Citation Nr: 21012065 Decision Date: 03/03/21 Archive Date: 03/03/21 DOCKET NO. 16-47 571 DATE: March 3, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from October 1964 to October 1967. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Huntington, West Virginia. The RO denied reopening the claims for service connection for bilateral hearing loss and bilateral tinnitus because the evidence submitted was not new and material. In a January 2020 decision, the Board found that new and material evidence had been submitted sufficient to warrant reopening of the service connection claims. In the same decision, the Board remanded the appeal to the RO for further development. 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives regarding the issues of service connection for bilateral hearing loss and tinnitus. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). In its January 2020 Remand, the Board directed that The examiner should also comment on the concept of a delayed onset hearing loss (i.e., does absence of pertinent complaints and normal audiometry at separation preclude a nexus between the current disability and exposure to noise trauma in service). In a February 2020 VA examination opinion, the VA examiner opined that the Veteran’s hearing loss and tinnitus was not related to his military service, to include military noise exposure. The Board deems this opinion to be inadequate. The examiner was requested to identify the possible causes of hearing loss and explain why or why not based on the totality of the evidence this particular Veteran’s hearing loss is or is not related to noise exposure in service. The examiner did not explain or rationalize why the concept of delayed onset hearing loss is inapplicable to the Veteran’s case. To that end, the Board must seek an addendum opinion that considers delayed onset hearing loss and explains why it is or is not applicable to the Veteran’s hearing loss and tinnitus, and a remand is required. The matters are REMANDED for the following action: 1. The AOJ shall associate the Veteran’s outstanding VA medical treatment records with his file. 2. Then, the AOJ should seek a medical opinion from an otolaryngologist or similarly qualified specialist that addresses the etiology of the Veteran’s bilateral hearing loss and tinnitus. The claims file must be made available to and be reviewed by the examiner. The examiner should specifically indicate whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s sensorineural bilateral hearing loss and tinnitus occurred in or is otherwise etiologically related to the Veteran’s military service, to include his exposure to hazardous noise during his active duty service. The examiner is asked to specifically comment on the concept of a delayed onset hearing loss (i.e., does absence of pertinent complaints and normal audiometry at separation preclude a nexus between the current disability and exposure to noise trauma in service). The examiner is asked to identify the possible causes of sensorineural hearing loss and explain why or why not based on a totality of evidence (including consideration of the causes of hearing loss and the fact that tinnitus has been deemed due to acoustic trauma) this particular Veteran’s sensorineural hearing loss and tinnitus is/are or is/are not related to noise exposure in service, to include the concept of delayed onset hearing loss. The examiner should specifically consider the effects, if any, of the Veteran’s tour of duty working near an air strip with C-130’s taking off and landing. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 3. Thereafter, readjudicate the claims. If any benefit sought on appeal remains denied, furnish the Veteran and his representative, if any, a supplemental statement of the case and an appropriate period of time to respond. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael J. O’Connor 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.