Citation Nr: 21009633 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 16-40 815A DATE: February 23, 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 from January 1980 to January 1984. This appeal comes to the Board of Veterans’ Appeals (Board) from a January 2016 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO.) In July 2019, the Board denied the issues on appeal. In July 2020, the United States Court of Appeals for Veterans Claims (Court) granted a Joint Motion for Remand (JMR) of the Veteran and the Secretary of Veterans Affairs (the Parties) to vacate and remand the Board’s decision. The issues have now been returned to the Board. Entitlement to service connection for a bilateral hearing loss disability is remanded During service the Veteran’s MOS was that of Torpedoman’s mate. He reported significant noise exposure and drastic changes in air pressure. The Veteran contends he experienced hearing loss and tinnitus due to the changes in air pressure both while firing torpedoes and while serving on a submarine generally, and not solely from noise exposure. The issues on appeal are remanded by the Parties to correct a duty to assist error. Specifically, the Parties agreed that a January 2016 VA examination was inadequate because the examiner only provided an opinion addressing noise exposure and did not provide an opinion as to whether the Veteran’s hearing loss could be attributed to significant air pressure changes. The Parties also agreed that the examination failed to provide a reasoned medical explanation regarding change in air pressure and the absence of a significant threshold shift. The negative opinion did not provide any medical reasoning to enable a Board determination as to whether the Veteran’s hearing loss was caused by drastic changes in air pressure, or whether drastic changes in air pressure would cause a threshold shift from enlistment to separation in the same manner as noise exposure might. The Parties also agreed that on remand “the examiner must be instructed to address a July 2015 audiology note which provides Appellant’s left ear word discrimination score was below 94% at 84%, but states that the test results are not adequate for adjudication purposes.” The Board concluded in the vacated decision that there was no hearing loss in the left ear. However, the JMR notes that this word discrimination score satisfies the definition of hearing loss disability under 38 C.F.R. § 3.385. The JMR states that the Board must obtain a new VA examination; the Board herein complies with the JMR. Entitlement to service connection for tinnitus is remanded The JMR remanded tinnitus as inextricably intertwined with the issue of entitlement to service connection for hearing loss because the VA examiner concluded the Veteran’s tinnitus was at least as likely as not a symptom associated with the hearing loss. Thus, the Veteran’s claim for service connection for bilateral hearing loss has the potential to have significant impact on his claim for service connection for tinnitus. The Board remands the issue in compliance with the JMR. Accordingly, the matters are REMANDED for the following action: 1. Schedule the Veteran for an audiological examination by an appropriate clinician. The examiner should: (a.) Review the July 2015 VA audiology note which provided the Veteran’s left ear word discrimination score at 84 percent. Can the examiner ascertain why these test results would not be adequate for adjudication purposes? (b.) State whether it is at least as likely as not that frequent drastic changes in air pressure aboard a submarine and in the MOS of torpedoman caused the Veteran’s hearing loss. A rationale must be provided to support all opinions. If the opinion relies at all on threshold shifts (or lack thereof) in service, provide a reasoned medical explanation addressing why a significant threshold shift would be expected if the Veteran’s hearing loss was pressure induced, rather than noise induced. LAURA E. COLLINS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Brewer, 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.