Citation Nr: 21025582 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 17-19 661 DATE: April 28, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1978 to December 1978. In May 2020, the Board remanded this case for additional development. The Board finds that there has been substantial compliance with the Board remand requests. Stegall v. West, 11 Vet. App. 268 (1998). 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. In May 2020, the Board requested a medical opinion which addressed the nature and etiology of bilateral hearing loss and tinnitus. An October 2020 VA examiner opined that bilateral sensorineural hearing loss and tinnitus were not the result of noise exposure in service. As a rationale, the examiner stated that the entrance audiogram was normal, there was no separation audiogram, and there were no complaints of or treatment for hearing loss or tinnitus while in service. The examiner stated that a significant permanent shift in hearing thresholds could not be determined and the evidence was against a nexus. The Board finds the October 2020 opinion incomplete and a remand for further development is required. The examiner based the opinion on the absence of medical records. The Board notes that the absence of in-service evidence does not preclude service connection for hearing loss and tinnitus. The requirements for service connection for hearing loss as defined in 38 C.F.R. § 3.385 need not be shown by the results of audiometric testing during a period of active service in order for service connection to be established. An opinion based on the absence of treatment records without consideration of a Veteran's competent reports is inadequate. Dalton v. Nicholson, 21 Vet. App. 23 (2007). When VA provides an examination or obtains an opinion, the examination or opinion must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Because of the deficiencies in October 2020 VA examination, remand for additional VA examination is necessary. The matters are REMANDED for the following action: 1. After obtaining any necessary releases, obtain all relevant VA and private treatment records not already associated with the claims file. 2. Schedule the Veteran for a VA audiology examination with an examiner who has not previously examined the Veteran to diagnose and determine the nature and etiology of bilateral hearing loss and tinnitus. The examiner must review the record, to include including this Remand. The examiner is advised that a rationale based solely on the absence of treatment or documentation is incomplete. The examiner should state whether there was affirmative medical evidence showing that there was no hearing loss during service rather than a mere absence of treatment or documentation. If bilateral hearing loss and tinnitus are attributed to another etiology, the examiner must explain why the other etiology is more likely. A complete rationale which includes citation to any relevant facts, evidence, or medical principles must be provided for all opinions provided. The examiner should: (a.) Opine whether it is at least as likely as not (50 percent or greater probability) that bilateral hearing loss and tinnitus were incurred in service, or are etiologically related to any event, injury, or disease during service. (b.) Elicit a full history from the Veteran to include post-service work, social activities, and medical history. (c.) Discuss any significance of: (1) post-service employment history which includes working with trucks and working on a farm; (2) a November 2015 report of a gradual onset of hearing loss; and (3) medical records from January 2002 to February 2015, showing no reports of hearing loss or tinnitus. (d.) Consider the Veteran’s lay statements of onset of hearing loss and tinnitus symptoms while in service and continuation since service. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E.O., 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.