Citation Nr: 21029019 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 17-58 580 DATE: May 12, 2021 REMANDED Entitlement to service connection for right ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 1969 to May 1972. The Veteran appeared and testified at a virtual teleconference hearing in April 2021 before the undersigned Veterans Law Judge. A transcript of the testimony is of record. Entitlement to service connection for right ear hearing loss is remanded. The Veteran seeks service connection for right ear hearing loss, stating that his hearing loss, noted on induction, was permanently worsened during his service. Unfortunately, the issue must be remanded. As much as the Board of Veterans' Appeals (Board) regrets the additional delay, it cannot make a fully informed decision on the issue of entitlement to service connection for right ear hearing loss. Specifically, the Board cannot grant service connection for hearing loss without an adequate opinion of record discussing whether the Veteran's pre-service hearing loss was aggravated (permanently worsened) as a result of service. The Board concedes current hearing loss, per VA regulations. Next, the Veteran's pre-service right ear hearing loss is noted on his induction examination report. Thus, the question before the Board is whether this noted hearing loss was aggravated (permanently worsened) in service. See Crowe v. Brown, 7 Vet. App. 238, 245 (1994). Specifically, the Veteran's audiogram from July 1969, one month after entering service, shows abnormal tonal threshold levels at 500, 1,000, 2,000, and 4,000 Hz in his right ear, and he was diagnosed with severe sensorineural hearing loss in the right ear. By contrast, the Veteran's separation audiogram, dated April 1972, shows slightly improved tonal threshold recordings at 500, 1,000, and 2,000 Hz. The notation contrasts with the Veteran's reported experience in service. While his primary MOS of a Personnel Clerk does not carry a high probability of noise exposure, consistent with his statements, military personnel records indicate that the Veteran was an armorer/unit supply specialist in Vietnam in 1970. This position had a higher probability of noise exposure because, as reported by the Veteran, he was responsible for transporting people and equipment daily via large cargo trucks, he was exposed to helicopter and ship noise, and his area experienced combat and mortar attacks. The Veteran also alleges that he was sometimes responsible for overseeing under-fire drills or performing military funerals, which required exposure to gunfire. Additionally, the Veteran was assigned these duties despite a notation on a July 1969 entrance examination recommending that the Veteran should have permanent assignment limitations avoiding exposure to small arms fire or loud noises, except for pay or rank qualifications, due to his right ear hearing loss. The Veteran underwent VA examinations in December 2015 and August 2018, but neither examiner considered the Veteran's entrance and exit tonal thresholds, and instead believed that no hearing examinations were performed upon entrance or exit from service. While both stated that the Veteran's hearing was aggravated by active duty, they both noted that they could not opine as to the extent of the aggravation due to a lack of tonal thresholds. Unfortunately, the Board is not competent to decide whether this constitutes a permanent worsening of the disability. This question should be referred to an appropriate medical professional. Upon reexamination, the examiner should be sure to review the entire evidence of record, including the audiograms performed on entrance and exit from service. The matters are REMANDED for the following action: 1. Obtain all outstanding treatment records from any VA medical center or facility from which the Veteran has received treatment. If the Veteran has received private treatment, he should be afforded an opportunity to submit those records as well. 2. Forward the claims file to the VA examiner who conducted the August 2018 VA examination (or to an appropriate clinician if the original examiner is not available) to determine the nature and etiology of the Veteran's right ear hearing loss. The examiner should opine whether it is at least as likely as not related to an in-service injury, event, or disease, including the Veteran's serving as an armorer/unit supply specialist in 1970. Specifically, the examiner is asked to opine as to whether the Veteran's right ear hearing loss noted at induction was at least as likely as not aggravated (permanently worsened) in service and, if so, whether any increase in severity was due to (a) the natural progress of the hearing loss, or (b) the Veteran's in-service noise exposure. The examiner is directed to review the July 1969 audiogram performed upon entrance into service, as well as the April 1972 audiogram performed around the time of separation from service. The examiner should provide a complete rationale for all opinions rendered based on a review of the record. A new examination is not necessary unless deemed so by the examiner, or that the prior examiner is unavailable. B.T. KNOPE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Veltri, Associate Counsel