Citation Nr: 19169474 Decision Date: 09/06/19 Archive Date: 09/06/19 DOCKET NO. 16-09 901 DATE: September 6, 2019 REMANDED Entitlement to service connection for a right elbow disability is remanded. Entitlement to service connection for a low back disability is remanded. Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1992 to December 1992 and from June 2004 to November 2005. This matter comes before the Board of Veteran’s Appeals (Board) on appeal from an August 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for a right elbow disability is remanded. 2. Entitlement to service connection for a low back disability is remanded. The Veteran contends that he injured his right elbow and low back while working as track vehicle mechanic while on deployment to Kuwait and Iraq. Specifically, the Veteran stated he injured his elbow when he fell off a truck he was working on and he injured his lower back when he was lifting heavy metal and glass components that were being fitted on to up-armored Humvees. See February 2019 hearing transcript. He submitted a buddy statement in December 2015 from a fellow soldier describing the heavy work of up-armoring vehicles. In disability compensation claims, a VA medical examination must be provided when there is: (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence which establishes that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies; (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) insufficient competent medical evidence on file for the Board to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). After a review of the record, the Board has determined that a remand for a VA examination to determine the nature and etiology of the Veteran’s low back and right elbow disabilities is appropriate. Id. VA treatment records show that the Veteran is currently receiving treatment for chronic low back pain and elbow pain. Service treatment records (STRs) do not show that the Veteran was treated for either condition. In fact, the STRs contain no complaints for either the low back or the right elbow. However, STRs show that the Veteran was uninterested in being held at Fort Drum for a medical hold, which is consistent with his testimony that he did not report his injuries on his post deployment medical examination. The Board cannot make a fully informed decision regarding entitlement to service connection for a low back disability or a right elbow disability because no VA examiner has opined on whether the Veteran’s low back and right elbow disabilities were caused by or the result of an in-service injury, illness or event. Therefore, a VA examination is necessary on remand. 3. Entitlement to service connection for bilateral hearing loss is remanded. At his August 2015 VA examination, the Veteran was found not to have hearing loss for VA compensation purposes. However, at the February 2019 hearing, the Veteran asserted that his hearing has worsened since his last VA examination. As there is an assertion of worsening symptomatology, a remand is warranted to ensure that the record contains evidence of the current severity and etiology of the Veteran’s claimed hearing loss. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159; Green v. Derwinski, 1 Vet. App. 121 (1991); Caffrey v. Brown, 6 Vet. App. 377, 381 (1994). The matters are REMANDED for the following action: 1. After obtaining any necessary releases, obtain all outstanding VA and private treatment records pertinent to the Veteran’s low back disability, right elbow disability and bilateral hearing loss. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of the Veteran’s low back and right elbow disabilities. The examiner must opine whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran’s low back and right elbow disabilities began during service or is otherwise related to an in-service injury, event or disease. In rendering this opinion, the examiner must discuss the Veteran’s lay statements regarding his duties as a tracked vehicle mechanic, the in-service events that precipitated the injuries, and his complaints of low back pain and right elbow pain during service and continuity of symptomatology thereafter. 3. Schedule the Veteran for a VA audiological examination with an appropriate examiner to determine the nature and etiology of the Veteran’s bilateral hearing loss. The examiner must opine whether it is at least as likely as not (a 50 percent probability or greater) that any diagnosed hearing loss began during service, within one year of service separation, or is otherwise related to an in-service injury, event or disease. In rendering this opinion, the examiner must discuss the Veteran’s credible lay statements regarding his noise exposure in service. All opinions offered must be accompanied by a clear rationale consistent with the evidence of record. If the examiner finds it impossible to provide any part of the requested opinions without resort to pure speculation, he or she should so indicate and provide a rationale as to why such a finding is made. Caroline B. Fleming Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Christopher W. King, Law Clerk The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.