Citation Nr: 18155051 Decision Date: 12/04/18 Archive Date: 12/03/18 DOCKET NO. 10-36 278 DATE: December 4, 2018 REMANDED Entitlement to service connection for bilateral hearing loss, to include as secondary to service-connected epilepsy, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1991 to April 1997. This matter comes before the Board of Veterans’ Appeals (Board) from a November 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In April 2012, the Veteran testified at a Board hearing before an Acting Veterans Law Judge who is no longer employed at the Board. The Veteran elected another hearing and, in December 2013, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. Transcripts of both hearings are of record. This matter was last before the Board in August 2017, at which time the Board denied the claim. The Veteran appealed the Board’s denial to the United States Court of Appeals for Veterans Claims (Court). In May 2018, pursuant to a Joint Motion for Partial Remand (JMPR) by the parties, the Court vacated the portion of the decision that denied the bilateral hearing loss claim, and returned it to the Board for further consideration consistent with the JMPR. Entitlement to service connection for bilateral hearing loss, to include as secondary to service-connected epilepsy In the JMPR, the parties determined the October 2016 VA opinion was inadequate to decide the claim. In essence, the parties stated that the examiner did not fully address whether the appellant’s hearing loss was a delayed response to in-service noise exposure. The parties also took issue with the October 2016 VA examiner’s statement that a “limited review” of the literature did not find a causal or permanent worsening beyond normal progression association between hearing loss and epilepsy/seizure disorder; the parties determined that the examiner should adequately review the medical literature (not a limited review) before issuing an opinion. The matter is REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for his bilateral hearing loss. After securing any necessary releases, request any relevant records identified that are not associated with the claims file. In addition, obtain updated VA treatment records. If any requested records are unavailable, the Veteran should be notified of such. 2. After records development is completed, send the claims file to a VA audiologist to obtain an addendum opinion with respect to the Veteran’s claimed bilateral hearing loss. If a new examination is deemed necessary   to respond to the questions presented, one should be scheduled. Following review of the claims file, the examiner should provide the following opinions: a. Is it at least as likely as not (50 percent probability or greater) that any current bilateral hearing loss disability is related to service? The examiner must explain why or why not, to include specifically addressing why the current bilateral hearing loss is/is not a delayed response to the conceded in-service noise exposure. b. If not caused by service, is it at least as likely as not that the Veteran’s bilateral hearing loss was caused by his service-connected epilepsy? The examiner must explain why or why not. The examiner must adequately review medical literature (versus the “limited review” noted by the October 2016 examiner) when rendering the opinion. c. If not caused by the service-connected epilepsy, is it at least as likely as not that the Veteran’s current bilateral hearing loss was worsened (aggravated) beyond natural progression by his service-connected epilepsy? The examiner must explain why or why not. The examiner must adequately review medical literature (versus the “limited review” noted by the October 2016 examiner) before issuing the opinion. d. If the examiner finds that the Veteran’s current bilateral hearing loss was worsened (aggravated) by his service-connected epilepsy, the examiner must attempt to quantify the level of aggravation beyond the baseline level of the bilateral hearing loss. A clear rationale must be provided for all opinions expressed. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. C. Birder, Associate Counsel