Citation Nr: 21009869 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 14-31 114A DATE: February 23, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Air Force from October 1970 to October 1974. In March 2020, the Board of Veterans’ Appeals (Board) remanded the issue of entitlement to service connection for bilateral hearing loss for further development. Specifically, the Board instructed the regional office (RO) to obtain an addendum opinion pertaining to the Veteran’s claim. Upon review of the record, the Board finds that the claim must be remanded. The Board sincerely regrets the additional delay caused by this remand but wishes to assure the Veteran that it is necessary for a full and fair adjudication of his claim. Bilateral hearing loss The Board finds that a new examination and etiological opinion is warranted for the Veteran’s claim. The Veteran contends his bilateral hearing loss is related to service. An addendum opinion was associated with the Veteran’s claims file in March 2020, in which the examiner concluded the Veteran’s bilateral hearing loss was less likely than not related to service. Although the examiner acknowledged that the Veteran had conceded hazardous noise exposure, she found that service treatment records did not show significant threshold shifts upon separation. She cited the Institute of Medicine (IOM) study for her rationale of the “extremely unlike[lines]” of delayed onset of hearing loss, while noting that definitive studies to address such an issue had not been performed. The Board finds the March 2020 VA opinion to be inadequate. The examiner heavily relied on the IOM study that is ultimately inconclusive as to the issue of delayed onset hearing loss. See McCray v. Wilkie, 31 Vet. App. 243 (2019). Moreover, she also focused her attention on the lack of significant threshold shifts in service; however, the proper inquiry is whether the Veteran’s current hearing loss is related to the Veteran’s conceded in-service noise exposure (i.e., noise exposure that was so significant that an October 2012 examiner found was the likely cause of the Veteran’s tinnitus). See Hensley v. Brown, 5 Vet. App. 155, 164 (1993). Finally, the March 2020 examiner did not provide an actual etiology for the Veteran’s bilateral hearing loss. Therefore, remand for a new examination is needed to adequately address the likely etiology of the Veteran’s bilateral hearing loss. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 3014 (2008). The matters are REMANDED for the following action: 1. Assist the Veteran in associating with the claims file updated treatment records. 2. Schedule an examination to determine the nature and etiology of the Veteran’s bilateral hearing loss. The claims file should be made available to the examiner for review. Based on review of the record, and the examination of the Veteran, the examiner should respond to the following: Is it at least as likely as not (i.e., at least a 50 percent probability) that the Veteran’s bilateral hearing loss had its onset in or is related to service? The examiner is advised that exposure to loud noise in service is CONCEDED and that an October 2012 VA examiner found to be the likely cause of the Veteran’s service-connected tinnitus. The examiner is advised that the 2005 IOM study is inconclusive regarding delayed-onset hearing loss and is asked to conduct a search of the relevant literature prior to opinion. In addition, the examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that his reports must be taken into account in formulating the requested opinion. The examiner must provide the rationale for all proffered opinions. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify   the additional information that is needed. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. L. Park, 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.