Citation Nr: 22016006 Decision Date: 03/21/22 Archive Date: 03/21/22 DOCKET NO. 17-05 598A DATE: March 21, 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 from April 1975 to April 1978. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. The Veteran asserts that she has bilateral hearing loss and tinnitus due to active duty service. The Veteran has stated that while on active duty, she was exposed to noise from truck driving without hearing protection. The service personnel records show that the Veteran served as a Motor Transport Operator. Therefore, the Board finds that the Veteran was likely exposed to loud noises from trucks while on active duty. Post-service treatment records and August 2015 VA examination reports show current diagnoses of bilateral sensorineural hearing loss and tinnitus. On VA examination of August 2015, the examiner found that it was less likely than not that bilateral hearing loss was caused by or a result of an event in service. The examiner stated that hearing tests conducted at enlistment and separation did not show a significant shift in hearing thresholds in service. Therefore, the examiner concluded that there was no historical evidence to support hearing loss was incurred in or aggravated by service. However, the examiner noted that incomplete records were provided and only audiograms dated 1975 and 1977 were reviewed as no other medical records were available to the examiner. Additionally, the August 2015 examiner found that the Veteran's tinnitus was at least as likely as not a symptom associated with the Veteran's hearing loss as tinnitus was known to be a symptom of hearing loss. The Board appreciates the efforts made by the VA examiner. However, as the August 2015 VA examiner relied on the absence of symptoms or treatment in-service for the negative opinion and the examination did not include a review of the Veteran's claims file, the Board finds the opinion inadequate. When VA undertakes to obtain an evaluation, it must ensure that the evaluation is adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). An opinion that relies only on the absence of symptoms or treatment in-service is not adequate. A lack of medical evidence in-service treatment records does not preclude service connection. Buchanan v Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). Further, as the examiner was not fully informed of the pertinent facts and medical history of the case, the Board finds the examination to be incomplete. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Remand is necessary for an adequate etiology opinion regarding the demonstrated bilateral hearing loss and tinnitus. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Schedule the Veteran for a VA audiology examination to obtain an opinion on the cause of bilateral hearing loss and tinnitus. Following a review of the record, to include the Veteran's lay statements concerning in-service noise exposure, hearing loss symptoms, tinnitus, and the onset of current symptomatology, the examiner should opine as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran's bilateral hearing loss or tinnitus had its onset during, or is otherwise related to service, to include established in-service noise exposure. A clearly stated rationale for any opinion offered should be provided and must not be based solely on the lack of any in-service records. The examiner must consider the Veteran's lay statements regarding symptoms of hearing loss and tinnitus during and after service. MARJORIE A. AUER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Gastoukian, Kelly 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.