Citation Nr: 21022599 Decision Date: 04/16/21 Archive Date: 04/16/21 DOCKET NO. 18-50 687 DATE: April 16, 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 Army from June to October 1969, with additional service in the Army Reserve. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2018 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In October 2020, the undersigned conducted a hearing via videoconference. A transcript of the hearing has been associated with the claims file. This matter has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.800(c). Service Connection Generally, the Veteran asserts that service connection is warranted for bilateral hearing loss incurred during his active service. He reports that he sought treatment for hearing loss from civilian doctors approximately 30 years prior to seeking VA treatment for the first time in 2017, although those treatment records have since been destroyed. He also argues that his hearing loss is related not only to his active duty service between June and October 1969, but also his Reserve service. To that end, he argues that his hearing loss is related to monthly inactive duty for training (INACDUTRA) and annual two-week active duty for training (ACDUTRA) periods, during which time he launched grenades and shot rifles without hearing protection at military drills. For VA purposes, impaired hearing is considered a disability when auditory thresholds at any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater, when auditory thresholds for at least three of those frequencies are 26 decibels or greater, or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. The evidence indicates that the Veteran currently has a hearing loss disability for VA purposes. The Veteran’s September 1968 enlistment examination revealed pure tone thresholds, in decibels, at the following frequencies: Ear 500 Hertz 1000 Hertz 2000 Hertz 3000 Hertz 4000 Hertz Right (25) (15) (25) X (40) Left (20) (10) (10) X (30) The Board notes that, based on recent historical research of service audiometric practices, service department audiometric tests prior to January 1, 1967, were generally conducted using American Standards Association (ASA) units. For service department audiograms conducted after December 31, 1970, it is assumed the standards set by the International Standards Organization-American National Standards Institute (ISO-ANSI) were used. However, between January 1, 1967, and December 31, 1970, some service department audiograms were recorded in ISO-ANSI units, whereas others were recorded using ASA units. As the September 1968 enlistment examination report affirmatively indicates that the audiogram data are in ASA units, the Board has converted the data to ISO-ANSI units by adding 15 decibels to the ASA units at 500 Hertz, 10 decibels to the ASA units at 1000 Hertz, 2000 Hertz, and 3000 Hertz, and 5 decibels to the ASA units at 4000 Hertz. The conversion is reflected in the parentheses above. While the Veteran’s right ear hearing acuity met the VA definition of a hearing loss disability under 38 C.F.R. § 3.385 at his enlistment examination, his left ear did not and is presumed to have been sound at entrance. In October 1969, the Veteran underwent a separation examination prior to his release from active duty. Pure tone thresholds, in decibels, were as follows at these frequencies: Ear 500 Hertz 1000 Hertz 2000 Hertz 3000 Hertz 4000 Hertz Right 0 (15) -5 (5) 0 (10) X 5 (10) Left 5 (20) 10 (20) 5 (15) X 0 (5) Unlike the data from his enlistment audiogram, it is unclear on the face of the examination report whether this data was recorded using ASA or ISO-ANSI units. As such, the Board has provided both unconverted and converted data, in parentheses, and will rely on whichever data is more favorable to the Veteran. As set forth above, the Veteran served in the Army Reserve following his release from active duty in October 1969 until some point in 1974. Available service treatment records from his Reserve service include an audiogram from a June 1973 periodic examination. Pure tone thresholds, in decibels, were as follows: Ear 500 Hertz 1000 Hertz 2000 Hertz 3000 Hertz 4000 Hertz Right 20 5 10 X 40 Left 15 10 10 X 75 As the audiogram was performed in 1973, the Board will assume that it was conducted using ISO-ANSI, and no conversions are necessary. The Board has carefully considered the Veteran’s contentions and the available evidence of record. At this juncture, however, the Board cannot reach the merits of his claim, as remand is warranted for additional development. To that end, VA has a duty to assist claimants with obtaining evidence needed to substantiate a claim. