Citation Nr: 21030769 Decision Date: 05/19/21 Archive Date: 05/19/21 DOCKET NO. 18-33 039 DATE: May 19, 2021 REMANDED Entitlement to service connection for bilateral hearing loss disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 1961 to June 1964. In a November 2019 Board decision, entitlement to service connection for a bilateral hearing loss disability was denied. The Veteran appealed the November 2019 decision to the United States Court of Appeals for Veterans Claims (Court). In a January 2021 order, the Court vacated the Board's decision and remanded the issue pursuant to a Joint Motion for Remand (JMR). Entitlement to service connection for bilateral hearing loss disability is remanded. While further delay is regrettable, additional development is warranted before the Veteran's claim may be decided. In the January 2021 JMR, the parties agreed that the Veteran's December 2015 VA examination is inadequate and that a new VA opinion is required. Accordingly, this case must be remanded to obtain a new VA opinion. The matter is REMANDED for the following action: Obtain an opinion from an appropriate clinician to determine the nature and etiology of the bilateral hearing loss disability. The need for an in-person VA examination is left to the discretion of the examiner offering the requested opinion. The claims file and a copy of the below facts must be made available to the reviewing VA examiner. To assist in a review of the claims file, the examiner is informed of the following facts with citations in the record, when applicable: The Veteran is claiming that his bilateral hearing loss disability was incurred in or is otherwise related to in-service noise exposure. The Veteran served on active duty from June 1961 to June 1964. In-service noise exposure has been accepted as true. The June 1961 Report of Medical Examination at induction shows a score of 15/15 on both the left and right side for the whispered voice test. See VBMS entry with document type, "STR - Medical," receipt date 10/07/2015, at p. 32. In the June 1961 Report of Medical History at induction, the Veteran denied a history of ear trouble and running ear. See VBMS entry with document type, "STR - Medical," receipt date 10/07/2015, at p. 33. The April 1964 Report of Medical Examination at separation shows a hearing test was performed with audiometric findings. See VBMS entry with document type, "STR - Medical," receipt date 10/07/2015, at p. 4 (item # 71). The April 1964 Report of Medical History at separation shows the Veteran denied a history of ear trouble and running ear. See VBMS entry with document type, "STR - Medical," receipt date 10/07/2015, at p. 5 (item # 20, first column). A January 2008 VA treatment record shows that the Veteran was documented as being "Hard of Hearing." See VBMS entry with document type, "CAPRI," receipt date 07/09/2019, with "#2" in the subject field, at pp. 13-14. A July 2009 VA treatment record shows that the Veteran's Hearing Status was documented as "Good." See VBMS entry with document type, "CAPRI," receipt date 01/24/2019, with "#1" in the subject field, at p. 648. A December 2011 private medical record from Pulmonary Medicine Associates shows that Dr. Michel LeBrun performed a physical examination and wrote that the Veteran had, "Normal hearing." See VBMS entry with document type, "Medical Treatment Record - Non-Government Facility," receipt date 11/06/2015 at p. 10. An April 2015 VA treatment record shows the Veteran reported that he had experienced hearing loss for many years. See VBMS entry with document type, "CAPRI," receipt date 01/24/2019, with "#1" in the subject field, at pp. 577-578 & 579-581. An April 2015 VA treatment record shows the Veteran underwent an audiological examination. The examiner wrote hearing loss was suspected since the 1960s with both ears being equal, and that the Veteran denied tinnitus. The audiologist diagnosed bilateral mild to moderate SNHL .25-8kHz with good speech discrimination. See VBMS entry with document type, "CAPRI," receipt date 7/09/2019, with "#3" in the subject field, at p. 723. In a December 2015 VA examination report, the audiologist, after performing a hearing test, noted that the entrance examination documented hearing within normal limits using the whispered voice test. She stated the separation examination documented hearing within normal limits, bilaterally. The audiologist concluded that the Veteran's bilateral hearing loss disability was less likely than not related to service. She explained that although there was no frequency-specific data in the Veteran's entrance examination, based on the thresholds obtained at the Veteran's separation examination, a Standard Threshold Shift (STS) is highly improbable. She added that improbability of STS during military service indicates that it is NOT at least as likely as not that the Veteran's current hearing loss was related to his military service. See VBMS entry with document type, "C&P Exam," receipt date 12/30/2015, with "DBQ AUDIO" in the subject field. At a May 2019 Board hearing, the Veteran testified that he noticed hearing loss immediately upon separation from service, and that he was exposed to loud noise from heavy weapons during service. See VBMS entry with document type, "Hearing Transcript," receipt date 05/29/2019, at pp. 3-4. The December 2015 audiologist's opinion has been determined to be inadequate because of an insufficient medical explanation. For example, the audiologist opined that a significant threshold shift in hearing ability during active service was "highly improbable," but the military entrance audiogram did not contain specific data to support such a conclusion since it documented only a whispered voice test. In addition, the VA audiologist did not explain how a lack of in-service significant threshold shift in hearing ability supported a finding that the Veteran's current bilateral hearing loss is not related to in-service noise exposure. The examiner's review of the record is NOT restricted to the evidence listed above. This list is provided in an effort to assist the examiner in locating potentially relevant evidence. The examiner is asked to answer the following question: Is it at least as likely as not (50 percent probability or higher) that the Veteran's bilateral hearing loss disability is related to in-service noise exposure during the Veteran's active duty from June 1961 to June 1964? Please state upon what facts and medical principles you base the opinion. The examiner is asked to provide a rationale for all conclusions reached with reference to relevant evidence of record and/or medical principles, as appropriate. If the examiner is unable to provide an opinion without resorting to speculation, he or she should explain why this is so and what, if any, additional evidence would be necessary before an opinion could be rendered. A. P. SIMPSON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Husain, 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.