Citation Nr: 21042062 Decision Date: 07/11/21 Archive Date: 07/11/21 DOCKET NO. 14-35 101A DATE: July 11, 2021 REMANDED Entitlement to service connection for a bilateral hearing loss disability is remanded. REASONS FOR REMAND The Veteran had active service in the U.S. Navy from January 1983 to September 1987. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2012 rating decision issued by the Department of Veterans Affairs (VA). In October 2018 and November 2020, the Board remanded the appeal to the Agency of Original Jurisdiction (AOJ), for additional evidentiary development. 1. Entitlement to service connection for a bilateral hearing loss disability is remanded. In the October 2020 Appellate Brief, the Veteran's representative asserted that a single synaptopathic exposure (traumatic event) can accelerate cochlear aging. The fact that initially reversible noise damage can have dramatic long-term consequences in amplifying age-related sensorineural hearing loss is of great significance in the consideration of noise-risk assessments, per an article published in the Journal of Neuroscience in May of 2015. The most recent VA medical opinion was obtained in April 2021. The VA examiner opined that the Veteran's bilateral hearing loss disability was less likely than not due to his active service. Although noise exposure is conceded and the relationship of noise exposure, cochlear auditory damage and hearing loss is well-established, cochlear auditory damage and hearing loss are not conceded base on noise alone. The VA examiner explained that there is no evidence showing acceleration of cochlear aging given the fact that veteran's hearing sensitives improvement in 2012 comparing to 2005 and the evidence is against the nexus in this case. The VA examiner did not adequately explain this conclusion. This rationale is inadequate because it does not provide any explanation why the Veteran did not sustain cochlear damage when he was exposed to noise during his active service. The Veteran's hearing has gotten worst during the appeal period and there is no rationale provided in the opinion why the Veteran did not sustain cochlear damage when he was exposed to noise during his active service. Finally, the rationale does not address the Veteran's contention that initially reversable noise damage can have dramatic long-term consequences in age related hearing lost. As reference in a May 2015 article published in the Journal of Neuroscience. Therefore, a remand is required to obtain adequate medical opinion. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's bilateral hearing loss disability is at least as likely as not related to his active service to include his conceded in-service noise exposure. The Examiner must consider and discuss: the article referenced in the October 17, 2020 Appellate Brief; an article published in the Journal of Neuroscience in May of 2015 "shows that auditory damage can accelerate hearing loss in aging in some cases." The Examiner must provide a complete rationale for all opinions provided, citing all evidence and medical literature relied upon. If the Examiner cannot reach a conclusion on any issue without resorting to mere speculation, the Examiner must explain why. 2. After the above development, and any additionally indicated development, has been completed, readjudicate the issue on appeal. If the benefit sought is not granted to the Veteran's satisfaction, send the Veteran and his representative a Supplemental Statement of the Case (SSOC) and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. DAVID L. WIGHT Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Le, Tai D. 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.