Citation Nr: 21009427 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 16-41 257 DATE: February 22, 2021 REMANDED Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran had active duty service from November 1969 to October 1972. This matter is on appeal before the Board of Veterans’ Appeals (Board) from a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) rating decision dated in February 2016. The Veteran testified at a Board hearing in June 2019, and a copy of the transcript has been associated with the record. A September 2019 Board decision was vacated by the United States Court of Appeals for Veterans Claims (CAVC) in September 2020 pursuant to a Joint Motion for Partial Remand (JMPR). As explained below, in compliance with the CAVC order, a remand is necessary. 1. Entitlement to service connection for tinnitus is remanded. The Veteran was afforded a VA examination in July 2016 for his tinnitus. Unfortunately, the negative nexus opinion provided was inadequate. The examiner explained that the Veteran’s Military Occupational Specialty (MOS) had a low probability of noise exposure, and that a line of duty injury or disease was not shown; however, the Veteran is already service-connected for right ear hearing loss, meaning the criteria for an in-service event has already been satisfied. In this regard, the JMPR also noted that the July 2016 examiner did not reconcile her negative nexus opinion with the Veteran’s December 2015 reports of noise exposure, including that he was “exposed to ‘shooting back and forth’ in the jungle during his service,” and “noise exposure from riding as a passenger in ‘deuce and a half’ convoys for a couple of months, as a platoon sergeant in a helicopter unit for 4 months, and as a manger [sic] for an officer club for 6 months (with loud noise from live music).” Additionally, the July 2016 examiner wrote that “a clear nexus cannot be established,” which misrepresents the burden. It only needs to be at least as likely as not that a nexus between noise exposure and tinnitus exists. Similarly, the examiner cited an Institute of Medicine study indicating that “[a] more complete understanding of the mechanisms by which tinnitus is generated will be needed before the existence of delayed-onset of noise-exposure can be confirmed or rejected.” In keeping with the benefit of the doubt standard of proof, a medical principle need not reach scientific consensus to adequately support a grant of VA benefits. Wise v. Shinseki, 26 Vet. App. 517, 532 (2014). Therefore, an adequate opinion must be obtained on remand. The matters are REMANDED for the following action: 1. Obtain a supplemental opinion from a qualified VA examiner regarding the etiology of the Veteran’s tinnitus. If the examiner determines that he or she cannot respond to the Board’s inquiries herein without examining the Veteran, then an examination must be afforded. If an in-person examination is not feasible, then the Veteran should be afforded an examination by other means. (a.) The examiner is advised that the criterion of an in-service event (noise exposure) has already been satisfied, as evidence by the grant of service connection for hearing loss; (b.) The examiner must provide an opinion as to whether it is at least as likely as not (50 percent or greater) that the Veteran’s tinnitus is etiologically related to, incurred in, or caused by the Veteran’s military service, including noise exposure. A complete rationale must be provided for all expressed opinions. A complete explanation for all opinions expressed must be provided. A clearly stated rationale must not be based solely on lack of documentation or records. The reasons for any opinion must include a discussion of the relevant evidence. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why. S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Smith, 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.