Citation Nr: 21014836 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 15-37 385 DATE: March 15, 2021 REMANDED Entitlement to service connection for left ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from March 1968 to February 1971 and from November 1974 to August 1976, to include service in Vietnam. His decorations include the Vietnam Service Medal and the Combat Action Ribbon. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a February 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office in Montgomery, Alabama. In November 2018, the Veteran testified at a Board video-conference hearing before a Veterans Law Judge. A transcript of that hearing has been associated with the record. In July 2019, the Board remanded the Veteran’s claim for service connection for bilateral hearing loss to the agency of original jurisdiction (AOJ) for additional development. In October 2020, after taking further action, the AOJ granted service connection for right ear hearing loss, but confirmed and continued the prior denial of service connection for left ear hearing loss and returned that matter to the Board. In November 2020, the Board wrote the Veteran and his representative to inform them that the Veterans Law Judge who conducted the hearing in November 2018 was no longer employed by the Board. The Veteran was offered the opportunity to testify at another Board hearing, but declined. Although the Board regrets the additional delay, further development is necessary to ensure substantial compliance with the prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to service connection for left ear hearing loss is remanded. In the July 2019 remand, the Board asked the AOJ to provide the record on appeal to an audiologist or other suitably qualified medical professional for purposes of obtaining an opinion with respect to the etiology of the Veteran’s hearing loss. Among other things, the examiner was to address the medical significance, if any, of the fact that the Veteran had an apparent upward puretone threshold shift in the right ear during service, specifically from 0 to 15 decibels at 4000 Hertz. In November 2019, a VA audiologist offered a favorable nexus opinion as to service connection for right ear hearing loss. In reaching that conclusion, the examiner noted that the Veteran’s August 1976 separation examination showed “hearing WNL [within normal limits], bilaterally, with no significant change in hearing except for a 15dB decrease at 4KHz in the right ear.” (Emphasis added.) In so doing, the examiner did not offer an express nexus opinion as to left ear hearing loss. In October 2020, an addendum opinion was procured in which an examiner offered an unfavorable nexus opinion as to service connection for the left ear. The examiner stated that it was “not likely” that the Veteran’s military noise exposure had an effect on his hearing in the left ear. In support of that opinion, the examiner noted that the Veteran’s hearing was within normal limits in the left ear at the time of his August 1976 separation examination, with “no significant shift” in the left ear. Of note, the Veteran’s August 1976 separation examination reflects an apparent upward puretone threshold shift in the left ear during service, from 0 to 10 decibels at 6000 Hertz, as compared to a January 1968 entrance examination. Neither of the aforementioned examiners specifically commented on the medical significance of that apparent shift, if any. As such, an addendum opinion is necessary. 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). This matter is REMANDED for the following action: 1. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 2. After the foregoing development has been completed, make arrangements to provide the record on appeal to the VA examiner who previously offered an opinion in this case in November 2019. The examiner should be asked to again review the record and prepare a supplemental report as to whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that the Veteran’s left ear hearing loss had its onset during, or is otherwise related to, service, to include as due to in-service exposure to noise. In so doing, the examiner must address the medical significance, if any, of the apparent 10-decibel threshold shift in service at 6000 Hertz in the left ear when comparing audiometric test results from January 1968 and August 1976. If the November 2019 examiner is no longer employed by VA or is otherwise unable to provide the opinion(s) requested, arrange to obtain the requested information from another qualified examiner. The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner(s) selected to offer the requested opinion. A complete rationale for all opinions expressed must be provided. 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issue remaining on appeal should be readjudicated based on the entirety of the evidence. If the benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Joseph T. Leonard, Law Clerk 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.