opinions. S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Costello, 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.