Citation Nr: 18132294
Decision Date: 09/06/18	Archive Date: 09/06/18

DOCKET NO. 14-24 990A
DATE:	September 6, 2018
REMANDED
Entitlement to service connection for right ear hearing loss is remanded.
Entitlement to service connection for chronic obstructive pulmonary disease is remanded.
REASONS FOR REMAND
The Veteran served on active duty from August 1962 to December 1970.
This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).
The Veteran testified at a hearing before the undersigned in May 2018.  A transcript of the hearing is of record.
Entitlement to service connection for right ear hearing loss. 
The Veteran contends that he is entitled to service connection for right ear hearing loss based on acoustic trauma sustained during his military service.  The Veteran testified that during service, he ended up on the lower level of the ship where the guns were mounted.  Two guns went off at the same time and blew him back through the ship’s hatch, resulting in a concussion and blood dribbling from his right ear.  The Veteran testified that his hearing loss began following this in-service injury.  See May 2018 Hearing Transcript.  The Veteran also reported that his MOS in service was jet engine mechanic, and that he did not wear hearing protection.  See March 2011 Statement in Support of Claim.  In his July 2014 Appeal to the Board, the Veteran reported that during service, he had sick calls several times for ear pain and roaring noise in the ears.  He also reported that VA has issued hearing aids for both ears.  See July 2014 Form 9. 
The Veteran has both a current disability and an in-service injury.  A January 2011 VA examination showed that the Veteran has current right ear hearing loss with pure tone threshold of 80 decibels at the frequencies of 500, 1000, 2000, 3000 and 4000 hertz and a poor speech recognition score of 20 percent.  See January 2011 VA Examination.  Additionally, the Veteran complained of right ear ache and pain in service in October 1963 and July 1964.  In January 1965 the Veteran required cleaning of both the ear canals and drums after excessive wax was noted.  See November 2014 STR-Medical at 22, 29, 85.
Notwithstanding the evidence of a current disability and an in-service event, the record does not contain an adequate etiology opinion.  The January 2011 VA examiner opined that the Veteran’s right hearing loss is more likely due to some other medical condition.  See January 2011 VA Examination at 4.  Subsequently, in July 2014, Veteran’s private physician opined that the Veteran’s neurosensory hearing loss is more likely than not related to the Veteran’s military service.  The record contains no other opinions regarding the etiology of the Veteran’s right ear hearing loss.
The opinions of record are inadequate.  First, while the VA examiner opined that the Veteran’s right ear hearing loss may be related to some other medical condition, no opinion is offered as to whether this medical condition and the related hearing loss is a result of an in-service injury or event.  The examiner did not address the Veteran’s reports of in-service injury that caused his ears to bleed, the Veteran’s report of not using hearing protection in-service and the in-service treatment records which show complaints of right ear aches and treatment.  The private physician’s opinion is inadequate because he offered no rationale or supporting evidence. 
As neither the VA examiner or the Veteran’s private physician offer an opinion supported by adequate rationale and that considered all the evidence of record, this matter must be remanded for an addendum opinion. 
Entitlement to service connection for chronic obstructive pulmonary disease. 
The Veteran contends that his COPD is a result of exposure to lead paint, asbestos, second-hand smoke, and Agent Orange during military service.  The Veteran also reported that as a part of his job in-service he was exposed to dust from sanding, with his only protection being a paper mask.  He also reported that he began experiencing breathing problems during service.  See May 2018 Hearing Transcript.
Treatment records show that the Veteran has a current diagnosis of COPD.  See November 2015 Medical Treatment Record- Non-Government Facility.  The Veteran is competent to report in-service exposure to dust from sanding, second hand smoke, and difficulty with breathing.  Moreover, service treatment records contain complaints of chest pain and congestion in- service.  See November 2014 STR-Medical.  
The Veteran was afforded VA examinations in December 2011 and November 2012.  See December 2011 VA Examination, November 2012 VA Examination.  Neither examination addressed contentions regarding the Veteran’s exposure to lead, asbestos, or dust from sanding.  The Board observes that the Veteran’s military occupational specialty was aviation machinist mate, which is noted to have probable asbestos exposure.  See M21, IV.ii.1.I.3.d. (last accessed September 5, 2018).
Moreover, in November 2017 the Veteran’s treating physician reports that the Veteran has been diagnosed with bronchiectasis.  Unfortunately, the record contains no treatment records from this physician.  Moreover, while the Veteran signed an authorization for release of information, there is no evidence that attempts were made to obtain these records.  Similarly, the Veteran reports receiving treatment from Dr. J.G.  The Veteran signed an authorization to release information, however there is no evidence that a request for records was ever made.  See January 2012 VA Authorization for Release of Information.  These records should be obtained. 
The matters are REMANDED for the following action:
1. Contact the Veteran to obtain an authorization for release of information and obtain treatment records from Drs. J. Grove and D. Henson. 
2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s right ear hearing loss is at least as likely as not related to in-service acoustic trauma.  In rendering a decision, the examiner should address: 
(a.) The Veteran’s history of right ear pain, to include October 1963, July 1964, and January 1965 STRs;
(b.) The Veteran’s contentions that he worked as a jet engine mechanic and did not wear ear protection despite being exposed to loud noises; and
(c.) The June 2014 positive nexus opinion by a private treating physician who opined that it is more likely than not that the Veteran’s hearing loss is related to his military service. 
3. Only after the first remand directive has been completed, schedule the Veteran for a VA examination.  The examiner should: 
(a.) Determine whether the Veteran has a current diagnosis of bronchiectasis.  If it is determined that the Veteran has bronchiectasis, the examiner should opine whether it is ast least as likely as not that the Veteran’s bronchiectasis is a result of an in-service injury or event. 
In rendering an opinion, the examiner should consider all evidence of record, including the Veteran’s contentions that he was exposed to lead paint, dust from sanding, and asbestos. 
(b.) Determine whether it is at least as likely as not that the Veteran’s COPD is a result of an in-service injury or event. 
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In rendering an opinion, the examiner should consider all evidence of record, including the Veteran’s contentions that he was exposed to lead paint, dust from sanding, and asbestos. 
4. After the above development has been completed, readjudicate the claims.  If a benefit sought remains denied, provide the Veteran and his representative with a supplemental statement of the case and return the case to the Board.
 
S. HENEKS
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A. Wimbish, Associate Counsel

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