Citation Nr: 22016876 Decision Date: 03/23/22 Archive Date: 03/23/22 DOCKET NO. 17-56 146 DATE: March 23, 2022 REMANDED Service connection for hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1969 to March 1972. The case is on appeal from a May 2015 rating decision. In his September 2016 VA Form 9 (Appeal to the Board), the Veteran requested a Board hearing. The Board notified the Veteran of hearings in December 2020 and May 2021 scheduled for February 2021 and August 2021, respectively. The February 2021 hearing was postponed. The Veteran did not appear for the August 2021 hearing. As no good cause for the failure to appear at the August 2021 Board hearing has been given, the Board will proceed to adjudicate the claim. 38 C.F.R. § 20.704(d). Service connection for hearing loss. A remand is necessary to obtain a new medical opinion regarding the etiology of the Veteran's hearing loss. The Veteran was afforded a VA examination of his hearing loss and tinnitus in April 2015. The examiner opined that tinnitus was at least as likely as not related to service, but that hearing loss was less likely than not related to service. The examiner noted that the Veteran claimed in-service noise exposure from mortar explosions and denied significant post-service noise exposure working in manufacturing. The examiner explained that noise will affect outer hair cell function by sheering off sensitive stereocilia. This damage results in subjective ringing in the ears. However, a negative nexus opinion was given for hearing loss, as the Veteran had normal hearing upon separation and has had no medical diagnosis of or treatment for hearing loss. The April 2015 hearing loss opinion is inadequate as the examiner's conclusion is based on incorrect facts and lacks a sufficient rationale regarding the delayed onset of hearing loss. First, the Veteran does have a hearing loss disability. At the April 2015 VA examination, the following pure tone thresholds were recorded: HERTZ 500 1000 2000 3000 4000 RIGHT 15 25 25 50 50 LEFT 15 20 20 60 45 These audiometric results clearly show a hearing loss disability for VA purposes. See 38 C.F.R. § 3.385. Second, the examiner also did not explain the significance of the lack of diagnosis of hearing loss prior to April 2015. This is needed in light of the examiner's positive nexus opinion for tinnitus and the Veteran's denial of significant post-service noise exposure. Thus, a remand for a new medical opinion is necessary. The matter is REMANDED for the following action: Obtain a new medical opinion regarding the etiology of the Veteran's hearing loss. Specifically, the examiner should state whether: It is at least as likely as not that the Veteran's hearing loss is related to service. A complete rationale should be provided for any opinion rendered. Specifically, the examiner should discuss the Veteran's report of in-service noise exposure, the Veteran's report of no significant post-service noise exposure, and reconcile the conclusion reached with the positive nexus opinion for tinnitus. Finally, if relying on the lack of a diagnosed hearing loss disorder prior to April 2015 to support a negative opinion, the examiner should explain why the delayed onset of hearing loss is significant in light of the Veteran's health and noise exposure history. C. CRAWFORD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. George 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.