Citation Nr: 18112331 Decision Date: 06/19/18 Archive Date: 06/19/18 DOCKET NO. 16-51 788 DATE: June 19, 2018 REMANDED Entitlement to a compensable rating for hearing loss is remanded. REASONS FOR REMAND 1. Entitlement to a compensable rating for hearing loss is remanded. The Veteran asserts in his substantive appeal (VA Form 9) that the September 2016 VA contract examination is not an accurate representation of his hearing loss, particularly regarding speech recognition. He wrote that the evaluation was conducted in haste and during the speech recognition test, he repeatedly told the technician that he could not make out what was said, to which the technician increased the volume. The Board notes that while the September 2016 VA examination shows speech recognition as 100 percent in both ears, a private evaluation from December 2014 indicates speech recognition as 92 percent in the right ear and 84 percent in the left ear. For disability evaluation purposes, VA regulations require the use of the Maryland CNC speech discrimination test. 38 C.F.R. § 4.85(a). The December 2014 evaluation does not indicate the type of test used. The Board finds that additional development would be helpful in evaluating the Veteran’s level of hearing loss disability. The record shows that the Veteran has been receiving treatment for his hearing loss with Dr. C.T.O. through the VA voucher program. There is only one evaluation from Dr. C.T.O.’s office in the claims file: the December 2014 evaluation. The Agency of Original Jurisdiction (AOJ) should seek an appropriate authorization form and obtain any additional records from Dr. C.T.O. The AOJ should also request Dr. C.T.O.’s office identify the type of speech recognition testing employed during auditory evaluations. See Savage v. Shinseki, 24 Vet. App. 259, 273 (2011). Because the Veteran has consistently reported difficulty understanding speech and there is a discrepancy in the speech recognition results from the December 2014 and September 2016 evaluations, the Board finds that a new VA examination is needed. The matter is REMANDED for the following action: 1. The Veteran should be given an opportunity to identify any outstanding private or VA treatment records relevant to the claim on appeal, including records from Dr. C.T.O. Request that Dr. C.T.O.’s office identify the type of speech recognition testing they employ during auditory evaluations, such as the Veteran’s December 2014 evaluation. After obtaining any necessary authorization from the Veteran, all outstanding records, to include updated VA treatment records dated from July 2016 to the present, should be obtained. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and afford him an opportunity to submit any copies in his possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the Solicit an appropriate authorization form from the Veteran for records of treatment with Dr. C.T.O 2. After completing the above development, and following the receipt of any outstanding records, the Veteran should be afforded an appropriate VA examination to determine the current nature and severity of his service-connected bilateral hearing loss. The record, to include a copy of this remand, must be made available to and be reviewed by the examiner, and the examination report should note that review. Any appropriate test and studies-in particular, audiometry and speech discrimination testing-should be accomplished, with all results made available to the examiner prior to the completion of his or her report. For each ear, the examiner should provide numeric interpretation of any hearing tests/audiograms conducted. The examiner should also set forth numeric values for each of the pure tone thresholds at 1000, 2000, 3000, and 4000 Hertz and then provide the average puretone threshold for these four frequencies. The reported numeric values and speech recognition scores (Maryland CNC test) must be in conformity with the requirements of 38 C.F.R. § 4.85. The examiner should fully describe the functional effects of the Veteran’s hearing loss. All testing results, along with complete, clearly stated rationale for the conclusions reached, must be provided. The examiner should also review the December 2014 evaluation with speech recognition scores of 92% and 84% and reconcile those with the 100% speech recognition scores recorded in September 2016. 3. If the issue on appeal remains denied, furnish the Veteran and his representative a supplemental statement of the case and return the case to the Board, if otherwise in order. KRISTY L. ZADORA Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A.P. Armstrong