Citation Nr: 22014271 Decision Date: 03/12/22 Archive Date: 03/12/22 DOCKET NO. 19-03 145 DATE: March 12, 2022 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1970 to May 1972. This matter comes to the Board of Veterans' Appeals (Board) on appeal from an August 2018 rating decision issued by a Department of Veterans Affairs (VA) Regional Office. In August 2021, the Veteran testified at a virtual Board hearing before the undersigned Veterans Law Judge. A transcript of that hearing has been associated with the record. 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. Although the Board sincerely regrets the additional delay, a remand is necessary to ensure that there is a complete record upon which to decide the Veteran's claim and to afford him every possible consideration. Specifically, the Board finds that a remand is required to obtain potentially relevant and outstanding medical records. A November 2015 VA treatment note reflects that when the Veteran presented for a hearing examination and hearing aid discussion at VA, he provided to the clinician for review (1) the results of a January 2015 hearing examination at Costco, as well as (2) a hearing test from his employer completed in 1999 which showed a mild high frequency hearing loss. See also August 2021 Board hearing transcript (indicating that his previous employer, Georgia Pacific, had administered a number of hearing tests over the years and that he "thought [he] provided one of those to [his representative]".) Unfortunately, no private audiology reports have been associated with the electronic claims file to date. See, e.g., 38 C.F.R. § 3.159(e)(2) (if VA becomes aware of the existence of relevant records before deciding a claim, VA will, among other things, request that the claimant provide a release for the records). Additionally, the Board notes that a copy of the November 2015 audiogram discussed in that VA treatment report has also not been associated with the electronic claims file. See November 2015 VA treatment report (noting "A CPRS version of the audiogram is available under the 'Tools' pull down menu. Click on 'Outpatient Resources' then select 'Audiogram Display' to view pure-tone, speech, and immittance data). As VA is in possession of the report, a copy of this audiogram, and any new VA treatment records generated since September 2018, should also be associated with the claims file. After the development requested above has been completed, the claims file should be sent to a VA clinician for review and to provide a new opinion that adequately acknowledges and addresses the Veteran's competent reports of in-service noise exposure from a grenade simulator, tanks, and weapons fire, as well as his reports of intermittent tinnitus and temporary diminished hearing, described as "muffled voices," after in-service noise exposure. See Board hearing testimony at p.4. These matters are REMANDED for the following actions: 1. Ask the Veteran to submit, or to complete a VA Form 21-4142 in order for VA to obtain on his behalf, copies of any outstanding and relevant private treatment records, including but not limited to (1) the January 2015 Costco audiogram and (2) hearing tests, including one from 1999, administered while he was employed at Georgia Pacific. Make two requests for the authorized records from any identified private treatment providers unless it is clear after the first request that a second request would be futile. 2. Obtain a copy of the November 2015 VA audiogram referenced in the November 2015 VA treatment report, as well as any VA treatment records from September 2018 through the present. 3. After the foregoing development has been completed to the extent possible, ask a VA clinician with appropriate experience to review the record and prepare a supplemental report as to each of the following questions: a. Is it at least as likely as not (i.e., is it 50 percent or more probable) that the Veteran's hearing loss had its onset in, or is otherwise related to, service, to include in-service exposure to noise? b. Is it at least as likely as not that the Veteran's tinnitus had its onset in, or is otherwise related to, service, to include in-service exposure to noise? The examiner should presume that the Veteran was exposed to loud noise in service from grenade simulators, tanks, and weapons fire, and should discuss the Veteran's report that he experienced temporary diminished hearing, described as "muffled voices," after in-service noise exposure. The examiner should also discuss the medical significance, if any, of the fact that that no audiometric data were recorded at 2000 Hertz for either ear when the Veteran was examined for service separation. The examiner should specifically discuss whether, in the absence of audiometric data at 2000 Hertz, it is possible to determine whether the Veteran's hearing was normal at that frequency at the time of separation, and whether it is possible to determine whether any threshold shifts occurred at that frequency during service. If the examiner places reliance on the 2005 report from the Institute of Medicine, pertaining to delayed onset of hearing loss, the examiner must acknowledge and discuss any apparent qualifiers or contradictions in that report as they relate to the acknowledgement therein that definitive studies have not been performed to determine whether permanent noise-induced hearing loss can develop much later in one's lifetime, long after the cessation of noise exposure. The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner selected to offer the requested opinions. A complete rationale for all opinions expressed must be provided 4. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issues on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Gielow, 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.