Citation Nr: 21041836 Decision Date: 07/10/21 Archive Date: 07/10/21 DOCKET NO. 18-25 496 DATE: July 10, 2021 REMANDED Entitlement to service connection for hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1953 to September 1956. These matters are on appeal to the Board of Veterans' Appeals (Board) from a July 2017 rating decision. A hearing was held by the undersigned Veterans Law Judge in May 2021. 1. Entitlement to service connection for hearing loss 2. Entitlement to service connection for tinnitus The Veteran contends his diagnosed hearing loss and tinnitus are a result of in-service acoustic trauma through his duties as a tank driver and frequently hearing the firing of weapons in close proximity with no hearing protection. In his hearing, the Veteran explained that he experienced hearing loss and tinnitus while in service that have continued ever since. A VA opinion was obtained in July 2017. The examiner opined that the disabilities were less likely than not related to service, and more likely related to other factors such as age or post-service occupational noise exposure. He noted the Veteran's normal hearing in service, the lack of complaints of symptoms for several decades, and post-service employment as a heavy equipment operator. Similarly, the same nexus opinion was applied to tinnitus because the main cause of tinnitus is hearing loss. The examiner inaccurately stated that there were no complaints of hearing loss or tinnitus for almost 60 years; however, a November 1994 medical treatment record reflects a complaint of ringing in the ears. Moreover, the examiner concluded that the disabilities were less likely than not related to service "given the hearing levels were considered WNL at separation." 38 C.F.R. § 3.385 does not preclude service connection for a current disability where hearing was within normal limits on audiometric testing at separation from service if there is sufficient evidence to demonstrate a relationship between the veteran's service and his current disability See Hensley v. Brown, 5 Vet. App. 155 (1993). Because it appears the examiner largely relied on normal hearing in service in reaching his negative conclusion, the opinion is inadequate in that regard. When VA undertakes to provide a VA examination or obtain a VA opinion it must ensure that the examination or opinion is adequate. See Barr v. Nicholson, 21 Vet. App. 303 (2007). Therefore, the Board finds that a remand for a new examination and medical opinion is necessary. The matters are REMANDED for the following action: Obtain a new VA opinion, to include an examination if deemed necessary, on whether it is at least as likely as not (50 percent or greater probability) that the Veteran's hearing loss and/or tinnitus are related to his in-service noise exposure. The examiner must consider and address all relevant evidence of record, to include the Veteran's assertions that his symptoms have existed since service and the 1994 notation of ringing in the ears. Additionally, the examiner must address the Veteran's citation to 2005 medical literature authored by Dr. Kujawa indicating that hearing damage can occur and manifest years after acoustic trauma, which appears contradictory to the Institute of Medicine study referenced by the 2017 VA examiner. Finally, the examiner is reminded that, in accordance with regulation, normal hearing at separation from service alone is an insufficient basis to find a lack of nexus. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Carroll, 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.