Citation Nr: 21010319 Decision Date: 02/24/21 Archive Date: 02/24/21 DOCKET NO. 16-58 530 DATE: February 24, 2021 REMANDED 1. Entitlement to service connection for left ear hearing loss is remanded. 2. Entitlement to service connection for right ear hearing loss is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty from December 9, 1990 to January 8, 1991. These matters are before the Board of Veterans’ Appeals (Board) on appeal of an October 2015 Department of Veterans Affairs (VA) rating decision. In May 2019, a videoconference hearing was held before the undersigned; a transcript is in the record. In November 2019, the Board remanded these matters for additional development and granted service connection for tinnitus. A June 2020 rating decision implemented the grant of service connection for tinnitus. 1. 2. Entitlement to service connection for right and left ear hearing loss. The November 2019 Board remand ordered a VA examination to confirm whether he has a left ear hearing loss disability and to determine the etiology of his hearing loss in each ear. If a hearing loss disability in either ear was determined to be unrelated to service, the examiner was asked to identify the alternate etiology that was considered to be more likely. On October 2020 VA audiological examination, mixed hearing loss in the right ear and sensorineural hearing loss in the left ear were diagnosed. The examiner stated that a right ear mixed hearing loss has some medical involvement that would require ENT evaluation to determine the etiology. While the examiner indicated additional examination is required to determine the etiology of the right ear mixed hearing loss, there was no follow-up examination by an ENT clinician. Furthermore, the examiner opined that the etiology of bilateral hearing loss cannot be determined, but then opined “etiology of military noise exposure can be effectively ruled out by a review of medical records,” stating bilateral hearing loss developed approximately 22 years after separation from service. However, the examiner did not identify the alternate etiology for the left ear hearing loss that is considered to be more likely. The October 2020 VA opinion is non-responsive to the Board’s remand directives, and corrective action is necessary. See Stegall v. West, 22 Vet. App. 268 (1998). The matters are REMANDED for the following: Arrange for the Veteran’s record to be forwarded to an appropriate clinician (in otology or otolaryngology (because the October 2020 examiner indicated such is needed), not an audiologist), for review and a medical advisory opinion regarding the etiology of his right and left ear hearing loss. [If further examination is deemed necessary for an opinion sought, it should be arranged.] The consulting provider should: (a.) Identify the likely etiology for the Veteran’s hearing loss in each ear. Specifically, is it at least as likely as not (a 50% or greater probability) that the disability is etiologically related to his service (was incurred therein), including as due to his acknowledged exposure to hazardous level noise therein. The opinion should specifically address the “medical” involvement noted by the October 2020 examiner. (b.) If hearing loss in either ear is determined to be unrelated to service (and exposure to noise therein), identify the etiology for the hearing loss that is considered to be more likely (and explain why that is so). All opinions must include rationale that cites to supporting factual data and medical principles, and includes comment on (expresses agreement or disagreement with) the opinions by the October 2020 consulting provider. GEORGE R. SENYK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Naumovich, 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.