Citation Nr: 21011057 Decision Date: 02/26/21 Archive Date: 02/26/21 DOCKET NO. 15-20 765 DATE: February 26, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus, to include as secondary to hearing loss, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1982 to October 1989. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of March and June 2012 rating decisions by a Department of Veterans Affairs (VA) Regional Office (RO). In February 2019, the Board remanded the Veteran’s claim for additional development. The case is once again before the Board. 1. Entitlement to service connection for bilateral hearing loss is remanded. When the Board remanded the Veteran’s claim in February 2019, it asked for a new medical opinion and directed the examiner to address the Veteran’s lay statements and explain the impact of the Veteran’s noise exposure during service. After reviewing the Veteran’s electronic claims folder, the examiner observed that (1) the Veteran’s entrance and exit audiograms showed no significant threshold shifts and (2) hearing loss from acoustic trauma occurs immediately after exposure. Putting those two together, he opined that the Veteran’s hearing loss is less likely than not related to his service. Nowhere in the opinion does the examiner address the Veteran’s lay statements as directed by the Board. They are not listed in the evidence comments or mentioned in the rationale. What’s more, the examiner noted that the Veteran worked as an aviation maintenance administration man with a low probability of hazardous noise exposure during service. But as pointed out by the Veteran’s representative, the Veteran’s Naval Enlisted Classification (NEC) during service was AMS (Aviation Structural Mechanic), which carries a high probability of hazardous noise exposure. Because the examiner based his opinion, in part, on an inaccurate factual premise and did not substantially comply with the Board’s remand directives, remand is required for an addendum medical opinion. Reonal v. Brown, 5 Vet. App. 458, 461 (1993); Stegall v. West, 11 Vet. App. 268, 271 (1998). Remand is further warranted for the examiner to consider new medical evidence added to the file. In the Veteran’s February 2021 Informal Hearing Presentation (IHP), his representative cites two studies supporting the Veteran’s claim. VA received this new evidence after the examiner submitted his opinion, meaning that he could not have considered it. Accordingly, remand is also warranted to obtain an addendum medical opinion that adequately considers the relevant and potentially favorable medical evidence of record. 2. Entitlement to service connection for tinnitus, to include as secondary to hearing loss, is remanded. In April 2012, the examiner opined that the Veteran’s tinnitus is at least as likely as not a symptom associated with his hearing loss. As a result, the Board finds that the record reasonably raises the issue of secondary service connection for tinnitus secondary to hearing loss. See Robinson v. Shinseki, 557 F.3d 1355, 1361 (Fed. Cir. 2009). Because a decision on the Veteran’s hearing loss claim could significantly impact his tinnitus, the issues are inextricably intertwined, and remand of both is required. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). Finally, as the case is being remanded for additional development, any outstanding VA treatment records should be associated with the claims file. See Bell v. Derwinski, 2 Vet. App. 611, 613 (1992) (per curiam). The matters are REMANDED for the following action: 1. Obtain all outstanding VA treatment records and associate them with the claims file. 2. Then, arrange for an appropriate healthcare provider to review the Veteran’s claims file and provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s hearing loss had its clinical onset during service or is due to an event or incident of the Veteran’s period of active service. In the opinion, the examiner is asked to do the following: (i) address the Veteran’s lay statements in the August 2012 Notice of Disagreement and the June 2015 VA Form 9 and explain the impact, if any, of the Veteran’s noise exposure in the military due to his military occupational specialty (MOS); and (ii) address the studies cited by the Veteran’s representative in the February 2021 IHP. If the reviewing health care provider finds that physical examination or telehealth interview of the Veteran and/or diagnostic testing is necessary, such should be accomplished. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. 3. After undertaking any additional development deemed appropriate and giving the Veteran full opportunity to supplement the record, adjudicate the Veteran’s pending claim in light of any additional evidence added to the record. If any benefit sought on appeal remains denied, the Veteran and his representative should be furnished with a Supplemental Statement of the Case and be afforded the applicable opportunity to respond before the record is returned to the Board for further review. M. Donohue Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Canedy, 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.