Citation Nr: 21040398 Decision Date: 07/03/21 Archive Date: 07/03/21 DOCKET NO. 18-45 532 DATE: July 3, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from September 1964 to January 1968. This matter is before the Board of Veterans' Appeals (Board) on appeal from an April 2018 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In the September 2018 Form 9, Substantive Appeal, the Veteran elected an optional Board hearing. A Board hearing was held in February 2021, and the Veteran along with his wife testified before the undersigned Veteran's Law Judge. A copy of the February 2021 Board hearing transcript (February 2021 Board Hearing Transcript) was associated with the claims file. In May 2017, the Veteran submitted his intent to file a claim, and in November 2017, he applied for entitlement to service connection for bilateral hearing loss and tinnitus. In the April 2018 rating decision, the Veteran was granted service connection for tinnitus and was denied service connection for bilateral hearing loss. The Veteran contends that his hearing loss is attributed to military service where he served as a radioman and was exposed to gunfire from six to eight inch guns while in Vietnam. The September 1967 military personnel records show the Veteran was awarded three bronze stars on a Vietnam Service Medal for Vietnam Operations. His DD-214 states that he was awarded a Vietnam Campaign Medal with device and Vietnam service medal with 3 bronze stars. The July 1964 enlistment exam shows the Veteran reported that his last occupation prior to entering military service was being a painter and that the Veteran's hearing was within normal limits. At the January 1968 separation examination, the Veteran's hearing was not tested. The October 2017 and December 2017 VA treatment records show the Veteran being diagnosed as having bilateral hearing loss with the left ear being worse than the right ear. The October 2017 VA treatment notes that the Veteran reported noise exposure in service, i.e. gunfire, while he was a radioman. The clinician believed the Veteran's hearing loss was longstanding. In the February 2018 VA treatment records, the Veteran was diagnosed as having bilateral grossly symmetric sensorineural hearing loss (SNHL). In April 2018, the Veteran was afforded a VA examination. The findings of the examination established that the Veteran met the criteria for bilateral hearing loss for VA purposes under 38 C.F.R. § 3. 385. The examiner diagnosed the Veteran as having bilateral SNHL at lower (500-4000 Hz) and higher (6000 Hz or higher) frequencies. During the examination, the Veteran reported ringing in his ears after he was in close proximately to six and eight inch gun fire aboard the ship. The examiner opined that the Veteran's bilateral hearing loss was not caused by or a result of military service. The examiner's rationale relied on the fact that the "veteran worked in construction for over 20 years around power tools and jack hammers. He did no use ear protection. His hearing loss is also asymmetrical. This is not typical of acoustic trauma." The examiner concluded that post-service exposure was the cause of his bilateral hearing loss. However, the Veteran consistly stated that he did not work in construction or noisy work sites after being discharged from the military. He stated in his June 2018 notice of disagreement and his September 2018 VA Form 9 that the examiner's opinion used inaccurate facts because the Veteran did not work in construction, did not use a jack hammer, and did not work on noisy construction sites, but he did paint finished homes prior to joining military service, which he listed on his July 1964 enlistment examination. Moreover, at the February 2021 Board hearing, the Veteran testified that as a radioman, he was exposed to gunfire noise and radio shack noise. He explained that the April 2018 examiner asked him of his entire work history. He was as interior house painter prior to joining the Navy and that after discharge, he was salesman for three years and then a real estate appraiser for about 35 to 40 years. See February 2021 Hearing Transcript at 2, 3, and 7; July 1964 service treatment records. A medical opinion is adequate when it is based upon consideration of the Veteran's prior medical history and examinations and also describes the disability in sufficient detail so that the Board's "'evaluation of the claimed disability will be a fully informed one." D'Aries v. Peake, 22 Vet. App. 97, 104 (2008) quoting Ardison v. Brown, 6 Vet. App. 405, 407 (1994); see also Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Miller v. Wilkie, 32 Vet. App. 249, 254 (2020). Considering the April 2018 examiner failed to obtain, from the Veteran, an accurate history of his hearing loss during the examination and that the medical opinion relied on incorrect facts of his post-service occupation, the Board finds the examiner's nexus opinion inadequate. Once VA undertakes the effort to provide an examination when developing a service-connection claim, the examination must an adequate one. Barr at 311. Accordingly, the claim must be remanded to provide the Veteran with a new VA examination and to obtain a new nexus opinion. Additionally, the examiner needs to consider the Veteran's statements about his work history post-service including that he did not work in construction or on noisy work sites. While the Board regrets the delay, the Board cannot make a fully-informed decision on the issue of the Veteran's bilateral hearing loss because no adequate VA examiner has opined on whether the nature and etiology of the Veteran's current disability is attributable to service The matters are REMANDED for the following action: 1. Schedule the Veteran for an in-person VA audiological examination by an appropriate examiner with sufficient expertise to diagnose and determine the nature and etiology of the Veteran's bilateral hearing loss. 2. Provide the examiner the Veteran's complete claims file, including this Remand, for review. The examination report should reflect that such review was accomplished. 3. The examiner should interview and examine the Veteran. The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, post-service work history and that his reports must be considered in formulating the requested opinions. The examiner is requested to recognize that the Veteran did not work in construction or noisy work sites post-service. 4. Following the examination, and a review of the claims file and lay statements, the examiner should opine whether it is at least as likely as not (50 percent probability or greater) that the Veteran's current bilateral hearing loss is caused by or otherwise etiologically related to his active duty service to include his in-service noise exposure. 5. A complete rationale must be provided for any and all opinions offered. All appropriate studies and consultations should be accomplished, and all clinical findings should be reported in detail. If any requested opinion cannot be provided without resorting to mere speculation, the examiner must fully explain why this is the case and identify what, if any, additional evidence or information might allow for a more definitive opinion. 6. After completing the foregoing and any other development necessary, readjudicate the Veteran's claim. 7. If any benefit sought on appeal remains denied, a Supplemental Statement of the Case (SSOC) should be furnished to the Veteran and his representative, and he and his representative should be afforded a reasonable opportunity to respond. Cynthia M. Bruce Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Agarwal, 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.