Citation Nr: 18158179 Decision Date: 12/14/18 Archive Date: 12/14/18 DOCKET NO. 12-05 613 DATE: December 14, 2018 REMANDED Entitlement to service connection for left ear hearing loss is remanded. Entitlement to a compensable disability rating for service-connected right ear hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1953 to April 1955. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a November 2009 rating decision. The Veteran requested a Board hearing by videoconference, which was scheduled for May 9,2017. The Veteran did not appear for the hearing nor explain his failure to appear. Accordingly, the hearing request is considered withdrawn. 38 C.F.R. § 20.704(d). In August 2017, after reopening the Veteran’s claim for service connection for left ear hearing loss, the Board remanded these issues for further development, and the case has been returned for appellate consideration. As discussed below, the Board finds that there has not been substantial compliance with its August 2017 remand directives and, therefore, it may not proceed with a determination on the merits at this time. See Stegall v. West, 11 Vet. App. 268, 271 (1998). 1. Entitlement to service connection for left ear hearing loss is remanded. 2. Entitlement to a compensable disability rating for service-connected right ear hearing loss is remanded. In its August 2017 remand, the Board directed that the Veteran be afforded an audiological examination to determine the etiology of the left ear hearing loss and the current severity of the right ear hearing loss. A screen shot establishes that an examination was scheduled for September 18, 2017, and that it was canceled by the Veteran when he called to inform that he was hospitalized. It was noted: “He asked that the claim be cancelled.” Believing that the Veteran intended to withdraw his appeal rather than merely cancel his appointment, an October 2017 letter notified the Veteran that VA understood he wanted to withdraw his appeal and requested that he return the enclosed VA Form 21-4138. The Veteran did not respond. As there is no credible evidence that the Veteran wishes to withdraw his appeal, there has not been substantial compliance with the Board’s August 2017 remand directives, and the Board must remand this matter again. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159; Stegall v. West, 11 Vet. App. 268, 271 (1998) (stating that a remand by the Board confers on the Veteran, as a matter of law, the right to have compliance with its remand directives). The matters are REMANDED for the following actions: 1. Schedule the Veteran for a VA audiology examination to determine the etiology of his left ear hearing loss as well as the current severity of his service-connected right ear hearing loss. The electronic claims file and a copy of this remand must be provided to the examiner and he or she must indicate review of these items in the examination report. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed, including the Maryland CNC test and a puretone audiometry test. The examiner is requested to review all pertinent records associated with the claims file. a) The examiner must comment on the severity of the Veteran’s service-connected right ear hearing loss. He or she should discuss the effect of the disability on his occupational functioning and daily activities. b) The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s left ear hearing loss is related to service, to include exposure to noise from Howitzers or perforated left tympanic membrane. In the rationale, the examiner must address the Veteran’s lay statements describing his exposure to noise during service as well as his report of hearing loss during service. The examiner must also address the significance of the audiogram completed at separation from service. The examiner should note that the standards used in 1955 were ASA and should be converted to ISO-ANSI. It should be noted that the Veteran is competent to attest to factual matters of which he had first-hand knowledge, including noise exposure and observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The absence of evidence of a hearing loss disability during service is not always fatal to a service connection claim. Evidence of a current hearing loss disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting the regulatory requirements for hearing loss disability for VA purposes, and a medically sound basis upon which to attribute the post-service findings to the injury in service. The examiner should discuss medically known or theoretical causes of hearing loss and describe how hearing loss which results from noise exposure generally present or develop in most cases, as distinguished from how hearing loss develops from other causes, in determining the likelihood that any current hearing loss was caused by noise exposure in service as opposed to some other cause. (Continued on the next page)   2. After completing the above action and any other development as may be indicated by any response received as a consequence of the action taken in the paragraph above, the claims must be readjudicated. If the claims remain denied, a supplemental statement of the case must be provided to the Veteran and his representative. After the Veteran has had an adequate opportunity to respond, the appeal must be returned to the Board for appellate review. L. CHU Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Leanne M. Innet, Associate Attorney