Citation Nr: 20005341 Decision Date: 01/23/20 Archive Date: 01/22/20 DOCKET NO. 16-45 940 DATE: January 23, 2020 REMANDED An evaluation in excess of 50 percent for posttraumatic stress disorder (PTSD) is remanded. Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1966 to September 1968, with service in Southwest Asia. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision and an August 2016 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). In July 2019, the Veteran provided sworn testimony before the undersigned Veterans Law Judge (VLJ) at a Board hearing. A copy of the hearing transcript has been associated with the electronic claims file. By way of background, in August 2013, the RO granted service connection for PTSD with an evaluation of 30 percent disabling, effective April 12, 2013, and the Veteran timely appealed. Thereafter, in an August 2016 rating decision, the RO increased the evaluation to 50 percent. As this does not constitute a full grant, this issue remains on appeal. AB v. Brown, 6 Vet. App. 35, 39 (1993). Although the Board regrets the additional delay, a remand is necessary to ensure due process and proper development regarding the Veteran’s claims. 1. PTSD The Veteran was last afforded a VA examination in July 2013. When the evidence suggests a service-connected disability has worsened since the last examination, VA must provide a new examination. During the July 2019 Board hearing, the Veteran testified that his symptoms have worsened, including that he has suicidal thoughts, doesn’t do anything but sit around and eat, has a short temper and is on medication. VA medical treatment records also showed ongoing treatment for the Veteran’s PTSD, including reports in May 2018 of recurrent major depression, insomnia, mood disruption, hyperarousal, intrusive recollection, avoidance, and emotional numbing. Based on the foregoing, the Board finds remand is appropriate for the increased rating claim so that a new examination can be arranged to properly assess the current severity of the Veteran’s PTSD. 2. Bilateral Hearing Loss and Tinnitus. With regard to the claims for bilateral hearing loss and tinnitus, a July 2013 VA audiogram showed bilateral hearing loss for VA purposes and a tinnitus diagnosis. However, the examiner stated that an opinion could not be rendered without resorting to mere speculation because there was no hearing test done upon separation from service and it was likely/possible that aging, occupational and recreational noise exposure, and general health contributed to his hearing loss and/or tinnitus. However, the VA examiner did not provide a basis on which to conclude that the Veteran’s hearing loss was not related to military noise exposure, but rather provided a conclusory opinion. Significantly, before the Board can rely on an examiner’s conclusion that an etiology opinion would be speculative, the examiner must explain the basis for such an opinion, or the basis must otherwise be apparent in the Board’s review of the evidence. Jones v. Shinseki, 23 Vet. App. 382, 393-94 (2010). Thus, the opinion is inadequate, and a new opinion, which addresses the relationship between the Veteran’s current bilateral hearing loss and service, is necessary on remand. 3. TDIU The Veteran contends that due to his service-connected disabilities, specifically PTSD, he is unable to secure and maintain employment. See July 2019 Board hearing where he testified that he has not worked since 2009/2010 when he did work with his sons. The Board thus finds that he has reasonably raised a claim for a TDIU. Rice v. Shinseki, 22 Vet. App. 447 (2009). However, a remand is required prior to adjudication of the claim for TDIU because, as a decision on the other issues remanded in this appeal could significantly impact a decision on the issue of TDIU, the issues are inextricably intertwined. Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Obtain VA treatment records, in particular from Gainesville VAMC from September 2019 to present (including records from the Villages Community Clinic) and Ocala Vet Center for 2013 to present, and associate with the claims file. 2. Send the Veteran a VA Form 21-8940, Veterans Application for Increased Compensation Based on Unemployability and VA Form 21-4192, Request for Employment Verification, to be fully completed and returned to VA. 3. Schedule the Veteran for a VA examination to determine the current severity of the Veteran’s PTSD. The entire claims file and a copy of this remand should be made available to the examiner for review, and such review should be noted in the examination report. The examiner is requested to opine as to whether the Veteran’s psychiatric condition impacts his employability and comment on the degree or level of interference. 4. Obtain an opinion from a VA examiner as to the nature and etiology of the Veteran’s current bilateral hearing loss and tinnitus. If the VA examiner believes that an examination would be helpful, one should be scheduled. The examiner must review the Veteran’s claims file to become familiar with the relevant medical history, to specifically include the Veteran’s July 2013 VA audiogram. The examiner should offer an opinion as to whether: a) It is as least as likely as not (50 percent probability or greater) that the Veteran’s current bilateral hearing loss is related to service. b) it is as least as likely as not (50 percent probability or greater) that the Veteran’s tinnitus is related to service. The examiner must consider the Veteran’s reports of in-service acoustic trauma, to include the mortar attack on his base in Vietnam; his sworn testimony that he first noticed hearing loss and ringing in his ears following this event; the June 2003 VA medical record showing he was hard of hearing; the March 2011 VA medical record noting his military service as one positive exposure for his hearing loss; and his testimony that he did not have significant exposure to noise after service, and that when he went hunting once a year, he wore hearing protection. Rationale must be provided for the opinions proffered. If the examiner determines that a requested opinion is not possible without resort to mere speculation, then the examiner must explain why. In other words, simply stating that an opinion cannot be provided without resort to mere speculation is not acceptable without a detailed reason as to why this is so. MICHELLE L. KANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G.Hoy, 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.