Citation Nr: 21022574 Decision Date: 04/16/21 Archive Date: 04/16/21 DOCKET NO. 19-05 998 DATE: April 16, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1953 to September 1956 and from June 1958 to June 1964. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously remanded by the Board in August 2020 and February 2021 for further development. In the August 2020 remand, the Board’s directives required that the AOJ arrange for a VA medical opinion with an interview of the Veteran to determine the likely cause of his bilateral hearing loss. The examiner was instructed to ask the Veteran when his hearing impairment began. However, on remand the AOJ merely obtained a medical opinion in November 2020. The Veteran was not present nor interviewed by the November 2020 VA examiner, who stated that he could not find any lay statements about when the Veteran first noted hearing loss. In February 2021, the Board again remanded the claim, as there was not substantial compliance with the August 2020 remand instructive to interview the Veteran to determine when his hearing impairment began. However, when the RO attempted to schedule the Veteran for a new examination pursuant to the February 2021 Board Remand, the Veteran cancelled the examination, stating that he was too old and does not see any point in scheduling. See February 2021 Correspondence. The Veteran is 85 years old. The Board notes that due to the COVID-19 pandemic, the Veteran may have been hesitant to appear for an in-person examination. As such, on remand he should be asked to submit a written statement describing his history of hearing loss symptoms, to include when they began. Then, an addendum medical opinion should be obtained, as described below. The matter is REMANDED for the following action: 1. Obtain copies of the Veteran’s updated VA treatment records. 2. Ask the Veteran to submit a written statement describing his history of hearing loss symptoms, to include when they began. 3. Next, arrange for an appropriate examiner to review the Veteran’s file and provide a medical opinion as to the etiology of his hearing loss. The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's hearing loss had its clinical onset during active service is related to his in service noise exposure. In providing this opinion, the examiner should consider the following: • The Veteran’s history of being exposed to excessive noise for prolonged periods of time during his active duty. See February 2019 VA Form 9. His Military Occupation Code (MOS) was that of a tractor operator and a construction machine operator. See Form DD 214. He reported that he was exposed to noise during service when he operated heavy equipment without hearing protection; he stated that his right ear was next to the exhaust on one of these machines. See March 2018 CAPRI Medical Record. He also stated that he was exposed to noise as a member of the rifle team as a right handed shooter. See id. He reported that they operated for 12 hours a day at Camp Wolters in Texas. • The audiological testing conducted on the service separation examination dated in May 1964, converted from ASA to ISO-ANSI, showing puretone thresholds, in decibels, as follows: For the right ear, 25 decibels at 500 Hertz, 20 decibels at 1000 Hertz, 20 decibels at 2000 Hertz, N/A decibels at 3000 Hertz, and 15 decibels at 4000 Hertz; and for the left ear, 25 decibels at 500 Hertz, 20 decibels at 1000 Hertz, 20 decibels at 2000 Hertz, N/A decibels at 3000 Hertz, and 20 decibels at 4000 Hertz. • The Veteran’s statement on VA examination in October 2018 that he had experienced mostly constant tinnitus since 1964; and • Any written statements provided by the Veteran, pursuant to this Remand, describing his history of hearing loss symptoms, to include when they began. * If a negative opinion is provided, the examiner may not solely rely on the absence of medical evidence of hearing loss in STRs and must consider the Veteran’s lay statements regarding when his hearing impairment began, if obtained. A complete rationale must be provided for all opinions expressed. P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Mohammad 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.