Citation Nr: 18159444 Decision Date: 12/20/18 Archive Date: 12/19/18 DOCKET NO. 13-21 644 DATE: December 20, 2018 REMANDED Entitlement to service connection for bilateral hearing loss, to include as secondary to service-connected disability. INTRODUCTION The Veteran served on active duty from October 1989 to October 1992. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2010 rating decision by the Department of Veterans Affairs (VA) Regional Office in St. Petersburg, Florida. This appeal was before the Board in December 2016 and October 2017, at which times it was remanded for additional development. After the issuance of an October 2018 supplemental statement of the case, the appeal was remitted to the Board for further appellate review. In July 2016, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of this hearing has been associated with the claims file. REASONS FOR REMAND The Veteran’s above-captioned claim was remanded by the Board in October 2017, for the sole developmental purpose of obtaining a supplemental opinion from the VA examiner who conducted a July 2017 VA audiological examination. The Board requested that this examiner provide an etiological opinion as to whether the Veteran’s bilateral hearing loss was caused or aggravated a service-connected disability and/or any medications prescribed to treat a service-connected disability (i.e., service connection on a secondary basis). In November 2017, the examiner provided the following opinion: This [V]eteran’s hearing loss is less likely as not caused by or aggravated by the service[-]connected disabilities listed above. Rationale: The presence of the hearing loss upon enlistment is evidence for a pre-existing otologic condition which, as shown by the absence of a shift in hearing for the worse upon release from active duty was not caused by any condition listed above or otherwise. There is also not sufficient evidence to provide a nexus of aggravation or causation to the [V]eteran’s current and longstanding hearing loss and any of the conditions listed above. The entire first paragraph of the examiner’s rationale concerns the lack of a “shift in hearing for the worse” during the Veteran’s active duty and, on this basis, the examiner concludes that the Veteran’s bilateral hearing loss was not “caused by” any of his service-connected disabilities. The examiner does not provide any explanation as to how the lack of an in-service shift in puretone thresholds has any bearing whatsoever on whether a service-connected disability caused or aggravated the Veteran’s bilateral hearing loss. The second paragraph of the rationale is conclusory, as the examiner provides no underlying explanation for the negative opinion. At best, the examiner is identifying a lack of sufficient evidence associated with the record to render an opinion, but does not then discuss the nature of this deficiency or request that another examination be scheduled in order to correct the supposed evidentiary shortfalls. Additionally, the examiner failed to discuss, let alone reference, the medications prescribed to treat the Veteran’s service-connected disabilities in rendering the November 2017 addendum opinion, an aspect of the opinion that the Board specifically requested. In sum, the Board finds that the November 2017 supplemental opinion is wholly unresponsive to the remand directives and is, therefore, not probative in this matter. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Consequently, the Board finds that remand is required in order to provide the Veteran another examination, to be conducted by a different examiner. As an additional matter, correspondence sent by VA to the Veteran has been returned as undeliverable, including the October 2018 supplemental statement of the case. In reviewing recent mailings to the Veteran, the Board observes that VA is using two different addresses. While this appeal is in remand status, the Agency of Original Jurisdiction must verify the Veteran’s mailing address before undertaking any of the requested development. The matter is REMANDED for the following action: 1. Undertake efforts to verify the Veteran’s mailing address and resend the Veteran all documents returned as undeliverable. This development should occur before any other development is initiated. 2. Provide the Veteran with a VA examination regarding his bilateral hearing loss, to be conducted by someone other than the July 2017 VA examiner. The Veteran’s electronic claims file must be made available to the examiner and the examiner must specify in the report that it was contemporaneously reviewed. All pertinent symptomatology and findings must be reported. Any indicated special diagnostic tests that are deemed necessary for an accurate assessment must be conducted. The new examiner must then provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s bilateral hearing loss was CAUSED or AGGRAVATED BY a service-connected disability AND/OR any medications prescribed to treat a service-connected disability. The new examiner is advised that the Veteran’s service-connected disabilities are: posttraumatic stress disorder, irritable bowel syndrome, residuals of head injury with headaches, residuals of right knee injury post-surgery, tinnitus, impaired taste sensation, chronic fatigue syndrome, residuals of a skull fracture post-craniotomy, and diplopia. All rendered opinions must be accompanied by a thorough rationale. (Continued on the next page)   3. Once the above actions have been completed, re-adjudicate the claim. If any benefit remains denied, a supplemental statement of the case must be provided to the Veteran and his representative. After they have had an adequate opportunity to respond, the appeal must be returned to the Board for further appellate review. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Sean G. Pflugner, Counsel