Citation Nr: 1318294 Decision Date: 06/05/13 Archive Date: 06/11/13 DOCKET NO. 12-32 572 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Paul, Minnesota THE ISSUE Entitlement to an increased evaluation for bilateral hearing loss, currently evaluated as 20 percent disabling. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Nadine W. Benjamin, Counsel INTRODUCTION The veteran (appellant) served on active duty from July 1943 t0 March 1945. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Paul, Minnesota. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND Reason for Remand: To obtain an adequate VA examination and to obtain clarification of private records. Additional development is required before the issue on appeal can be adjudicated. Specifically, clarification is necessary regarding the findings on a private audiological examination. Finally, another VA examination is necessary, for the reasons discussed below. With regard to the claim for an increased disability rating for the bilateral hearing loss disability, there is an audiometric examination report dated in December 2009 from the Hearing Help Audiology Clinic which is inadequate for rating purposes, as it does not indicate whether the Maryland CNC speech discrimination test was used and it includes audiometric findings that are reported in graph form only. VA's duty to assist also includes undertaking reasonable efforts to obtain clarification of unclear evidence, which applies to medical examination reports of all kinds. 38 C.F.R. § 19.9 (2012). On remand, the RO/AMC should notify the Veteran and the examiner that the examination report provided is insufficient and request clarification. If no response is received, either from the private examiner or the Veteran, VA may continue with adjudication, weighing the accumulated evidence of record as usual. See Savage v. Shinseki, 24 Vet. App. 259 (2011). Additionally, the Veteran was examined by VA in May 2012. At that time, the claims file was not available. The Veteran underwent audiometric testing; however, as pointed out by the Veteran's representative, the examiner stated that the test results were inconsistent and unreliable. The examiner went on to state that the current results SHOULD NOT (emphasis in original) be used for rating purposes. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Thus another VA examination must be scheduled for the Veteran. Accordingly, the case is REMANDED for the following action: (Please note, this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). Expedited handling is requested.) 1. Contact Hearing Help Audiology Clinic and request that they identify which speech discrimination test was utilized during the December 2009 examination, as well as to provide the puretone threshold findings in numerical form. If the examiner is unavailable or does not respond, the RO/AMC should make a notation of this fact in the record. 2. Notify the Veteran that the December 2009 examination by Hearing Help Audiology Clinic is inadequate and that the RO/AMC is contacting the provider for additional information. If, after allowing an adequate time for response, no response is received from Hearing Help Audiology Clinic notify the Veteran that the RO/AMC may continue to adjudicate the claim, weighing the accumulated evidence of record as usual. 3. Upon completion of the above development, afford the Veteran an appropriate VA audiology examination in order to determine the current nature and severity of his service-connected bilateral hearing loss disability. The claims file and any pertinent evidence in Virtual VA must be reviewed by the examiner in conjunction with the examination. If the examiner does not have access to Virtual VA, any relevant treatment records contained in Virtual VA file that are not available on CAPRI or AMIE must be made available to the examiner for review. All indicated evaluations, studies, and tests deemed to be necessary must be accomplished. The examiner must fully describe the functional effects caused by the Veteran's bilateral hearing loss disability. The examiner must also offer an opinion as to whether it is at least as likely as not the Veteran's service-connected bilateral hearing loss renders him unable to secure and follow a substantially gainful occupation. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. 4. The Veteran must be properly informed of his scheduled VA examination, and he should be given notice of the consequences of failure to report for the examination, including an explanation of the provisions of 38 C.F.R. § 3.655. If the Veteran does not report for the examination, the claims folder should include clear documentation of his failure to report. 5. The RO should review the claims folder and ensure that all of the foregoing development actions have been conducted and completed in full. If any development is incomplete, appropriate corrective action is to be implemented. 38 C.F.R. § 4.2 (2012); See also Stegall v. West, 11 Vet. App. 268 (1998). 6. When the development requested has been completed, readjudicate the claim on appeal. If any benefit sought is not granted to the fullest extent, the Veteran and his representative must be furnished a supplemental statement of the case (SSOC), and be afforded a reasonable opportunity to respond before the record is returned to the Board for further review. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ KATHLEEN K. GALLAGHER Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2012).