Board of Veterans' Appeals decision
Decision 19103285
Decided January 11, 2019 · Judge Tanya Smith · Docket 12-21 394
The Board decided one issue.
Issues decided
Hearing loss
- Prior VA opinion found hearing loss at least as likely as not related to service
- Prior VA opinion lacked supporting rationale regarding separation audiogram
- Remand required for addendum opinion addressing specific audiogram findings
What was missing: A VA medical opinion with adequate rationale linking bilateral hearing loss to acoustic trauma experienced as an aircraft mechanic during service, specifically addressing the separation audiogram findings.
Issues, reasons and summaries are extracted by AI from the decision text and can contain errors.
Summary
The veteran, who served in the United States Air Force from July 1960 to March 1964, appeals the denial of service connection for bilateral hearing loss. This case comes before the Board on remand from the United States Court of Appeals for Veterans Claims following a Joint Motion for Remand. The Board previously denied service connection for bilateral hearing loss in June 2017, but this decision was vacated and remanded by the Court in April 2018. The primary issue on remand is the adequacy of a VA medical opinion regarding the veteran's hearing loss. The Board noted that a VA doctor provided a positive nexus opinion in April 2018, stating the hearing loss was at least as likely as not caused by acoustic trauma experienced as an aircraft mechanic. However, this opinion was deemed inadequate because it lacked a supporting rationale, failing to address the veteran's separation audiogram showing a threshold reading of 25 decibels at 4000 Hertz, which is above the normal range. The case is remanded for a new VA opinion to address this specific finding and provide a reasoned explanation for the nexus conclusion. The veteran may submit further evidence if desired.
Veteran's service
Air force · Peacetime era · served 1960–1964
Official decision
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Citation Nr: 19103285 Decision Date: 01/11/19 Archive Date: 01/11/19 DOCKET NO. 12-21 394 DATE: January 11, 2019 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1960 to March 1964. This matter comes before the Board on appeal from a May 2010 Regional Office (RO) rating decision. In June 2013, the Veteran testified at a hearing before the undersigned Veterans Law Judge. This claim was previously denied by the Board in June 2017. It was appealed to the United States Court of Appeals for Veterans Claims. In March 2018, the parties submitted a Joint Motion for Remand requesting that the issue be vacated and remanded for compliance with the terms of the Joint Motion. The Court granted this motion in an April 2018 Order, and the case has been returned to the Board for further adjudication. Entitlement to service connection for bilateral hearing loss is remanded. The March 2018 Joint Motion notes that the threshold for normal hearing is from 0 to 20 decibels, and higher threshold levels indicate some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 160 (1993). As noted by the Joint Motion, when converted from ASA to ISO units, the Veteran’s right ear threshold measured 25 decibels at the 4000 Hertz frequency. The parties thus agreed that the Veteran’s hearing was not considered to be “normal” on separation, and a remand was required for a new opinion to address this information. After the Joint Motion, in a November 2018 Informal Hearing Presentation, it was noted that a “VA doctor provided a positive nexus opinion in April 2018 for [the Veteran’s] bilateral hearing loss. Therefore, the only adequate medical opinion of record is the April 2018 medical opinion. In addition, the Board may not remand for VA medical opinion solely to controvert otherwise uncontroverted medical evidence favoring the appellant.” The April 2018 opinion consists entirely of the following: “I have reviewed [the Veteran’s] Military and civilian medical records. I conclude his hearing loss is at least as likely as not (50/50 probability) caused by the acoustic trauma that he experienced as a[n] aircraft mechanic while serving in the United States Air force. I state the information I have given is true to best of my knowledge and belief.” This opinion is inadequate because it fails to provide a supporting rationale for the conclusion reached. A medical opinion must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008) (citing Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). While this case is in remand status, the Veteran may submit another opinion that corrects this deficiency if he so desires. The matter is REMANDED for the following action: 1. Send the claims file to a qualified individual to obtain an addendum opinion to the December 2015 VA opinion that addresses the following: Is it at least as likely as not (a 50 percent probability or greater) that the Veteran’s bilateral hearing loss is etiologically related to service? In providing this opinion, please discuss the fact that the Veteran’s right ear had a threshold reading of 25 decibels at the 4000 Hertz frequency at the time of his separation from service which is 5 decibels above normal (0 to 20 decibels). Please see the Veteran’s service treatment records for the in-service audiograms and the Board’s June 2017 decision, pages 7 and 8, for the audiograms (which have been converted from ASA units to ISO units). If the VA examiner is unable to offer an opinion without resorting to speculation, a thorough explanation as to why an opinion cannot be rendered should be provided. TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Elizabeth Jalley, Counsel units). If the VA examiner is unable to offer an opinion without resorting to speculation, a thorough explanation as to why an opinion cannot be rendered should be provided. TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Elizabeth Jalley, Counsel