Citation Nr: 21040564 Decision Date: 07/06/21 Archive Date: 07/06/21 DOCKET NO. 16-54 962 DATE: July 6, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1965 through April 1968. This matter comes before the Board of Veterans' Appeals (BVA or Board) on appeal from a July 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In April 2020, the Board remanded this matter to the Agency of Original Jurisdiction (AOJ) for additional development. The appeal has since returned to the Board. 1. Entitlement to service connection for hearing loss is remanded. The Veteran contends that his bilateral hearing loss is related to his service. Specifically, he alleged that his bilateral hearing loss was caused by being in close proximity of two explosions and noise exposure from combat. Treatment notes as early as September 1988 document the Veteran's complaint of high pitch frequency loss in the left ear from an injury in Vietnam. In March 2021, a VA examiner determined that the Veteran experienced a mild conductive loss in his left ear. The examiner further explained that conduction loss is not a loss that is consistent with noise exposure and is usually consistent with middle ear pathology. The examiner recommended that the Veteran obtain the expertise of an ear, nose, and throat specialist to further investigate the nature of the Veteran's conductive loss. As the record stands, the Board is unable to make a fully informed decision in this matter because no VA examiner has conclusively determined the nature and etiology of the Veteran's loss. Rather, the March 2021 VA 2021 determined that further development as to the nature of the Veteran's hearing loss, was warranted. As the Veteran has provided evidence of various in-service injuries that he alleged is the cause of his hearing loss, further development is necessary to determine if the cause of his hearing loss is related to service. The Board is aware that the Veteran's right ear impaired hearing did not meet VA's definition of hearing loss during the period on appeal. As the matter will be remanded for further development, the examiner should also reconsider whether the Veteran's right ear impaired hearing meets the definition of hearing loss for VA purposes at the time of the examination. The matters are REMANDED for the following action: 1. Schedule the Veteran to a VA examination with an otolaryngologist (ear, throat, and nose doctor) to consider the nature and etiology of the Veteran's hearing loss. (Note that the prior Compensation examiner determined that they did not have the requisite medical experience to make the determination. Therefore, this specialist is requested, based on that examiner's findings.) The examiner is asked to opine whether it is at least likely than not that the Veteran's hearing loss is related to his service, to include the Veteran's reporting of experiencing close proximity explosions and combat noise exposure during service. In formulating an opinion, the examiner is asked to consider that the Veteran reported high pitch sensory hearing loss in 1988 due to injury in Vietnam and his detailed report of injuries sustained during service. See VBMS documents labeled Medical Treatment Record-Non-Government Facility, receipt date 3/30/1988, page 2 of 88, and Correspondence, receipt date 7/24/14. The examiner is asked to provide the underlying reasons for all opinions expressed, and is reminded that the term "as likely as not" does not mean "within the realm of medical possibility," but rather that the evidence of record is so evenly divided that, in the examiner's expert opinion, it is as medically sound to find in favor of the proposition as against it. Bethany L. Buck Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N.B. Mmeje, 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.