Citation Nr: 21021916 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 17-01 065 DATE: April 14, 2021 REMANDED The claim for service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran had active service from January 1962 to December 1965. The Veteran testified at an August 2018 Board hearing before the undersigned Veterans Law Judge (VLJ). The transcript has been obtained and associated with the claims file. The claim was previously remanded by the Board in November 2020 for additional development pursuant to an April 2020 Memorandum Decision. The Board finds that further development is warranted prior to adjudication. Stegall v. West, 11 Vet. App. 268 (1998). The claim for service connection for bilateral hearing loss is remanded. As stated in the November 2020 Board remand, the April 2020 Memorandum Decision determined that the Board erred by failing to return the July 2015 VA examination report for clarification. Specifically, the July 2015 VA examiner determined that the first evidence of hearing loss arose in 2015 and therefore, hearing loss was not likely caused by or related to service. However, the record reflected at least two receipts of hearing aids from early 2000 and that the Veteran’s wife, who he married 5 years after his military service, noted the Veteran’s hearing loss approximately 2 years into their marriage. As such, it was found to be unclear how the VA examiner determined that the first evidence of hearing loss did not arise until 2015. Given this discrepancy and pursuant to the Memorandum Decision, a remand was necessary for additional development. Pursuant to the Board remand, the Veteran was afforded a new VA examination in December 2020 where a diagnosis of bilateral sensorineural hearing loss as defined by the VA was confirmed. However, the VA examiner determined the following: The Veteran reported 4 years of service in the Air Force. Reviewing the Veteran’s medical records, DD-214, and MOS of AGE aircraft mechanic, which has a high probability for hazardous noise exposure. Hearing testing at enlistment in 1962 showed normal hearing levels. Hearing testing at separation in1965, showed normal hearing levels for both ears. Reviewing the Veteran’s medical records showed no hearing loss at the time of separation. Given the normal hearing at discharge and the lack of any changes in hearing during service, it is less likely as not that the [V]eteran’s hearing loss was caused by or a result of his military noise exposure. The Veteran’s hearing loss is at least as likely as not related to presbycusis hearing loss. The Veteran’s hearing loss is less likely a result of military noise exposure. According to a January 2021 addendum opinion, the VA examiner further stated, “Yes the Veteran is using hearing aids to treat his hearing loss. He did not use them in the Air Force. He did not [start] using the hearing aids until 2000 which is 35 years after his time in the Service. Therefore, the Veteran’s hearing loss is less likely a result of military noise exposure.” Despite the December 2020 VA opinion and January 2021 addendum opinion, the Board finds another remand is required for an adequate etiological opinion. Where VA provides the veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Veteran contends his bilateral hearing loss stemmed from noise exposure during military service. The Veteran’s hazardous noise exposure during service has been conceded. He testified at the Board hearing that at separation he was not provided with an examination to test his hearing, only a questionnaire, and although his hearing loss started many years prior to his VA examination, it was noted in the report that it was observed in 2015. Furthermore, the statement of the Veteran’s wife, who he married 5 years after his military service, noted the Veteran’s hearing loss approximately 2 years into their marriage, was not discussed in the VA examiner’s opinions. Likewise, the Veteran credibly testified that he first bought hearing aids in the early 1980s. If hearing loss as defined by 38 C.F.R. § 3.385 is not shown in service or at separation from service, service connection may still be established if medical evidence shows that it is actually due to incidents during service. Hensley v. Brown, 5 Vet. App. 155, 159-60 (1993). Rather, according to the December 2020 VA opinion and the January 2021 VA audiological examination report, the VA examiner focused solely on the absence of hearing loss at discharge, without addressing the effects of the Veteran’s in-service noise exposure, post-service occupational/recreational noise exposure, and the lay statements of the Veteran and his wife. It is noted that the Veteran disputed that any audiometric testing was ever conducted at separation, explaining that he was discharged shortly before Christmas and did not go through a rigorous screening. Accordingly, a new addendum opinion is needed. The matters are REMANDED for the following action: Obtain an addendum opinion to those obtained in December 2020 and January 2021. If an opinion cannot be provided without a physical examination, one should be provided. The VA examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) the Veteran’s current hearing loss either began in or was otherwise caused by his military noise exposure. Why or why not? In doing so, the VA examiner is asked to specifically consider and address the lay statements of the Veteran and his wife regarding his treatment (specifically, the use of hearing aids around 2000) and continuity of symptomatology from service to the present. The VA examiner should also review the memorandum decision (see CAVC Decision dated 4/13/2020 p. 59-65) for an explanation as to why the 2015 VA examination was found to be inadequate, as well as the Veteran’s credible testimony at his August 2018 Board hearing. (Continued on the next page)   The examiner is informed that evidence of a current hearing loss disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting the regulatory requirements for hearing loss disability for VA purposes, and a medically sound basis upon which to attribute the post-service findings to the injury in service. See Hensley v. Brown, 5 Vet. App. 155, 159 (1993). MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board H. Yoo, 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.