Citation Nr: 21042315 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 16-21 054 DATE: July 12, 2021 REMANDED The claim of entitlement to service connection for a bilateral hearing loss disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1968 to November 1969. This matter comes to the Board of Veterans' Appeals (Board) on appeal of a rating decision by a U.S. Department of Veterans Affairs (VA) Regional Office (RO). In June 2019, the Board remanded this matter for additional medical inquiry. The case is again before the Board for appellate review. Another remand is warranted. The record contains two VA opinions addressing the claim, offered by the same audiologist. In each, the audiologist indicates that she cannot provided a medical opinion because the record is incomplete. She notes the absence of an audiogram at discharge from service the December 1969 discharge report of medical examination states "inoperable" with regard to a hearing test at service separation. And she indicates that audiograms conducted since service, related to the Veteran's post-service employment, would be useful in formulating an opinion, but are not of record. On remand, the RO should attempt to include in the record any audiology evidence produced pursuant to post-service employment. The matter is REMANDED for the following action: 1. Request from the Veteran authorization to obtain any audiology evidence related to his post-service employment. In a January 2015 statement, the Veteran indicated that he worked in OSHA-compliant employment after 1981. The VA examiner indicated that "serial audiograms" would have been conducted if "the plant where he worked was OSHA-compliant[.]" Communicate to the Veteran the significance of this evidence in light of the absence of evidence showing hearing acuity at discharge from service. 2. If additional audiology evidence is included in the claims file pursuant to #1, return the case to the VA examiner who provided the November 2019 report, or to a suitable substitute, for issuance of an addendum opinion. After reviewing the claims file, the examiner should address the following question. Is it at least as likely as not (probability of 50 percent or more) that the bilateral hearing loss disorder had its onset in service or is related to an event, disease, or injury during service? As was done in the November 2019 report, accept as true the Veteran's reports of loud noises during service. The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. In rendering the requested opinion, the examiner should note that the Veteran is competent to attest to matters of which he has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should indicate this in the examination report and provide a rationale for that determination. In remanding this case, the Board makes no credibility determination, expressed or implied, at this juncture. Please explain in detail any opinion provided and the supporting rationale. (Continued on the next page) If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to any particular question(s). G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Christopher McEntee, 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.