Citation Nr: 21012665 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 17-26 178 DATE: March 4, 2021 REMANDED Entitlement to service connection for the Veteran’s bilateral hearing loss is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty from January 1973 to January 1978. This matter comes before the Board of Veterans’ Appeals (“Board”) on appeal from August 2016 rating decision of the Department of Veterans Affairs (“VA”) Regional Office (“RO”). The Board remanded the matter in March 2020 and directed the RO to obtain an opinion regarding the nature and etiology of the Veteran’s bilateral hearing loss. Hence, a medical opinion was obtained in November 2020. However, the Board finds the opinion inadequate for deciding the issue on appeal. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). Regrettably, the Board concludes that further remand is necessary in this matter. Entitlement to service connection for the Veteran’s bilateral hearing loss is remanded. In his February 2014 and May 2016 statements in support of claim, the Veteran stated that he was a weapon mechanic of different aircrafts and was exposed to high levels of noises. The Veteran also requested to review his in-service medical record from May 1974 for deciding the issue. The Board notes that the service treatment records from May 1974 and May 1975 specify that the Veteran was issued earplugs, which indicate the Veteran was exposed to high levels of noises. Pursuant to March 2020 remand, the Veteran was afforded a VA examination and a medical opinion was obtained in November 2020 for determining the nature and etiology of the Veteran’s bilateral hearing loss. The examiner opined that the Veteran’s bilateral hearing loss is less likely than not related to his military service. The examiner referenced the Veteran’s normal hearing at his separation audiogram and noted that the Veteran’s military occupational specialty, as Administrative Specialist, placed him at low risk for exposure to hazardous noise levels. The examiner stated that there is no medical or scientific data that can support later onset of hearing loss and concluded that the Veteran’s hearing loss should be the result of aging. The Board finds the November 2020 medical opinion inadequate for deciding the issue on appeal because in March 2020 remand, the examiner was asked to discuss the Veteran’s contentions regarding his noise exposure during service, which the examiner failed to address. Instead, the examiner relied on the Veteran’s military occupational specialty as Administrative Specialist and opined that the Veteran was not exposed to high noises. Whereas, the Board notes that the in-service treatment records from May 1974 and May 1975 indicate that earplugs were issued to the Veteran, which indicate that the Veteran was exposed to high levels of noise. The Board cannot render an informed decision because the medical opinion is inadequate for deciding the issue on appeal. The Veteran’s contention regarding in-service noise exposure which is corroborated by service treatment records is an integral part of the medical opinion. The examiner’s conclusion is in part based on an inaccurate factual premise that the Veteran did not have excessive noise exposure during service, hence a remand is needed for an addendum opinion. The matter is REMANDED for the following actions: 1. Forward the claims file and a copy of this remand to the examiner, who performed the November 2020 examination, or to an appropriate substitute if the examiner is unavailable, for an addendum opinion on the nature and etiology of the Veteran’s bilateral hearing loss. All pertinent symptomatology and findings must be reported in detail. 2. A clear rationale must be provided for all opinions expressed. The examiner is advised to consider the Veteran’s lay statements regarding in-service noise exposure, and the May 1974 and May 1975 service treatment records indicating that earplugs were issued to the Veteran for protection from noise exposure. The Board is asking whether it is “at least as likely as not” that the Veteran’s bilateral hearing loss was incurred in or caused by the reported in-service acoustic trauma instead of certainty from the examiner. The term “at least as likely as not” does not mean “within the realm of possibility.” Rather, it means that the weight of the medical evidence both for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against it. 3. If the examiner finds that the Veteran’s bilateral hearing loss is not related to his service, then the examiner must discuss medically known or theoretical causes of hearing loss and describe how hearing loss which results from noise exposure generally presents or develops in most cases, as distinguished from how hearing loss develops from other causes, in determining the likelihood that current hearing loss was caused by noise exposure in service as opposed to some other cause. If the examiner is unable to provide an opinion without resorting to mere speculation, then the examiner must state this and provide any information needed to make an opinion, if possible. 4. Thereafter, readjudicate the claim on appeal. If the benefit sought remains denied issue the Veteran and his representative a supplemental statement of the case and provide a reasonable opportunity to respond before returning the matter to the Board for further appellate review. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Tariq, Nadeem, Associate Attorney 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.