Citation Nr: 21039785 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 16-38 960 DATE: July 1, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran had active service in the United States Air Force from May 1971 to April 1975. This appeal comes to the Board of Veterans' Appeals (Board) from a June 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In November 2019, the Board remanded the issue for further development. Entitlement to service connection for bilateral hearing loss is remanded. In December 2019, a VA addendum medical opinion was obtained regarding the nature and etiology of the Veteran's current bilateral hearing loss. The VA examiner stated that a review of the Veteran's service treatment records revealed that the Veteran had normal hearing sensitivity at both the enlistment and separation examinations without any significant threshold shifts in either ear when comparing the audiograms. After citing to additional research, the examiner opined that as a result, given normal hearing at separation from active duty service, and no significant shift in thresholds from enlistment to separation, hearing loss was less likely as not caused by or aggravated by military noise exposure. The December 2019 VA medical opinion is inadequate because it relied on normal hearing test results at separation, and the examiner failed to actually explain how the evidence supported her opinion that conceded in-service noise exposure did not cause the Veteran's bilateral hearing loss. See Hensley v. Brown, 5 Vet. App. 155 (1993) (holding that a veteran who left service with hearing within normal limits on audiometric testing at separation was not precluded, as a matter of law, form establishing service connection for hearing loss). While there is no "reasons and bases" requirement for VA examiners, the examiner must explain why the Veteran's in-service noise exposure has not resulted in his current bilateral hearing loss. Further, in their June 2021 informal hearing presentation, the Veteran's representative discussed medical research that may be positive to the Veteran. Upon remand, the examiner must also review and comment on this research. The matters are REMANDED for the following action: Obtain a VA addendum medical opinion to determine the nature and etiology of the Veteran's bilateral hearing loss. If an opinion cannot be rendered without performing a VA examination, then a VA examination should be scheduled and conducted. The examiner should review a copy of this remand and the claims file. After reviewing the Veteran's claims file, the examiner is to state whether it is at least as likely as not that the Veteran's bilateral hearing loss is related to his military service, to include conceded in-service noise exposure? In answering this question, the examiner is to specifically note that the Veteran's military occupation specialty was construction equipment operator, and to address the Veteran's specific contentions regarding the noise he was exposed to. The examiner must also discuss the research article cited to in the Veteran's June 2021 Appellate Brief that concluded that hearing damage resulting in degeneration years later might occur, despite "normal" hearing shortly post-exposure. All opinions must be accompanied by a sufficient rationale. A negative opinion cannot be solely based on the absence of medical evidence. Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Crawford, 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.