Citation Nr: 21041574 Decision Date: 07/09/21 Archive Date: 07/09/21 DOCKET NO. 18-12 475 DATE: July 9, 2021 REMANDED The petition to reopen the claim for service connection for bilateral hearing loss is remanded. The petition to reopen the claim for service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1969 to June 1972, including service in the Republic of Vietnam. This matter comes before the Board of Veterans' Appeals (Board) from a November 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing with the undersigned in February 2021. A transcript of that hearing has been added to the Veteran's file. A VA audiological examination was performed in October 2017. However, a new VA medical opinion is warranted. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). In the examination report, the examiner opined that the Veteran's hearing loss was less likely than not related to in-service noise exposure. In support of this finding, the examiner stated, in part, that "it is difficult to attribute this recent hearing impairment functioning solely to the trauma suffered during military service and not to consider other factors such as aging and nose exposure from occupational activities after service." This opinion is insufficient, as the standard for establishing service connection does not require that hearing loss be attributed "solely" to in-service acoustic trauma, but rather that there be a link between disabling hearing loss and such trauma, even if post-service factors may have caused further hearing loss. See Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Moreover, the Veteran did not state that he had post-service occupational noise exposure. Thus, that is not a consideration relevant to the determination, unless the Veteran endorses such exposure. Accordingly, a new medical opinion must be obtained that is keyed to the correct standard and accurately based on the record. The claim for service connection for tinnitus is also remanded for a new medical opinion. In the October 2017 VA examination report, the examiner stated that the Veteran denied experiencing tinnitus. However, at his hearing before the Board in February 2021 the Veteran stated that the examiner asked him if he had ringing in his ears and he "said occasionally. But talking with my representative, she explained that tinnitus and that was, was also noises and hissing, like, watching T.V. with no projection. It was just snow noise and yes, I did have that at the time. Thus, a new medical opinion should be obtained as to whether the Veteran's tinnitus is linked to his in-service noise exposure. The matters are REMANDED for the following action: 1. Add to the file any outstanding VA treatment records for the Veteran dated since June 2021. 2. Obtain a new VA medical opinion regarding service connection for hearing loss and tinnitus, as specified below. (a) The examiner is asked to opine whether it is at least as likely as not (50% probability or more) that the Veteran's bilateral hearing loss is related to his in-service noise exposure from aircraft, weapons/mortars, rockets, explosions and mechanical/maintenance activities. Please note: The October 2017 VA medical opinion is not sufficient, as it seems to assume that the Veteran's hearing loss must be "solely" attributable to in-service acoustic trauma to establish service connection (there need only be a medical link between disabling hearing loss and such exposure, even if other factors may have contributed to his hearing loss), and because it assumes that the Veteran had post-service occupational noise exposure. (b) The examiner is asked to opine and to whether it is at least as likely as not (50% probability or more) that the Veteran's tinnitus is linked to his in-service noise exposure from aircraft, weapons/mortars, rockets, explosions and mechanical/maintenance activities. In providing the above opinions, the examiner should consider the Veteran's description of in-service symptoms as well as his post-service symptoms. See Transcript of Hearing, dated February 2, 2021. If there is any medical reason to accept or reject the proposition that the Veteran's reported symptoms in service and thereafter represented the onset of his current disabilities, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disabilities are known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? (Continued on the next page) All examination findings, along with a complete rationale for all opinions expressed, should be set forth in the examination reports. P.M. DILORENZO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Hofmeister 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.