Citation Nr: 21012809 Decision Date: 03/05/21 Archive Date: 03/05/21 DOCKET NO. 19-26 987 DATE: March 5, 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 March 1962 to March 1966. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a September 2018 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In January 2021, the Veteran testified in a videoconference hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing is included in the record and has been reviewed. 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends that his current hearing loss is the result of hazardous noise exposure in service. In August 2018, a VA opinion for the Veteran’s hearing loss was completed. The examiner gave a negative opinion that the Veteran’s hearing loss was due to military service. The examiner noted that the entrance and separation audiograms were normal. See August 2018 VA Examination. The examiner also stated that the Veteran did not complain of hearing loss while in active duty service. Id. The August 2018 examiner failed to consider the Veteran’s lay statements and pertinent medical notes in rendering the opinion. Notably, the examiner did not discuss the Veteran’s threshold shift from the beginning to end of his service. The physician also failed to consider the Veteran’s VA records which included consistent reports of hearing loss as well as the Veteran’s contentions that military noise exposure caused his hearing loss. See August 2019 CAPRI Records. Finally, the Veteran and his spouse’s reports of the presence of perceived hearing loss shortly after discharge have been found to be credible. Any etiology opinion must take into account the Veteran’s credible medical history. The Board finds that the VA medical opinion is inadequate as it relies on a rationale that hearing was within normal limits during active duty with no significant threshold shifts during active service. According to 38 C.F.R. § 3.385, service connection for a current hearing disability is not precluded where hearing was within normal limits at separation. See Hensley v. Brown, 5 Vet. App. 155, 159-60 (1993). The VA medical opinion provider also failed to address the allegations of in-service difficulty hearing, which runs afoul of the Court’s recent holding in Miller v. Wilkie, 32 Vet. App. 249 (2020) (an “examiner must address the Veteran’s lay statements to provide the Board with an adequate medical opinion”). As such, a remand is necessary for an addendum opinion to discuss the nature and etiology of the Veteran's bilateral hearing loss. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (Once VA undertakes the effort to provide an examination, it must provide an adequate one). The matter is REMANDED for the following action: 1. Obtain an addendum medical opinion from a medical professional with appropriate expertise. The examiner should review the Veteran's claims file. If the examiner determines that an opinion cannot be provided without an examination, the Veteran should be scheduled for one. Based on a review of the record, and a new examination if necessary, the examiner must address the following: Whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's bilateral hearing loss is related to his active service or is caused by or aggravated by military service. The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. The examiner is advised that normal hearing at separation is not sufficient to serve as a rationale as 38 C.F.R. § 3.385 establishes that service connection for a current hearing disability is not precluded where hearing was within normal limits at separation In all opinions rendered, the examiner is advised that the Veteran is competent to report his symptoms of bilateral hearing loss from in-service injury to the present. The examiner must specifically consider and discuss the Veteran's in-service exposure to acoustic trauma and continuity of symptomology since service. The examiner must also address the Veteran and his spouse’s credible testimony that the Veteran had perceived hearing loss shortly after discharge. The opinion and rationale should reflect such consideration. See January 2021 Hearing Transcript ; see also January 2021 Correspondence; see also August 2019 CAPRI Records. The examiner must specifically address, and reconcile to the extent possible, his or her medical opinion with the August 2018 VA medical opinion. If the medical professional cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the medical professional shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board V. Schmidt 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.