Citation Nr: 21010483 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 09-26 900 DATE: February 25, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from April 1979 to September 1989. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2008 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Fort Worth, Texas. In May 2014, the Veteran testified before the undersigned at a hearing. A transcript of her testimony has been associated with the claims file. The Board most recently remanded this matter for additional development in February 2017. Subsequently, the Board issued a decision denying entitlement to service connection for bilateral hearing loss in September 2019. The Veteran timely appealed this decision to the Court of Appeals for Veterans Claims (Court). While her appeal was pending before the Court, however, the parties entered into a Joint Motion for Remand (JMR). Pursuant to the JMR, the parties agreed that the Board erred in its September 2019 decision to the extent that it relied on an inadequate VA medical opinion and by failing to sufficiently address the Veteran’s lay statements regarding the onset of her hearing loss. Consistent with the terms of the JMR, the Court vacated the Board’s September 2019 decision and remanded the claim for additional development. The matter now returns to the Board. Having carefully considered the terms of the JMR, the Board finds that remand is necessary to obtain a new VA medical opinion with respect to the etiology of the Veteran’s hearing loss. As set forth in the JMR, the RO obtained a VA addendum opinion in April 2017. The April 2017 VA examiner ultimately offered a negative nexus opinion, which was based in part on the absence of in-service treatment records showing hearing loss on enlistment and separation. More specifically, the examiner’s opinion stated that the Veteran’s enlistment audiogram from 1979 and separation audiogram from 1989 showed audiometric thresholds within normal limits. However, the examiner’s opinion was based on an inaccurate factual premise. To that end, the examiner referenced a separation examination from 1989 that does not exist. Indeed, the record indicates that the Veteran waived her separation medical examination in September 1989. Accordingly, remand is necessary to obtain a new VA medical opinion that accounts for the absence of a separation examination. See Barr v. Nicholson, 21 Vet. App. 303, 311; Reonal v. Brown, 5 Vet. App. 458, 461 (1998) (holding that a medical opinion based upon an inaccurate factual premise has no probative value). The matter is thus REMANDED for the following action: Obtain an addendum medical opinion addressing the nature and etiology of the Veteran’s bilateral hearing loss. The entire claims file, to include a copy of this remand, must be furnished to the examiner. The examiner must review the claims file in its entirety and acknowledge such review in his or her examination report. Based on a review of the record, the examiner should opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral hearing loss had its onset during military service or is otherwise etiologically related to her service, to include noise exposure during service. The examiner is reminded that the absence of contemporaneous service treatment records, alone, is an insufficient basis for a negative medical nexus opinion. In doing so, the examiner should also address the possibility of delayed onset hearing loss following acoustic trauma, discuss causes of hearing loss, and describe how hearing loss that results from noise exposure generally presents or develops, in determining the likelihood that any current hearing loss was caused by noise exposure in service. The examiner must also address the Veteran’s lay statements regarding her employment at an airport following service, including her statements that she discovered that she had some hearing loss in 1990. A complete rationale is required for any opinions rendered by the examiner. All opinions should be based on examination findings, historical records, and medical principles. (Continued on the next page)   If the requested opinions cannot be provided without resorting to mere speculation, the examiner should so state but, more importantly, explain why an opinion cannot be provided without resorting to speculation, as merely stating this will not suffice. M. Tenner Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Rademacher, 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.