Citation Nr: 20032902 Decision Date: 05/11/20 Archive Date: 05/12/20 DOCKET NO. 10-16 617 DATE: May 11, 2020 REMANDED 1. Service connection for bilateral hearing loss is remanded. 2. Service connection for deviated nasal septum is remanded. REASONS FOR REMAND The Veteran had active service in the Air Force from May 1980 to June 2000. He maintains that service connection bilateral hearing loss and a deviated nasal septum are warranted. After a thorough review of the evidence of record, the Board finds that a remand of this appeal is necessary to accord him appropriate Department of Veterans Affairs (VA) examinations. 1. Service Connection for Bilateral Hearing Loss The Veteran was last afforded a VA examination for his bilateral hearing loss in July 2010, at which time he was found to have normal hearing bilaterally. While the Board will not remand for a new VA examination solely based on the passage of time, the Board finds that remand for a new examination in this appeal is warranted. See Palczewski v. Nicholson, 21 Vet. App. 174, 182 (2007) (the duty to assist does not require that a claim be remanded for a new VA examination solely because of the passage of time). Coupled with the age of the examination, the Veteran’s continued assertions of hearing difficulties bilaterally in the past 10 years since that examination, and his contentions that during active duty (particularly while stationed at Nellis Air Force Base) he was exposed to loud roaring sounds of fighter jets engines and was not given ear protection, the Board concludes that a current VA audiological examination is necessary. 2. Service Connection for Deviated Nasal Septum In McLendon v. Nicholson, 20 Vet. App. 79 (2006), the United States Court of Appeals for Veterans Claims (Court) indicated that there was a four-part test to determine whether an examination was necessary under 38 C.F.R. § 3.159(c)(4); Id. at 81. Under this test, VA will provide a medical examination or obtain a medical opinion where there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability; (2) evidence establishing that an event, injury, or disease occurred in service; (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 to make a decision on the claim. Id. The third element is a “low threshold,” requiring “only that the evidence ‘indicates’ that there ‘may’ be a nexus between the in-service event and the current disability.” Id. at 86. Here, the Veteran can establish all four elements of the four-part test laid out in McLendon. First, private treatment records indicate that the Veteran was diagnosed with a septal deviation in February 2008. Service treatment records indicate that the Veteran started to experience breathing problems in service. Also, there is evidence of sinus tenderness and nasal congestion in the service treatment records, and current medical evidence of chronic nasal obstruction. Service medical records reported that the Veteran would have a twitch at night, blocking him from receiving enough air to the point where he would sometimes feel as if he were suffocating. Significantly, there are no private medical opinions or any VA examinations that addresses whether the Veteran’s deviated nasal septum is related to service. In the present case, the Veteran has a diagnosis of a deviated septum and service treatment records indicating that a relevant in-service event occurred. Additionally, the probative evidence of record does not contain a medical opinion regarding the etiology of the Veteran’s currently diagnosed deviated nasal septum disability. Accordingly, the Board finds that an examination is warranted to develop this service connection claim. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. at 70. These matters are REMANDED for the following action: 1. Procure updated VA and private medical treatment records. Associate any such available records with the Veteran’s claims folder. 2. Then, accord the Veteran an appropriate VA examination to determine the nature, extent, and etiology of his bilateral hearing loss. The entire claims file must be made available to the examiner for review in conjunction with this examination, and the examiner should acknowledge such review in the examination reports. Any indicated tests and studies must be accomplished, and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s bilateral hearing loss was incurred in his active service or is otherwise causally related to his active service or any incident therein. In rendering this opinion, the examiner should specifically address the Veteran’s contentions about his military noise exposure. The examiner is advised that the Veteran is competent to report his symptoms and history and that such reports must be acknowledged and considered in formulating diagnoses and opinions. A clear explanation for all opinions would be helpful, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner is unable to provide an opinion, he or she should explain why. 3. Also, accord the Veteran an appropriate VA examination to determine the nature, extent, and etiology of his deviated nasal septum. The entire claims file must be made available to the examiner for review in conjunction with this examination, and the examiner should acknowledge such review in the examination reports. Any indicated tests and studies must be accomplished, and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s deviated nasal septum was incurred in his active service or is otherwise causally related to his active service or any incident therein. In rendering this opinion, the examiner should specifically address the findings of sinus tenderness and nasal congestion in the service treatment records. The examiner is advised that the Veteran is competent to report his symptoms and history and that such reports must be acknowledged and considered in formulating diagnoses and opinions. A clear explanation for all opinions would be helpful, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner is unable to provide an opinion, he or she should explain why. No action is required of the Veteran until he is notified by VA. However, he is advised of his obligation to cooperate in ensuring that the duty to assist is satisfied. Kowalski v. Nicholson, 19 Vet. App. 171 (2005); Wood v. Derwinski, 1 Vet. App. 190 (1991). His failure to help procure treatment records, or to report for a scheduled VA examination, may impact the decision made. 38 C.F.R. § 3.655. He has the right to submit additional evidence and argument, whether himself or through his representative, with respect to this matter. Kutscherousky v. West, 12 Vet. App. 369 (1999). This matter must be afforded prompt treatment. The law requires that all remands by the Board or the Court be handled in an expeditious manner. 38 U.S.C. §§ 5109B, 7112 (West 2014). THERESA M. CATINO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Dourmashkin, 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.