Citation Nr: 18148976 Decision Date: 11/08/18 Archive Date: 11/08/18 DOCKET NO. 08-34 011 DATE: November 8, 2018 REMANDED ISSUES Entitlement to a compensable rating for bilateral hearing loss on an extraschedular basis pursuant to 38 C.F.R. § 3.321, to include whether secondary service connection is warranted for a neurological or an acquired psychiatric disorder, is remanded. Entitlement to a rating greater than 10 percent for tinnitus on an extraschedular basis pursuant to 38 C.F.R. § 3.321, to include whether secondary service connection is warranted for a neurological or an acquired psychiatric disorder, is remanded. INTRODUCTION The Veteran served from January 1963 to November 1965. The Veteran’s claims for an extraschedular evaluation of service-connected bilateral hearing loss and tinnitus have been pending since August 2003 and were most recently denied in a Board decision in September 2016. Thereafter, the Veteran appealed his denial to the United States Court of Appeals for Veterans Claims (Court). In March 2018, the Court vacated the September 2016 Board decision and remanded it for further consideration. The Board also notes that on November 1, 2018, the Veteran appealed his denial of entitlement to service connection for allergic rhinitis, chronic sinusitis, and residuals of a laminectomy of his lower back. In addition, the Veteran appealed a noncompensable evaluation for service-connected hemorrhoids. These issues are not presently before the Board and will be addressed in a later decision. 1. Entitlement to a compensable rating for bilateral hearing loss on an extraschedular basis pursuant to 38 C.F.R. § 3.321, to include whether secondary service connection is warranted for a neurological or an acquired psychiatric disorder, is remanded. 2. Entitlement to a rating greater than 10 percent for tinnitus on an extraschedular basis pursuant to 38 C.F.R. § 3.321, to include whether secondary service connection is warranted for a neurological or an acquired psychiatric disorder, is remanded. The Board regrets the additional delay; however, a remand is warranted in this matter to address the Veteran’s complete disability picture. The Veteran contends that his service-connected bilateral hearing loss and tinnitus disabilities cause symptomology that are not contemplated by the applicable rating criteria. Specifically, he contends that he had balance problems due to bilateral hearing loss and that he has psychological symptoms associated with his tinnitus. At a June 2005 Board hearing, the Veteran reported the need for constant background noise to mask the ringing in his ears. He explained that this noise aggravated his wife and put a strain on his marriage. At a March 2008 hearing consultation, the Veteran reported balance problems, including an episode with headaches. In January 2009, the Veteran filed a Notice of Disagreement and reported that his hearing loss was causing communication problems with his wife and friends. In January 2011, a medical examiner noted that the Veteran’s hearing loss was a barrier to learning. During a June 2014 hearing examination, the Veteran reported that because of his hearing loss, “he has trouble following instructions at work. He can’t understand the people he talks with. He says his wife says it isn’t worth speaking to him because he can’t understand her and he misunderstands her. His hearing loss is causing problems at home.” The Veteran added that his tinnitus “aggravates him and he uses a sound generator to distract him from the ringing.” The Veteran’s contentions raise the issue of whether he has secondary neurological or psychological disabilities that are related to, proximately due to, or aggravated beyond their natural progression by the Veteran’s service-connected bilateral hearing loss or tinnitus condition. Further, these symptoms were not adequately considered in the August 2016 report that addresses an extraschedular impact. The report finds “no evidence of an effect on the Veteran’s average earning capacity, because it did not present evidence of an exceptional, or unusual disability picture, such as, marked interference with employment or frequent episodes of hospitalization that would render the application of the current rating schedule inadequate.” However, it did not consider if the symptoms as reported by the Veteran are not contemplated by the rating criteria or present an unusual disability picture, even if the totality of the symptoms do not amount to a marked interference with employment or frequent hospitalizations. Therefore, the matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination with an appropriate clinician to answer the following questions: (a.) Is it at least as likely as not that the Veteran has any psychological diagnosis; and if so is at least as likely as not that such a condition (1) related to, (2) proximately due to, or (3) aggravated beyond its natural progression by the Veteran’s service-connected bilateral hearing loss or tinnitus condition. A complete response will address all three statements. (b.) Is it at least as likely as not that the Veteran has any neurological diagnosis, to include problems with balance, dizziness, and/or headaches; and if so is at least as likely as not that such a condition (1) related to, (2) proximately due to, or (3) aggravated beyond its natural progression by the Veteran’s service-connected bilateral hearing loss or tinnitus condition. A complete response will address all three statements. 2. Obtain an opinion from an appropriate clinician on the expected functional impact of the Veteran’s audiological disabilities. Specifically, obtain an opinion of whether the symptoms reported by the Veteran, as follows, are unusual for the level of hearing loss or tinnitus as reported by the Veteran: At a March 2008 hearing consultation, the Veteran reported balance problems, including an episode with headaches. In January 2009, the Veteran reported that his hearing loss was causing communication problems with his wife and friends. In January 2011, a medical examiner noted that the Veteran’s hearing loss was a barrier to learning. During a June 2014 hearing examination, the Veteran reported that because of his hearing loss, “he has trouble following instructions at work. He can’t understand the people he talks with. He says his wife says it isn’t worth speaking to him because he can’t understand her and he misunderstands her. His hearing loss is causing problems at home.” The Veteran added that his tinnitus “aggravates him and he uses a sound generator to distract him from the ringing.” (Continued on the next page)   3. After the above development has been completed, readjudicate the issue of extraschedular consideration to include, whether secondary service connection is warranted for a neurological or an acquired psychiatric disorder. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD I. M. Hitchcock