Citation Nr: 20004482 Decision Date: 01/21/20 Archive Date: 01/21/20 DOCKET NO. 17-36 270 DATE: January 21, 2020 REMANDED The claim of entitlement to an evaluation in excess of 20 percent for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran had honorable active duty service in the United States Navy from June 1969 to July 1999. This matter comes before the Board of Veterans’ Appeals (Board) from rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). Although further delay is regrettable, the Board finds that remand is necessary in this case to ensure that due process is followed and that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2018). 1. The claim of entitlement to an evaluation in excess of twenty percent for bilateral hearing loss is remanded. The Veteran contends that he is entitled to compensation in excess of 20 percent for his bilateral hearing loss. The Veteran asserts that his hearing loss has worsened, and that his last VA examination for compensation purposes did not accurately reflect the amount of hearing loss he experiences. The Board cannot make a fully informed decision regarding the Veteran’s claim of entitlement to service connection for bilateral hearing loss because the medical evidence of record is inadequate. See 38 C.F.R. § 3.327. Specifically, the most recent audiological testing data and medical treatment records indicate that the Veteran’s hearing loss may have worsened since his last VA examination in December 2015. See private audiometric records dated October 2017; VA audiology note dated April 2017, indicating increased difficulty hearing certain sounds and voices. Additionally, while the evidence of record includes some of the Veteran’s private audiometric records as noted above, these do not appear to be complete records. It is also unclear from the pages submitted whether the audiometric examination was conducted in accordance with the strict testing requirements for VA compensation purposes. Further, the only indication of the name of the examining audiologist is included in a hand-written note on one page of the records. There are additional hand-written notes on the document but is unclear whether these notes are from an examining provider or from the Veteran. The Board cannot base a rating decision on this evidence alone. On remand, the RO should coordinate with the Veteran to obtain the complete records from this provider. The Board acknowledges the Veteran’s additional contention that, among other things, the VA hearing examinations he has received for compensation purposes have resulted in different findings than the examinations he has received for purposes of hearing aid fittings. Pursuant to 38 C.F.R. § 4.85(a) and (d), VA conducts two audiometric tests for compensation purposes: a puretone audiometry test, which measures puretone decibel thresholds at 1000, 2000, 3000, and 4000 Hertz, and a controlled speech discrimination test, the Maryland CNC. VA evaluates service-connected hearing loss through the mechanical application of a veteran’s audiometric testing results to a rating table. See Doucette v. Shulkin, 28 Vet. App. 366, 368 (U.S. 2017). The Veteran is advised that he may submit additional private medical opinion evidence regarding his hearing loss if he wishes, however, any private examination evidence will be held to the same strict standard that VA compensation examinations are reviewed for rating purposes. Lastly, the Board notes that in his July 2017 Form 9, the Veteran stated he was willing to complete another VA medical examination in order to resolve his hearing loss claim. He requested, however, that the examination be completed by his regular VA audiologist in North Little Rock. This request is further addressed in the remand directives below. The matters are REMANDED for the following action: 1. Obtain any relevant, outstanding VA treatment records that are not already associated with the claims file. If no records are available, the claims folder must indicate this fact and the Veteran should be notified in accordance with 38 C.F.R. § 3.159(e). All attempts to contact the Veteran should be documented in the record. 2. Contact the Veteran and the representative of record in order to identify and obtain any outstanding non-VA treatment records regarding the issue on appeal, including complete records from Taylor Hearing Centers in Mountain Home, Arkansas. If additional non-VA providers are identified, obtain releases for those records. Make all reasonable attempts to obtain the non-VA treatment records and associate them with the claims file. If such records cannot be obtained, inform the Veteran and the representative of record, and afford an opportunity to provide these outstanding records. 3. Once the aforementioned development has been completed, schedule the Veteran for a VA audiological examination before an appropriate clinician regarding his claim of entitlement to an increased evaluation for his bilateral hearing loss. If possible, this examination should be conducted by the Veteran’s regular VA audiologist at the North Little Rock VA facility. The Agency of Original Jurisdiction (AOJ) should ensure that the examiner provides all information required for rating purposes, to include an audiogram, performed by a stated licensed audiologist. Specifically, the results of the audiological evaluation must state, in numbers, the findings of puretone decibel loss at 1000, 2000, 3000, and 4000 Hertz, provide the puretone threshold average, and must also state the results of the word recognition test, in percentages, using the Maryland CNC test. Have the examining clinician provide information to demonstrate that they are qualified to offer the above requested opinion (such as a curriculum vitae or similar demonstrable documentation). This information is to be associated with the Veteran’s claims file. If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary, he or she should be directed to clearly explain why that is so. Furthermore, if an opinion cannot be offered without resort to mere speculation, the examiner must fully explain why this is the case and identify what additional evidence, if any, would allow for a more definitive opinion. The Veteran’s claims file and a copy of this remand must be provided to the examiner. The examiner should thoroughly review the record and should note that review in the examination report. The examiner is asked to take a full history from the Veteran and must consider lay reports of observable symptomatology, including any symptoms related to a worsening of his hearing loss in each ear. After performing all indicated tests and studies, the examiner should address the following: (a.) Indicate whether the Veteran’s hearing loss in either or both ears has worsened since his VA examination of December 2015. Include a discussion of the veteran’s lay reports of worsening along with any objective evidence of worsening as discovered during audiometric testing. (b.) Provide an opinion as to the current severity of the Veteran’s hearing loss, and comment on the effect that the Veteran’s bilateral hearing loss disability has upon his daily functioning. Each opinion offered should be accompanied by a complete rationale, to include consideration of all VA and private medical evidence, as well as lay statements. 4. Following completion of the foregoing, the AOJ should review the record and readjudicate the claim on appeal. If the claim remains denied, the AOJ should issue an appropriate supplemental Statement of the Case, afford the Veteran and his representative an opportunity to respond, and return the case to the Board. B. MULLINS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Hart, Associate 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.