Citation Nr: 21025076 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 16-29 692 DATE: April 27, 2021 REMANDED Entitlement to service connection for a bilateral hearing loss disability is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran had active service in the United States Army from November 1967 to September 1969. Entitlement to service connection for hearing loss and entitlement to service connection for tinnitus are remanded. The appeal was remanded in March 2019 for an addendum opinion to a previous, April 2015, VA examination report. Regrettably, the medical opinion is incomplete and further development is still necessary. A medical opinion was provided in October 2019. In that opinion, the VA examiner relied in part on a 2006 Institute of Medicine (IOM) study. The Court recently directed attention to the fact that the IOM report on which the examiner relied contains apparent qualifiers or contradictions that may impact the probative value of medical opinions that rely upon it. See McCray v. Wilkie, 31 Vet. App. 243 (2019). In light of the Court's observation, the Board will remand the case for another examination and opinion. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s tinnitus and bilateral hearing loss disability are at least as likely as not related to his in-service noise exposure. The VA examiner is asked to address the in-service shift in the Veteran’s hearing acuity at 4000 Hertz. In so doing, the examiner should refrain from placing any reliance on the 2006 study from the Institute of Medicine, pertaining to delayed onset of hearing loss, which the Court has determined contains apparent qualifiers or contradictions that may impact the probative value of medical opinions that rely upon it. MARTHA R. LUBOCH Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Slovick, 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 This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.