Citation Nr: 19190455 Decision Date: 12/02/19 Archive Date: 12/02/19 DOCKET NO. 16-19 022 DATE REMANDED A higher initial rating for PTSD is remanded. Service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1978 to September 1982. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In May 2019 the Board remanded the claims for further development. Unfortunately, the Board finds further remand is required for both claims. Regarding the claim for an initial rating higher than 50 percent for PTSD, the Veteran testified at a December 2018 Board hearing that “I always have suicidal thoughts.” The most recent VA treatment records are from 2017, and the most recent examination is from June 2015. Given the objective evidence of worsening as related at the Board hearing, a new examination should be provided to evaluate the current severity of the Veteran’s PTSD. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997); see also 38 C.F.R. § 3.326(a). Regarding the claim for bilateral hearing loss, the May 2019 Board decision instructed the examiner to comment on evidence including treatment notes and a physical profile board proceeding. The directed opinion was provided in July 2019, but the examiner failed to opine on these pieces of evidence. A remand confers on the Veteran the right to compliance with the remand directives, and thus the Board must remand for substantial compliance with the directives of the previous decision. Stegall v. West, 11 Vet. App. 268, 271 (1998). Accordingly, the matters are REMANDED for the following action: 1. Associate with the Veteran’s claims file any VA treatment records not already of record. 2. Schedule the Veteran for an examination to determine the current severity of his service-connected PTSD. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to PTSD alone. 3. Obtain from the July 2019 clinician or, if he is unavailable, another clinician, an addendum opinion regarding the Veteran’s bilateral hearing loss claim. If the clinician determines that an examination would be helpful, instead schedule the Veteran for an examination with the clinician. The clinician must opine whether it is at least as likely as not that the Veteran’s bilateral hearing loss is etiologically related to active service, to include as due to documented hearing loss and documented ear infections while in service. The clinician’s rationale MUST address all of the following service records: a. October 1980 treatment note showing a diagnosis of ear infection; b. October 1980 treatment note documenting pain in both ears; c. November 1980 physical profile record that listed left-ear hearing loss and prohibited any assignment with exposure to loud noises or firing of weapons; and, d. May 1981 record of a physical profile board proceeding, which listed left-ear anacusis and right-ear moderate hearing loss, and which limited the Veteran’s assignment to no noise exposure over 85 dB or firing weapons without hearing protection. (Continued on the next page)   4. After the above development and any other development deemed necessary is completed, readjudicate the Veteran’s claims. K. Parakkal Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Davis, Counsel 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.