Citation Nr: 21025499 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 20-09 474 DATE: April 28, 2021 REMANDED Entitlement to service connection for bilateral sensorineural hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1961 to January 1977 and from January 1981 to October 1981. These matters are on appeal from a January 2018 rating decision. In February 2021, the Board remanded the claim for further development. After development was completed, the Agency of Original Jurisdiction (AOJ) issued a supplemental statement of the case (SSOC). The Veteran and his attorney were informed that they had 30 days from the date of the SSOC to respond. In March 2021 email correspondence, the Veteran’s attorney requested to waive the 30 days and to return the appeal to the Board. In subsequent March 2021 correspondence, the Veteran and his attorney were notified that the appeal was returned to the Board and resumed its place on the docket. As such, the Board will proceed with adjudication. The record indicates that the Veteran has a current diagnosis of bilateral hearing loss and tinnitus. See December 2017 and February 2021 VA medical examinations. The Veteran’s DD214 reveals that his military occupational specialty (MOS) was that of a jet engine technician for 21 years. The Board concedes that the Veteran was exposed to hazardous noise during active service. In February 2021, the Board remanded the claims so that the AOJ could obtain an addendum opinion. In a February 2021 VA medical opinion, the examiner opined that the claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. The examiner reasoned, in part, that there were no significant permanent shifts in hearing thresholds based on the Veteran’s hearing conservation data audiograms and on his separation examination. The examiner indicated that all the in-service audiograms (April 1961, 1962, June 1964, September 1970, and September 1971) were within normal limits in both ears. In addition to the in-service audiograms mentioned in the VA examination report, the service treatment records included audiograms dated in February 1961, January 1962, December 1966, and September 1968. The Board notes that, prior to November 1967, service department audiometric results were reported using standards set forth by the American Standard Association (ASA). Since November 1, 1967, those standards have been set by the International Standards Organization (ISO)-American National Standards Institute (ANSI). As VA’s current definition for a hearing loss disability, found at 38 C.F.R. § 3.385, is based on ISO-ANSI units, military audiograms dated before November 1967 must be converted from ASA to ISO-ANSI units prior to making findings related to a claimed hearing loss disability. ASA units are converted to ISO-ANSI units by adding 15 decibels to the finding at 500 Hz; 10 decibels to the findings at 1000 Hz, 2000 Hz, and 3000 Hz; and 5 decibels to the finding at 4000 Hz. Here, given that the Veteran’s February 1961, April 1961, January 1962, June 1964, and December 1966 audiograms are dated prior to November 1967, and there is no indication that ISO-ANSI standards are used, it is assumed that audiometric findings in the report used the ASA standard. Therefore, on remand the examiner must convert military audiograms dated before November 1967 from ASA to ISO-ANSI units. The matters are REMANDED for the following action: Obtain addendum opinions to ascertain the nature and etiology of the Veteran’s bilateral hearing loss and tinnitus. The Veteran should only be scheduled for another examination if it is deemed necessary by the clinician providing the opinion. The examiner is asked to review the claims file and document such in a report to be placed therein. The examiner shall include in the report consideration of the lay statements and lay history in medical reports and examinations from the Veteran as to his history of noise exposure during and after service and his symptoms to include their onset, severity, and impact on his work and daily life. i. For audiograms dated before November 1967 (specifically including audiograms dated in February 1961, April 1961, January 1962, June 1964, and December 1966), and where it is not clear whether such thresholds were recorded in ASA units or ISO-ANSI units, the examiner should consider the recorded metrics under both standards where appropriate, relying on the unit measurements most favorable to the Veteran’s appeal. ii. The examiner should opine as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s bilateral hearing loss had its onset in service, or is otherwise related to his military service, to include his conceded in-service noise exposure as a jet engine technician for 21 years. The examiner must consider the Veteran’s statements as to the onset of bilateral hearing loss, the continuity of symptoms since onset, and any exposure to loud noise in service. iii. The examiner should also opine as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that tinnitus had its onset in service, or is otherwise related to his military service, to include his conceded in-service noise exposure as a jet engine technician for 21 years. The examiner must consider the Veteran’s statements as to the onset of bilateral hearing loss, the continuity of symptoms since onset, and any exposure to loud noise in service. The examiner should also address whether or not the Veteran’s tinnitus is a symptom of his bilateral sensorineural hearing loss. (Continued on the next page)   iv. In providing a response, the examiner should discuss the representative’s October 2020 correspondence and referenced article from UC Health. v. Complete rationale must be provided for all opinions expressed. If the examiner is unable to provide any requested opinion without resorting to speculation, he/she should explain why and what, if any, additional evidence would be necessary before an opinion could be provided. Jenna Brant Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Crohe, 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.