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. This includes obtaining service treatment records from periods of active duty, as well as periods of ACDTURA and INACDUTRA service. Here, the Board notes that the RO submitted a request for records from the Veteran’s four-month period of active duty in 1969. Although six pages of service treatment records from his period of Reserve service were also obtained, including a June 1973 periodic physical evaluation, it appears that there are outstanding service treatment records from periods of ACDUTRA and INACDUTRA that have not been associated with the claims file. Remand is thus warranted to obtain complete service treatment records from the period following his release from active duty in October 1969 and his discharge from the Army Reserve in 1974. The Board also notes that the RO did not obtain records showing the actual dates of the Veteran’s ACDUTRA or INACDUTRA during the relevant period on appeal. On remand, the RO should thus make appropriate efforts to identify all periods of ACDUTRA, INACDUTRA. 38 C.F.R. § 3.159(c)(1)-(2). Additionally, the Board finds that remand is warranted to obtain an addendum medical opinion with respect to the etiology of the Veteran’s hearing loss. The RO afforded the Veteran a VA examination in January 2018. In the accompanying examination report, the VA examiner opined that the Veteran’s right ear hearing loss was not aggravated beyond its normal progression during his military service, while his left ear hearing loss was not caused by or a result of his military service. As rationale, she explained that his enlistment examination showed a mild hearing loss at 4000 Hertz in his right ear, while his October 1969 separation audiogram showed no significant threshold shifts in his right ear. With respect to the left ear, she reasoned that his hearing had been normal at enlistment and had not undergone any significant threshold shifts during his service. As set forth above, the Veteran had active service not only in the Army but also in the Army Reserve. He has consistently asserted that his hearing loss is related to both active duty and his Reserve service. Here, the VA examiner ultimately opined that the Veteran’s hearing was neither aggravated by nor underwent significant shifts during his military service. However, the VA examiner incorrectly assumed that his only active service was between June and October 1969. As such, the VA examiner’s opinion regarding his active service is based on an inaccurate factual premise and is entitled to no probative value. See Reonal v. Brown, 5 Vet. App. 460, 461 (1993). Moreover, the VA examiner did not address the Veteran’s lay statements regarding the reported onset of his hearing loss and would not have been able to review his complete service treatment records. An opinion that does not consider all relevant evidence of record, including lay statements, is inadequate. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Consequently, the RO must also obtain an addendum medical opinion that considers the Veteran’s periods of ACDUTRA and INACDUTRA service, as well as his lay statements regarding the onset of his hearing loss. Accordingly, the matters are REMANDED for the following action: (This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.800(c). Expedited handling is requested.) 1. Contact the National Personnel Records Center, the Records Management Center, the Defense Finance Accounting Service, or any other appropriate source to verify the exact beginning and ending dates of each period of active duty, ACDUTRA, and INACDUTRA. Thereafter, prepare a memorandum documenting the specific dates of his periods of service, including periods of ACDUTRA and INACDUTRA. A report of retirement points will not suffice. The summary must be associated with the claims file. 2. Obtain the Veteran’s service treatment records from any periods of ACDUTRA or INACDUTRA stemming from his enlistment in the Army Reserve. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file. If, after making reasonable efforts to obtain named records, they are unable to be secured, issue a formal finding that such records do not exist or that further efforts to obtain such records would be futile. The Veteran must be notified of the attempts made any why further attempts would be futile and allowed the opportunity to provide such records. 3. After identifying all periods of active duty, ACDUTRA, and INACDUTRA, and obtaining any outstanding service treatment records, obtain an addendum medical opinion regarding the etiology of the Veteran’s bilateral hearing loss. The entire claims file must be made available to the examiner for review, and the examiner must acknowledge such review in the examination report. After reviewing the claims file in its entirety, the examiner is asked to address the following: (a.) Provide an opinion as to whether the Veteran’s pre-existing right ear hearing loss was not aggravated by or during periods of active service, including ACDUTRA and INACDUTRA. (b.) Provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s left ear hearing loss was caused by or otherwise related to acoustic trauma during periods of active service, including ACDUTRA and INACDUTRA. A rationale should be provided for all opinions rendered. If the examiner cannot provide any of the requested opinions without resorting to speculation, he or she should provide an explanation stating why this is so. In so doing, the examiner should 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). M. Tenner Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Rademacher, 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.