Citation Nr: 22010771 Decision Date: 02/24/22 Archive Date: 02/24/22 DOCKET NO. 17-65 288 DATE: February 24, 2022 REMANDED Service connection for a back disability is remanded. Service connection for hypertension, claimed as secondary to a back disability, is remanded. Service connection for a right shoulder disability, claimed as secondary to a back disability, is remanded. Service connection for bilateral hearing loss is remanded. Service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran had active duty from October 1972 to September 1973. These matters come before the Board of Veterans' Appeals (Board) on appeal from a March 2016 rating decision. The Veteran testified before the undersigned in June 2021, and a transcript is of record. 1. Service connection for a back disability is remanded. The Veteran asserts his current back disability is related to an in-service accident. See June 2021 Board Hearing Transcript. The Veteran's service medical records reflect an in-service event as they document the Veteran strained his back moving a camper. The Veteran's VA treatment records show that he gave a history of post-service back injuries in 1992/1993 and 2003. See VA examination report, dated February 29, 2016. He also reported seeing a private doctor for his back in Texas, to include as part of Workman's compensation claims. See VA Primary Care Notes, dated July 21, 2014, and January 26, 2015. An April 2013 MRI of the Veteran's lumbar spine shows that he was referred by Ed Wolski, M.D. On remand, the Veteran's complete private treatment records should be obtained, as well as any records related to his claims for Workman's compensation. Following receipt of these records, an addendum medical opinion should be obtained, as set forth below. 2. Service connection for hypertension, claimed as secondary to a back disability, is remanded. 3. Service connection for a right shoulder disability, claimed as secondary to a back disability, is remanded. The Veteran's contends his hypertension and right shoulder disabilities are caused or aggravated by his back disability. See June 2021 Board Hearing Transcript. As these claims are inextricably intertwined with the claim for service connection for a back disability, adjudication is deferred at this time. 4. Service connection for bilateral hearing loss is remanded. 5. Service connection for tinnitus is remanded. Regarding these claims, the Veteran received a VA examination in February 2016. The report reflects a diagnosis of bilateral hearing loss for VA purposes. The report further reflects a diagnosis of tinnitus. VA also obtained VA etiological opinions in February 2016. For the Veteran's bilateral hearing loss, the examiner provided a negative opinion. For their rationale, the examiner found the Veteran's hearing acuity was normal bilaterally during enlistment and on separation from service. The examiner also did not find any significant threshold shifts in the Veteran's hearing acuity during active service. For the Veteran's tinnitus, the examiner also found it is less likely than not related to the Veteran's active service. The examiner notes the Veteran's military occupational specialty carries a high probability for noise exposure; however, the audiometric and scientific evidence does not support a nexus between tinnitus and his active-duty service. The Board finds the February 2016 VA audiological opinions to be inadequate as they do not explain why the absence of a significant puretone shift during service is a basis for finding that the Veteran's current hearing disabilities are less likely than not related to in-service noise exposure. Accordingly, a remand is required to obtain addendum opinions. The matters are REMANDED for the following action: 1. Obtain the Veteran's updated VA treatment records. 2. Obtain the Veteran's complete treatment records from Ed Wolski, M.D. 3. Ask the Veteran to identify all private medical care providers that treated him for his low back since his separation from service, to include, but not limited to, the private doctor in Texas who treated him as part of Workman's compensation claim(s) and any clinicians that treated him for his low back injuries in 1992/1993 and 2003. Then, make arrangements to obtain the Veteran's complete treatment records from these providers. 4. Ask the Veteran to provide information pertaining to any Workman's compensation claims. After securing any necessary releases, request any relevant records related to any claims for Workman's compensation benefits and associated medical treatment records. 5. After completion of the above development, obtain an addendum medical opinion for the Veteran's bilateral hearing loss and tinnitus. The examiner is asked to provide an opinion as to whether the Veteran's hearing loss and tinnitus are linked to his in-service noise exposure. If the opinion continues to be negative, the examiner must explain how the absence of a significant puretone threshold shift during service supports the conclusion reached. 6. Obtain an addendum medical opinion for the Veteran's low back disorder. The examiner is asked to provide an opinion as to whether the Veteran's low back disorder is linked to his in-service back injury in February 1973 when he strained his back lifting a camper. (Continued on the next page) In providing the requested opinion, the examiner should consider the Veteran's description of his in-service symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's symptoms in service and thereafter represented the onset of his current back disability, this should be noted. Stated another way, do the Veteran's reports about his 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? P. M. DILORENZO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Buck Denton 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.