Citation Nr: 21022863 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 17-00 471 DATE: April 19, 2021 REMANDED Service connection for bilateral hearing loss is remanded. Service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1969 to January 1972 with additional service in the National Guard. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2015 rating decision of the Department of Veteran Affairs (VA) Regional Office (RO). In February 2021 the Veteran presented testimony at a virtual hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that proceeding has been associated with the claims file. Service Connection- bilateral hearing loss and tinnitus Remand is required for an adequate medical linkage 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 received a June 2015 VA examination. The examiner opined that bilateral hearing loss was less likely than not cause by or the result of service. The examiner explained that the Veteran’s file showed no testing for pure tone thresholds during the Veteran’s active duty period. The examiner noted a June 1972 hearing test that showed normal hearing bilaterally. During the February 2021 Board hearing, the Veteran explained that during active duty and years of National Guard service he was exposed to a lot of noise. The examiner failed to address the Veteran’s declining hearing shown during periods of active duty for training (ACDUTRA). Notably, a May 1975 service treatment record (STR), showed bilateral hearing loss as defined by 38 C.F.R. § 3.385. Additionally, the Veteran’s STRs continued to show hearing loss in June 1982 and April 1986 audio exams. The Veteran’s service personnel records (SPRs) showed several periods of ACDUTRA. The Veteran’s SPRs showed he served in engineering and mechanical positions as his principal duties. As relevant here, the term “active service” includes active duty; any period of ACDUTRA during which the individual concerned became disabled from an injury incurred or aggravated in the line of duty while performing ACDUTRA. 38 U.S.C. § 101(24); 38 C.F.R. § 3.6(a). Because the examiner did not consider all relevant periods of active service (potentially including periods of ACDUTRA) and relevant STRs, remand is required for an adequate medical opinion. The June 2015 VA examiner indicated that tinnitus began during the 1990s and provided a negative nexus based on this date of onset. However, the examiner did not address the Veteran’s declining hearing as demonstrated during periods of ACDUTRA and whether tinnitus might be secondary to hearing loss and this medical opinion is therefore inadequate for the Board to use to decide the claim. See Stefl v. Nicholson, 21 Vet. App. 120, 123-24 (2007) (explaining that, generally, a medical opinion should address appropriately raised theories of entitlement to benefits). A July 2014 VA audiology treatment record noted occasional tinnitus and diagnosed bilateral hearing loss. Accordingly, remand is required. The matters are REMANDED for the following action: 1. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), contact the Veteran for additional information about treatment for his bilateral hearing loss and tinnitus and make efforts to obtain all VA and private treatment records concerning this claim. 2. After any additional records are associated with the claims file, obtain an addendum opinion from a VA examiner regarding the nature and cause of bilateral hearing loss and tinnitus. The entire claims file (including this remand order) must be made available to and be reviewed by the examiner. If an examination is deemed necessary, it shall be provided. (a) First, the examiner must provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s bilateral hearing loss was incurred during (that is, began during) any periods of ACDUTRA. (b) Second, the examiner must provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s tinnitus was incurred during (that is, began during) any periods of ACDUTRA. (c) Third, ONLY IF the examiner opines that the Veteran’s bilateral hearing loss began during a period of ACDUTRA, THEN the examiner must provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s tinnitus was (i) caused by OR (ii) aggravated beyond its natural progression, by the bilateral hearing loss. The examiner should consider the Veteran’s service in the National Guard and address relevant STRs that showed declining hearing during periods of ACDUTRA. 3. A detailed explanation (rationale) is requested for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested). VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Bruton, 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.