Citation Nr: 21039727 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 17-59 056 DATE: July 1, 2021 REMANDED Service connection for bilateral hearing loss is remanded. Service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from October 1975 to October 1978. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a January 2017 rating decision issued by a VA Regional Office (RO). In March 2021, the Veteran testified at a virtual Board hearing. Although the Veteran has a representative, he was not assisted during the Board Hearing. During the hearing the Veteran stated that he had additional evidence that he wanted to collect and submit, and he requested an additional 30 days in which to submit the evidence. The requested 30 days has elapsed. In June 2021, the Board duly sent the case to the Veteran's veterans service organization representative for review. The representative responded that the Board should rely on the Veteran's Board Hearing testimony; and stated "we have no further argument." 1. Service connection for bilateral hearing loss is remanded. 2. Service connection for tinnitus is remanded. The Veteran is requesting service connection for hearing loss and tinnitus, which he attributes to noise exposure during service. In correspondence dated in September 2017, he asserted that audiograms reflect "a degradation" in his hearing from the time of his 1975 enlistment until 1978. The Veteran also stated that he had ringing in the ears on multiple occasions after operating paint chippers, grinders, and sanders during service, and that he has had ringing in the ears from "military service to present." However, during his March 2021 Board Hearing he testified that he noticed the ringing in his ears shortly after service. He elaborated "I'd say a few years after, and then it's been more occurrent as I'm getting older." During the hearing he requested, and was afforded, an additional 30 days to submit more evidence, but thus far he has not submitted any new evidence. Service treatment records (STRs) include the following audiology reports. September 1975 Enlistment Examination Hertz 500 1000 2000 3000 4000 Right ear 15 5 5 5 15 Left ear 20 15 5 5 5 September 1978 Separation Examination Hertz 500 1000 2000 3000 4000 Right ear 10 5 5 0 0 Left ear 25 5 15 0 5 The STRs also chronicle complaints of clogged ears, stuffy ears, ear fullness, and otitis media. In October 1978, the Veteran separated from active duty service. In October 2016, he filed his claim for service connection. In December 2016, the Veteran was afforded a VA Hearing Loss and Tinnitus examination. The diagnosis was bilateral sensorineural hearing loss and tinnitus. According to the examiner, the Veteran's right ear hearing loss is not related to service "because separation exam revealed normal hearing" and "there was no reports of hearing problems in vet's STRs." The examiner next stated that the Veteran's left ear hearing loss is not related to service because "Vet's separation exam revealed a mild hearing loss at 6kHz, and no significant change as compared to enlistment examination," and there "was no report of hearing loss in vet's STRs." However, on review of the STRs the Board notes that the Veteran often complained of stuffy and clogged up ears during service. Indeed, he specifically complained of "hearing loss" during his September 1978 separation examination. STRs dated in May 1976 also contain the remarks "lack of hearing (both ears)." Although the examiner noted some of these complaints in the examination report under "evidence reviewed," it is unclear how these in-service treatment records weighed into the ultimate conclusion. The Board finds the examiner's rationale to be inadequate as the examiner did not reconcile the Veteran's in-service complaints and post-service description of hearing loss and, instead, seemed to solely rely on the audiograms found in his service treatment records. As for the Veteran's tinnitus, the Board finds the examiner's rationale similarly lacking. The examiner stated that the Veteran's tinnitus was likely attributable to his hearing loss, but on the other hand, not related to military noise exposure because the Veteran reported an onset of "apparent lately." The examiner did note consideration of the Veteran's in-service treatment for "stuffy ears" in 1977 and 1978, but found the Veteran, at that time denied reports of tinnitus. It is unclear from the way the opinion is written whether the examiner relied on inaccurate information. In fact, there is no such "denial" of tinnitus anywhere in the service treatment records. The Board finds the evidence insufficient at this time to render a decision and, therefore, a new VA examination is indicated. The matters are REMANDED for the following action: 1. Schedule the Veteran for a new VA audiological examination regarding his claim for service connection for hearing loss and tinnitus. The examiner must review the claims file and note that the claims file review took place. The examiner is asked to provide a response to the following: Whether the Veteran's current bilateral hearing loss, and whether the Veteran's tinnitus, at least as likely as not (a.) began during active service, (b.) manifested within one year after discharge from active duty service, or (c.) is etiologically related to his active service, to include loud noise exposure during service or his in-service treatment/complaints of "clogged ears," "stuffy ears," "ear fullness," and otitis media. The examiner must consider the Veteran's lay description of in-service noise exposure and his post service symptomatology. Facts and medical principles relied upon to arrive at an opinion should be set forth. With regard to the presently diagnosed sensorineural hearing loss, the examiner should explain the significance, if any, of the change in hearing thresholds from the time of the September 1975 enlistment examination to the September 1978 separation examination. The examiner should also discuss the episodes of clogged ears, stuffy ears, ear fullness, and otitis media documented in the STRs. In considering lay statements of record, the clinician should note that the Veteran is competent to attest to matters of which he had first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the clinician should provide a reasoned explanation. The clinician should consider all medical and lay evidence of record and offer a complete rationale for each opinion expressed. If the clinician concludes that any of the above questions cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so should be provided. 2. After completion of the above directives and any other necessary action, re-adjudicate the claims. SHEREEN M. MARCUS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. Childers, 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.