Citation Nr: 21032226 Decision Date: 05/26/21 Archive Date: 05/26/21 DOCKET NO. 18-21 813 DATE: May 26, 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 January 1969 to January 1971. In a decision issued in January 2020, the Board denied entitlement to service connection for bilateral hearing loss and tinnitus. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In December 2020, the Court issued an order that vacated the Board's January 2020 decision with respect to those issues and remanded the matter for adjudication consistent with the instructions outlined in a December 2020 Joint Motion for Partial Remand (JMPR) by the parties. Entitlement to service connection for bilateral hearing loss and tinnitus is remanded. In the December 2020 JMPR, the parties agreed that the Board erred when it relied on an inadequate January 2015 VA medical opinion. Likewise, the JMPR instructed the Board to remand the case in order to obtain a new VA medical opinion to address the nature and etiology of the Veteran's bilateral hearing loss and tinnitus. In the January 2015 VA examination, the examiner opined that the Veteran's bilateral hearing loss and tinnitus were less likely than not a result of his in-service noise exposure. In her rationale, the examiner cited the audiometry results from the Veteran's April 1968 induction and December 1970 separation examinations and indicated that the results showed no significant in-service threshold change. However, as observed by the December 2020 JMPR, the examiner failed to address whether the results of the induction and separation audiometry measurements used the same standard. See January 2015 VA Examination. Under current VA regulations, hearing loss is defined using units from the International Standards Organization (ISO) and the American National Standards Institute (ANSI). However, prior to 1969 audiometry examinations may have used the American Standards Association (ASA) units of measurement. The Board notes that the Veteran's December 1970 audiometric report includes a handwritten note that reads "ASA", which suggests that the examiner used the older standard; however, the April 1968 induction examination report includes no such indication, and therefore it is unclear as to which standard was used on the induction examination. Furthermore, the January 2015 VA examiner did not indicate which standard was used in the April 1968 induction examination nor did she convert those measurements to the updated ISO/ANSI standard. Accordingly, consistent with the JMPR, the Board finds that the January 2015 VA medical opinion is insufficient for rating purposes and remand is warranted for a new VA medical opinion consistent with the directives herein. The matters are REMANDED for the following actions: 1. Make reasonable efforts to obtain any outstanding and relevant VA and private treatment records. 2. Following the above development, obtain a VA medical opinion from an appropriate examiner to determine the nature and etiology of the Veteran's bilateral hearing loss and tinnitus (an examination may be conducted, if deemed necessary). The claims folder (including a copy of this remand) must be provided to and reviewed as part of the examination. All clinical findings should be reported in detail. The examiner should provide an opinion as to whether it is at least as likely as not (i.e., 50 percent or greater probability) that the Veteran's bilateral hearing loss had its onset in or is otherwise related to the Veteran's active duty service. The examiner should provide an opinion as to whether it is at least as likely as not (i.e., 50 percent or greater probability) that the Veteran's tinnitus had its onset in or is otherwise related to the Veteran's active duty service. In rendering the above opinions, the examiner must specifically address the Veteran's April 1968 induction and December 1970 separation examinations. Additionally, the examiner must convert any audiometric measurements from ASA units to the current ISO/ANSI standard. The examiner should also specifically address the February 2021 private medical opinion, which, in pertinent part, indicates that the Veteran's bilateral hearing loss and tinnitus were as likely as not caused by the Veteran's military service. The examiner is advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If his reports are discounted, the examiner should provide a reason for doing so. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Talton, John H. 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.