Citation Nr: 21030251 Decision Date: 05/18/21 Archive Date: 05/18/21 DOCKET NO. 17-20 007 DATE: May 18, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served honorably on active duty from January 1971 to January 1975, and from October 1975 to November 1980. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2016 rating decision of a Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran testified before the undersigned Veterans Law Judge at a hearing in February 2020. A transcript of the hearing has been associated with the claims file. As a preliminary matter, the Board notes that this claim was previously before the Board in April 2020, at which time it was remanded to the Agency of Original Jurisdiction (AOJ) for further evidentiary development. While the Board regrets the additional delay, as discussed in further detail below, an additional remand is necessary prior to adjudication of the Veteran's claim. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends that his current bilateral hearing loss is related to his active duty military service. Specifically, the Veteran asserts that his current hearing loss is related to noise exposure he experienced during active duty while serving as a helicopter gunner. Alternatively, the Veteran's representative has argued that his bilateral hearing loss is a residual of a head trauma that the Veteran suffered while on active duty service. See e.g., March 2021 appellate brief. In April 2020, the Board remanded the issue of service connection for bilateral hearing loss for a VA addendum opinion; the Board's April 2020 remand directives instructed the VA examiner to provide an opinion as to the etiology of the Veteran's diagnosed bilateral hearing loss, to include whether it was related to his military noise exposure, i.e., in-service noise exposure during his service as a gunner in a helicopter. On remand, an addendum opinion was obtained in January 2021. The VA examiner's January 2021 opinion was that it is less likely than not that the current bilateral hearing loss is etiologically related to service; however, the January 2021 VA examiner did not address whether the current bilateral hearing loss is etiologically related to the Veteran's October 1972 in-service fall and subsequent head injury. Evidence of record reflects that the Veteran was examined in October 1972 for a possible skull fracture and head abrasions. The Board also notes that the Veteran is currently service connected for seizures, which have been at least in part attributed to the 1972 in-service head trauma. See June 2006 rating decision. Accordingly, remand for a new VA addendum opinion addressing whether the Veteran's current bilateral hearing loss is etiologically related to his October 1972 in-service head injury is needed. This matter is REMANDED for the following action: 1. Send the Veteran's claims file to an appropriate VA clinician for review. The VA clinician is asked to provide the medical opinion requested below regarding service connection for bilateral hearing loss. The relevant documents in the electronic file should be made available to, and be reviewed by, the VA examiner. The VA examiner should note such review in the requested medical opinion. If the VA examiner determines that additional examination(s) of the Veteran is necessary to provide reliable opinions as to causation, such examination(s) should be scheduled; however, the Veteran should not be required to report for an examination as a matter of course, if it is not found to be necessary. The VA examiner should provide the following opinion: Is it at least as likely as not (i.e. 50 percent probability or greater) that the Veteran's current bilateral hearing loss is etiologically related to and/or a residual of active service, including to the October 1972 in-service head injury? The term "at least as likely as not" does not mean merely within the realm of medical possibility, but rather that the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of causation as it is to find against it. A rationale should be given for the provided opinion and conclusions rendered. The opinion should address the particulars of this Veteran's medical history and the relevant medical science as applicable to this claim. Bethany L. Buck Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. M. Lowman, 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.