Citation Nr: 18152209 Decision Date: 11/21/18 Archive Date: 11/21/18 DOCKET NO. 17-24 857 DATE: November 21, 2018 REMANDED Service connection for hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1966 to June 1970. This case is on appeal from an October 2015 rating decision. The decision in part denied service connection for hearing loss, hypertension and benign prostatic hyperplasia. In his May 2017 VA Form 9, the Veteran limited the scope of the appeal to the hearing loss and hypertension claims. Thereafter, in a May 2018 rating decision, the RO granted service connection for hypertension. As a result, the hearing loss claim is the sole issue on appeal. Service connection for hearing loss. The Veteran seeks service connection for hearing loss as a result of his duties as a Communications System Circuit Controller (32D - FXD STA TECH CON) in the Army, while serving in Thailand and Vietnam. A review of the Veteran’s service treatment records (STRs) shows normal thresholds during his audiology test at entrance in 1966. STRs and service personnel records (SPRs) reflect that the Veteran was exposed to recurrent noise while operating frequency radios and communications systems. The separation examination, performed in May 1970, is also normal but shows threshold shifts in relevant categories. A review of the Veteran’s VA treatment records covering the periods between 1999 to 2017, reflect that the Veteran began to complain of hearing loss in 2001. As per VA provider’s notes, by that time the Veteran was already wearing hearing aids. The records reflect recurrent hearing loss complaints thereafter. Considering the above evidence, A VA examination was scheduled for October 2015. The Veteran failed to report based on the distance between his domicile and the clinic. A second VA examination was scheduled for September 2017. Once again, the Veteran failed to report based on the distance. The RO denied the Veteran’s claim for hearing loss, in part, due to failure to report for VA examinations. In November 2017, the Veteran submitted audiology tests’ results from February 2017 and November 2017, which were performed at the Avada Hearing Care Centers in North Carolina. VA treatment records reflect that such audiology tests were ordered by the Veteran’s primary care doctor at Fayetteville VA medical center. The examiner’s notes confirm the Veteran “has very little residual hearing,” and that bilateral amplification is recommended. Although the examination results appear to show current hearing impairment, no opinion was provided as to the possible relationship between any current hearing loss and in-service noise exposure. VA must provide a medical examination or obtain a medical opinion when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service, or establishing that certain diseases manifested during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the Veteran’s service or with another service-connected disability, but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006); see also 38 U.S.C. § 5103A (d)(2); 38 C.F.R. § 3.159 (c)(4)(i). In this case, although two VA examinations were scheduled, the Veteran failed to report because of the distance between his domicile and the clinic selected by the RO. Therefore, no proper VA examination has been obtained to address the Veteran’s claim of entitlement to service connection for hearing loss. Under the circumstances outlined above, the Board finds VA should again attempt to provide a VA examination if possible, and to obtain a medical opinion in any case. In light of the remand, updated VA treatment records should be obtained. The matter is REMANDED for the following action: 1. Obtain updated VA treatment records dated since March 2018. 2. Schedule the Veteran for an VA examination in connection with his hearing loss claim. Any reasonable attempt should be made to schedule the examination in as close proximity to his home as possible. The examiner should first determine whether the Veteran has hearing impairment for VA purposes under 38 C.F.R. § 3.385. The examiner should then provide an opinion as to whether it is at least as likely as not (50 percent or greater possibility) that any current hearing loss had its onset during, or is otherwise related to the Veteran’s active duty service, to include noise exposure. A complete rationale should be provided for any opinion rendered. The examiner should address medical relevance of any threshold shifts noted between the Veteran’s entrance and separation examinations. 3. If the Veteran does not attend, the VA examination notification letter should be included in the record (Continued on the next page)   4. If an examination is not conducted, the claims file should be forwarded to an appropriate medical professional to attempt to provide an opinion attempting to answer the questions in paragraph 2. Ryan T. Kessel Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD William Pagan, Associate Counsel