Citation Nr: 21042331 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 16-61 973 DATE: July 12, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran service active duty from December 1993 to December 1997 with Reserve service afterwards. These matters are before the Board of Veterans' Appeals (Board) from a March 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In the December 2016 Form 9, the Veteran had elected the option for a live videoconference Board hearing. The Veteran did not appear at the scheduled hearing. 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. The Veteran reported ear pain during active duty military service multiple times. The Veteran's August 1993 enlistment examination reported that the Veteran had tubes in her ear when she was six or seven years old and that they were taken out. In June 1996 and August 1997, the Veteran reported that her ears were hurting. The Veteran initially sought entitlement to service connection for Meniere's Disease and was granted service connection in an August 2009 rating decision with a noncompensable rating effective February 12, 2009. The Veteran submitted private treatment records that reported that the Veteran experienced tinnitus and hearing loss in connection to his Meniere's Disease. In December 2000, the examiner indicated that the Veteran suffered from unilateral tinnitus. In July 2001, the Veteran reported that the tinnitus was intermittent and that it had a high-pitched ring. She furthered that it used to be constant, but that it now was intermittent. The examiner noted that the Veteran experienced additional symptoms of Meniere's Disease including dizziness, vomiting, nausea, tinnitus, otorrhea, and hearing loss. The examiner noted that the Veteran had ear surgery in 1989. In January 2002, the examiner noted that the Veteran's symptoms of hearing loss and ringing had resolved and that she had hearing within normal limits. A June 2003 record reported that the Veteran had right ear pressure and right ear ringing, but no recent history of hearing loss or tinnitus. In September 2012, a VA examiner opined that the Veteran's problems were not Meniere's Disease, since she had a normal audiogram in 2002 and found that the Veteran's problems were a result of a musculoskeletal and myofascial disorder as a result of dental problems. In October 2012, the Veteran was warranted a VA audiological examination with Puretone threshold averages of the right and left ear to be 16 and 9 decibels. Speech discrimination scores were 92 percent for the right ear and 98 for the left ear. The examiner ultimately diagnosed the Veteran with right ear sensorineural hearing loss in the frequency range of 6000 Hertz or higher frequencies which does not meet the criteria to be considered a disability for VA purposes. The examiner noted that the Veteran had normal hearing in her left ear. The examiner opined that the Veteran's hearing loss was not at least as likely as not caused by or a result of an even in military service since even though noise exposure was significant, the Veteran had normal hearing prior to service as well as at the end of service according to a normal audiogram dated January 16, 2002. The examiner noted that the Veteran was in service from 1993 to 2000. During the examination, the Veteran reported that she first noticed tinnitus around 1995 with the onset of dizziness and the diagnosis of Meniere's Disease. She described it as intermittent and that it was in both ears. When determining the etiology of the Veteran's tinnitus, the examiner noted that the tinnitus was at least as likely as not due to a know etiology. The examiner furthered that the known etiology was Meniere's Disease since tinnitus is a known and main symptom associated with Meniere's Disease. In a January 2013 rating decision, the RO proposed to sever service connection for Meniere's Disease since all instances of Meniere's disease was shown in her reserve duty service records and not in her active duty service treatment records. The RO concluded that the evidence of record failed to establish that the Veteran had Meniere's disease that was due to, a result of, or aggravated by her active duty military service. The RO also concluded that entitlement to service connection for tinnitus was denied since the October 2012 VA examination showed that the Veteran's tinnitus was a main symptom of her Meniere's disease and that she was already service connected for that. In a November 2013 rating decision, the RO severed service connection for Meniere's disease. In the April 2014 Notice of Disagreement, the Veteran reported that she was assigned to both supply and flight line duties and that her service treatment records showed chronic ear pain. She furthered that she was discharged from the reserves due to her hearing loss and tinnitus. In a February 2017 VA examination for ear disorders, the examiner noted that the Veteran had tinnitus more than once weekly for up to a day and that she experienced hearing loss as well. The Board finds that the October 2012 VA examination was inadequate. The examiner used the wrong dates of service and included the Veteran's Reserve service to opine whether or not the Veteran's hearing loss was linked to her military service. Additionally, the examiner noted that the Veteran's tinnitus was due to her Meniere's Disease, which later on was denied since the Veteran was already service connected for Meniere's Disease. However, service connection for Meniere's Disease was severed and thus the reasoning to deny service connection for tinnitus does not apply anymore. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). As such, the Board finds that the Veteran is warranted a new VA examination to determine the etiology of her bilateral hearing loss and tinnitus. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination for her bilateral hearing loss and tinnitus. The examiner must review the claims file. The examiner is asked to provide a response to the following: (Continued on the next page) Is the Veteran's bilateral hearing loss and tinnitus at least as likely as not related to service? Provide a rationale to support the separate opinions for each disability. In providing the requested opinion, consider the Veteran's description of her in-service injury and symptoms as well as her post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of her current disability, this should be noted. Stated another way, do the Veteran's reports about her symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? Thomas H. O'Shay Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Imam, 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.