Citation Nr: 21009841 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 15-14 572 DATE: February 23, 2021 REMANDED Service connection for hearing loss. Service connection for tinnitus.   REASONS FOR REMAND The Veteran served on active duty from October 1966 to October 1968. This matter is on appeal from a June 2012 rating decision. In May 2019, the Board reopened a previously denied claim of service connection for hearing loss. At that time, the Board also remanded the reopened claim and the tinnitus claim for additional development. 1. Service connection for hearing loss. 2. Service connection for tinnitus A VA examiner in January 2020 opined that the Veteran’s hearing loss and tinnitus were less likely than not related to service. The VA examiner based this opinion on in-service audiometer results within normal limits bilaterally with no hearing loss noted. In addition, the examiner found no significant threshold shifts noted when in-service results were compared. The examiner also considered the Veteran’s specialty during service and his report of use of explosives as a trained combat engineer. As for tinnitus, this VA examiner reasoned that the Veteran’s tinnitus was likely a symptom associated with hearing loss. The Board finds that this opinion is incomplete. First, the examiner did not appear to account for the change in audiometric standards during the time of the Veteran’s service and the present day. In July 1966, the International Standards Organization American National Standards Institute (ISO-ANSI) standards were adopted. Historically, since the ISO-ANSI standards were adopted as of November 1, 1967, any service department audiograms conducted prior to November 1967 will be converted from ASA to ISO-ANSI units. Service department audiometric test results prior to January 1, 1967, are presumed to be reported in ASA standards, and that audiometric test results since December 31, 1970, were reported in ISO-ANSI standards. With this in mind, the Veteran’s October 1966 entrance examination does not specify which standard was used. Assuming it used the ASA standard, his hearing thresholds were as follows upon audiometer testing (with the results converted to ISO-ANSI in parentheses): HERTZ 500 1000 2000 3000 4000 RIGHT 10 (25) 0 (10) 0 (10) -- 0 (5) LEFT 0 (15) 0 (10) 0 (10) -- 0 (5) At his October 1968 separation examination, his hearing acuity was tested using the ASA standard. His thresholds were as follows (with the results converted to ISO-ANSI in parentheses): HERTZ 500 1000 2000 3000 4000 RIGHT -10 (5) -10 (0) -5 (5) -5 (5) -5 (0) LEFT -10 (5) -10 (0) -5 (5) -5 (5) -5 (0) Second, the January 2020 VA examiner’s opinion is incomplete as the Veteran has reported a history that he first noticed symptoms of hearing loss proximate in time to service. For example, in an April 2015 statement, he wrote that when he returned from service, he was always accused of playing the radio and television very loudly, not always hearing alarm clocks, and not hearing certain sounds. His wife wrote similarly in a May 2012 statement that when he came home, she remembered his mother remarking about how loudly he would talk on the phone. Also, he was difficult to get up in the mornings as he would sleep through his alarm. Because the VA examiner did not consider this lay testimony, which is relevant evidence that he first manifested symptoms proximate in time to service, the opinion is inadequate Thus, a new opinion by a specialist is warranted. The matters are REMANDED for the following action: Forward the claims file to an otolaryngologist (ENT) for a medical opinion as to the hearing loss and tinnitus claims. After review of the file, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or better) that the Veteran’s hearing loss and/or tinnitus had their onset during, or are otherwise related to, his military service. A complete rationale should be provided for any opinion reached. Consideration should be given to (1) the ASA to ISO/ANSI testing conversions; (2) the Veteran’s combat service in Vietnam; and (3) the lay statements from the Veteran and his wife. If the absence of medical evidence is a component of the opinion, the medical importance of this should be explained. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Bosely, 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.