Citation Nr: 23020175 Decision Date: 03/31/23 Archive Date: 03/31/23 DOCKET NO. 19-15 407 DATE: March 31, 2023 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from July 1980 to January 1986. He is a recipient of the Army Achievement Medal and the Overseas Service Ribbon among other awards and decorations. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In August 2017, the Veteran was afforded a VA examination to determine the nature and etiology of his bilateral hearing loss; however, the Board finds the examination report inadequate for adjudication purposes. See Barr v. Nicholson, 21 Vet. App. 303 (2007); Stefl v. Nicholson, 21 Vet. App. 120, 125 (2007); 38 C.F.R. § 3.159(c)(4). Specifically, the VA examiner opined that although the Veteran had a moderate probability of hazardous noise exposure as a combat signaler, his bilateral hearing loss was less likely than not due to his military service because he had normal auditory thresholds bilaterally at separation from service. Nevertheless, the Veteran's separation examination shows a 10 decibel (dB) shift at 400 Hertz and a 15 dB shift at 500 Hertz for the right ear and a 15 dB shift at 500 Hertz, a 10 dB shift at 4000 Hertz, and a 5 dB Hertz shift at 6000 Hertz for the left ear; yet the examiner did not explain why these changes were not considered clinically significant threshold shifts (worsening). Furthermore, the August 2017 VA examiner notes that the Veteran's audiological testing results at that time were indicative of noise induced hearing loss, but seemingly attributed it to the Veteran's post-service history of noise exposure. In doing so, the examiner failed to explain why the Veteran's six-year history of in-service noise exposure was not a contributing cause to his current bilateral hearing loss. As such, more medical comment regarding the etiology of the Veteran's bilateral hearing loss is warranted. Last, a preliminary review of the record reveals that there are no private or VA treatment records associated with the claims file. Given the seemingly incomplete record, remand is also warranted on this basis. The matters are REMANDED for the following action: 1. Give the Veteran opportunity to identify any outstanding private or VA treatment records relevant to his bilateral hearing loss claim. After obtaining any necessary authorization from the Veteran, as relating to his confidential private treatment records, obtain all outstanding records whether private and/or VA. For private treatment records, make at least two attempts to obtain records from all identified sources. If these records are unavailable, inform the Veteran and his representative of this and give them opportunity to submit any copies in their possession. For federal records, so including those within VA's actual or constructive possession, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain them would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile and allowed opportunity to provide these records, himself, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(c) and (e). 2. After obtaining all additional treatment or other relevant records, provide the Veteran another VA audiological examination for supplemental medical comment regarding the etiology of his bilateral hearing loss, especially in relation to his military service. All relevant medical and other relevant records must be made available to the examiner for review, including a complete copy of this remand. Based on a review of the Veteran's medical records, his lay statements regarding the development and treatment of this claimed disability, and consideration of all other relevant evidence in the claims file, including a complete copy of this remand, the examiner is asked to answer the following question: Is it at least as likely as not (approximate 50 percent or greater probability) his bilateral hearing loss began during his service from July 1980 to January 1986, or, if sensorineural in nature, within a year of his discharge from service so by January 1987, or is otherwise related to or the result of his service, including especially the conceded noise exposure and consequent injury (acoustic trauma) during his service? The mere absence of evidence of treatment for hearing loss in the Veteran's STRs cannot, alone, be sufficient rationale for providing a negative opinion, nor if he did not have sufficient hearing loss during or even immediately after his service to meet the threshold minimum requirements of § 3.385 to be considered a ratable disability for VA compensation purposes (i.e., he only needs to currently satisfy the requirements of this VA regulation, not also have while in service or even immediately after). The examiner is also advised that the Veteran is competent to report noise exposure and hearing problems in service, his symptoms and history, and these reports must be specifically considered in formulating any responses. If the examiner rejects the Veteran's reports, the examiner must provide a reason for doing so. It is essential the examiner provide rationale for the responses, irrespective of whether responding favorably or conversely unfavorably, preferably citing to findings or other specific evidence in the file supporting conclusions and/or accepted medical authority. Colleen M. Glaser-Allen Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mukherjee, C. 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.