Citation Nr: 18149298 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 16-33 178 DATE: November 9, 2018 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for peripheral neuropathy of the right lower extremity, secondary to Agent Orange exposure, is remanded. Entitlement to service connection for peripheral neuropathy of the left lower extremity, secondary to Agent Orange exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1965 to February 1969. This appeal arose to the Board of Veterans’ Affairs (Board) from an April 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in the Philippines. 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends that he is entitled to service connection for bilateral hearing loss. For the following reasons, the Board finds a remand necessary prior to adjudication. Notably, the Veteran’s enlistment examination revealed preexisting left ear hearing loss disability, but not a preexisting right ear hearing loss disability. The Veteran received a Compensation and Pension (C&P) examination in April 2015, which revealed that the Veteran had bilateral hearing loss disabilities, for VA purposes. See 38 C.F.R. § 3.385. The examiner opined that he could not determine whether the Veteran’s preexisting left ear hearing loss was aggravated during service, nor whether the Veteran’s current right ear hearing loss was related to service. As VA is obligated to provide the Veteran with an adequate examination and opinion, a remand is in order to obtain an examination in which the examiner renders an opinion concerning the etiology of the Veteran’s right ear hearing loss and an opinion as to whether or not the Veteran’s service aggravated his pre-existing left ear hearing loss. See Barr v. Nicholson, 21 Vet. App. 303 (2007). 2. Entitlement to service connection for peripheral neuropathy of the right and left lower extremities, secondary to Agent Orange exposure, is remanded. The Veteran contends that he is entitled to service connection for peripheral neuropathy of the right and left lower extremities. For the following reasons, the Board finds a remand warranted prior to adjudication. The RO has conceded that the Veteran was exposed to Agent Orange in service. The Veteran’s medical records demonstrate that he suffers from peripheral neuropathy in his right and left toes. Peripheral neuropathy has been presumptively linked to Agent Orange exposure, but only in instances where neuropathy manifests to a compensable degree within one year of exposure. 38 C.F.R. § 3.307(a)(6)(ii). Although there is no evidence that peripheral neuropathy developed within one year of the Veteran’s exposure to Agent Orange in this case, service connection can still be awarded on a direct basis. See Combee v. Brown, 34 F.3d 1039, 1043-44 (Fed. Cir. 1994). To date, the RO has not provided the Veteran with an examination to determine whether or not his peripheral neuropathy is directly related service, to include his exposure to Agent Orange. The Board finds that such an examination is in order. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an examiner who has not previously examined the Veteran to determine the nature and etiology of his bilateral hearing loss. The examiner is asked to review the claims file and provide the following information: (a) Whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s preexisting left ear hearing loss was aggravated due to his military service. (b) Whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s current right ear hearing loss is related to his military service. (c) If it is determined that there is another likely etiology for the Veteran’s claimed hearing loss disabilities, that should be stated. 2. Schedule the Veteran for an examination by an examiner who has not previously examined the Veteran to determine the nature and etiology of his bilateral lower extremity peripheral neuropathy. The examiner is asked to review the claims file and provide the following information: (a) Is it as least as likely as not (a 50 percent or greater probability) that the disability was incurred in or is otherwise related to the Veteran’s service, to include exposure to Agent Orange? (b) If it is determined that there is another likely etiology for the Veteran’s disability, that should be stated. (Continued on the next page)   The examiner should set forth all examination findings, with a clear rationale for the conclusions reached. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Ryan, Associate Counsel