Citation Nr: 21031281 Decision Date: 05/21/21 Archive Date: 05/21/21 DOCKET NO. 17-41 393 DATE: May 21, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for vertigo is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1989 to February 1998. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2016 rating decision of a Regional Office (RO) of the Department of Veterans Affairs (VA). In February 2021, the Veteran testified before a Veterans Law Judge. A transcript of this hearing is of record. 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran seeks service connection for bilateral hearing loss. She asserts her service as a flight nurse in the U.S. Air Force exposed her to engine noise and other acoustic trauma, resulting in a current bilateral hearing loss. For the purposes of applying the laws administered by VA, impaired hearing will be considered a disability when the auditory threshold in any of the frequencies of 500, 1000, 2000, 3000, and 4000 Hertz (Hz) is 40 decibels (dB) or greater; or when the thresholds for at least three of these frequencies are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. See 38 C.F.R. § 3.385. Upon receipt of the Veteran's claim, she was afforded an April 2016 VA audiological examination. The audiometric testing results indicated her hearing loss of the right ear was insufficient to establish a disability as defined by VA. Regarding her left ear, a current hearing loss disability was established; the examiner concluded, however, that this current diagnosis did not have its onset in service and was not otherwise related to in-service acoustic trauma. Subsequent to that examination, the Veteran submitted statements from various private physicians. These statements contained both current diagnoses of bilateral hearing loss and medical opinions regarding an etiological nexus with service. While these statements indicate the Veteran has hearing loss of both ears, they do not contain audiometric findings to confirm whether her hearing loss of the right ear conforms to 38 C.F.R. § 3.385. Thus, it is necessary to obtain these testing results, or any other evidence which may establish hearing loss of right ear as defined by VA. Next, while the April 2016 VA medical opinion suggested the Veteran's hearing loss of the left ear had its onset subsequent to service and was unrelated to any acoustic trauma therein, it did not address the private opinions which were received subsequently. Thus, a VA medical opinion which address these private medical opinions is required. Finally, the Board notes the Veteran's VA treatment records were last obtained in June 2016, nearly five years ago. Any additional VA treatment records generated since that time should be obtained. 2. Entitlement to service connection for tinnitus is remanded. The Veteran seeks service connection for tinnitus. According to the April 2016 VA examination report, tinnitus "has a known association with hearing loss." Thus, this claim is inextricably-intertwined with an issue being remanded herein, and any adjudication must be stayed pending additional VA development. See Harris v. Derwinski, 1 Vet. App. 180 (1991). 3. Entitlement to service connection for vertigo is remanded. Finally, the Veteran seeks service connection for a disability characterized by vertigo, claimed as secondary to hearing loss and tinnitus resulting from acoustic trauma. As this claim is inextricably-intertwined with the issues being remanded herein, any adjudication must be stayed pending additional VA development. Id. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records not already obtained for the period from June 2016 to the present. 2. Schedule the Veteran for a VA audiological examination for an examination and medical opinion regarding her claimed bilateral hearing loss and tinnitus. The claims file must be made available to the examiner. Following review of the claims file and examination of the Veteran, the examiner should opine whether it is at least as likely as not (50 percent or greater probability) that any current hearing loss of either ear is a delayed reaction to or is otherwise related to any in-service noise exposure. It must be noted that the absence of evidence of a hearing loss disability during service is not always fatal to a service connection claim. The examiner is also asked to determine whether the Veteran's tinnitus was at least as likely as not (50 percent or greater probability) caused by service, or whether her tinnitus is at least as likely as not (50 percent or great probability) caused or aggravated by her hearing loss. The examiner is requested to provide a complete rationale for any opinion provided. In rendering an opinion, the examiner is asked to address the three private examiner opinions. Additionally, the Veteran is noted to be competent to report such observable symptomatology as ringing in the ears and/or a decline in hearing acuity. The Veteran is also noted to have medical training as a nurse, and confirmed service as a flight nurse aboard military aircraft. 3. After undertaking any additional development deemed appropriate and giving the Veteran full opportunity to supplement the record, adjudicate the Veteran's pending claims in light of any additional evidence added to the record. If any benefit sought on appeal remains denied, the Veteran and her representative should be furnished with a Supplemental Statement of the Case and be afforded the applicable opportunity to respond before the record is returned to the Board for further review. M. Donohue Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Thomas D. Jones, 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.