Citation Nr: 21012757 Decision Date: 03/05/21 Archive Date: 03/05/21 DOCKET NO. 17-30 983 DATE: March 5, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1966 to January 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a December 2016 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing conducted by the undersigned Veterans Law Judge in October 2019. A transcript of the hearing has been associated with the Veteran’s VA claims file. In February 2020, the Board remanded the Veteran’s claim for further evidentiary development. Upon review, the Board finds that there has not been substantial compliance with its remand directives. Although the Board regrets further delay, remand is necessary to ensure compliance with previous remand directives and proper development. When there is not substantial compliance with Board remand requests, the Board errs as a matter of law when it does not ensure compliance. Stegall v. West, 11 Vet. App. 268 (1998). The Veteran contends that his bilateral hearing loss stems from his service. Specifically, he asserts he was exposed to acoustic trauma from weapons and tanks in service. See June 2017 Correspondence. A VA audiological examination was conducted in October 2016. The examiner noted that he could not say without speculation what thresholds were prior to active duty as no service treatment records (STRs) were available for review at the time of the exam. The VA examiner provided an addendum opinion in November 2016 after STRs were associated with the Veteran’s claim file. The VA examiner opined hearing loss was less likely than not related to military noise exposure as thresholds were better on separation than they were on entrance. He noted hearing within normal limits bilaterally on entrance, except for a mild loss 4000Hz to 6000Hz for the left ear; and hearing within normal limits bilaterally on separation, with no significant threshold shifts. During the October 2019 Board hearing, the Veteran testified that he was exposed to hazardous noise from driving tanks and from firing weapons in service without ear protection. See October 2019 Hearing Transcript. He testified to unloading ammunition right behind the line of tanks that were firing. Id. In addition, hazardous noise exposure has been acknowledged and reported. See July 2020 Statement of the Case. As part of the February 2020 remand, the Board requested that outstanding VA treatment records and an addendum medical opinion be obtained. The examiner was specifically directed to discuss the impact of in-service and post-service noise exposure on the current hearing loss disability and to address the Veteran’s lay statements describing in-service noise exposure from weapons and tanks. Pursuant to the Boards remand, records from the Des Moines VA were obtained and associated with the claims file and a March 2020 addendum medical opinion was obtained; however, the Board finds that the medical opinion failed to substantially comply with the Board’s February 2020 remand instructions. Notably, the sole rationale was again based on no significant permanent shift in hearing thresholds other than improvement from enlistment to separation. In addition, the VA examiner did not discuss the impact of in-service and post-service noise exposure on the current hearing loss disability as requested. Thus, as there has not been substantial compliance with the prior remand directives an addendum opinion is required. Stegall, 11 Vet. App. at 271. The matters are REMANDED for the following action: 1. Obtain an addendum medical opinion from an appropriate clinician to determine the nature and likely etiology of the Veteran’s bilateral hearing loss. The Veteran’s claims folder must be made available to the examiner. All diagnostic testing deemed to be necessary by the examiner should be accomplished. Following the examination and a review of the relevant records the examiner should: (a) Opine as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s bilateral hearing loss originated during or is otherwise etiologically related to his military service and explain why. (b) In rendering an opinion, the examiner should discuss the impact of any in-service and post-service noise exposure on the current hearing loss disability. (c) In rendering an opinion, the examiner should address the Veteran’s lay statements regarding acoustic trauma in service, to include his statements in the June 2017 correspondence and his testimony at the October 2019 Board hearing. (Continued on the next page)   2. Once each of the above requests has been completed, to the extent possible, readjudicate the appeal. Jenna Brant Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Aston, 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.