Citation Nr: 20044697 Decision Date: 07/06/20 Archive Date: 07/06/20 DOCKET NO. 15-07 916 DATE: July 6, 2020 REMANDED Service connection for an acquired psychiatric disability, to include as secondary to a service-connected hearing loss disability, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1951 to November 1951 in the United States Marine Corps. He also served on active duty from September 1952 to August 1954 in the United States Army, and was awarded the Combat Infantryman Badge for this period of service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2014 decision of the Department of Veterans Affairs (VA) Regional Office (RO). In January 2016, the Board reopened the above claim for service connection and remanded the matter on the merits for further development. In June 2016, the Board denied the claim. The Veteran appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court). In July 2017, the Court vacated the June 2016 Board decision and remanded the matter to the Board for development consistent with the parties' Joint Motion for Remand (Joint Motion). In January 2018, the Board remanded the claim in accordance with the Joint Motion. On December 6, 2018, the Veteran’s attorney submitted, via facsimile, a timely request to submit additional argument or evidence, and the Board, without awareness of the facsimile, issued a decision on the issue on December 6, 2018 denying the claim. In April 2019, the Board vacated its December 2018 decision and granted a 90-day extension of time for the submission of additional evidence. In November 2019, the Board remanded the claim for further development. 1. Service connection for an acquired psychiatric disability, to include as secondary to a service-connected hearing loss disability, is remanded. In October 2019, the Veteran submitted medical treatise evidence to support his assertion that his psychiatric disability is secondary to the service-connected hearing loss. In November 2019, the Board remanded the claim in order to obtain a medical opinion addressing the matter of secondary service connection. In January 2020, a VA examination was conducted. The Veteran’s attorney argues that the examination report does not substantially comply with the Board’s November 2019 remand directives, and the Board agrees. Stegall v. West, 11 Vet. App. 268 (1998). The examiner opined that the current mild neurocognitive disorder was less likely than not directly related to service, or related on a secondary basis. In doing so, the examiner noted a lack of psychiatric treatment in service or shortly thereafter, and provided an extensive discussion of the possible various causes of mild neurocognitive disorder. However, the examiner did not clearly address the impact of the Veteran’s hearing loss on his psychiatric disability, which was the basis for the November 2019 remand. As such, a further opinion must be obtained. The matter is REMANDED for the following action: Schedule the Veteran for an examination to obtain an opinion addressing the nature and etiology of his acquired psychiatric disability, to include mild neurocognitive disorder. A complete explanation must be provided for all opinions rendered. The examiner must respond to the following inquiries: 1. Is it at least as likely as not (50 percent probability or greater) that the Veteran's mild neurocognitive disorder, is the result of a disease, injury, or event in service, to include his combat service in Korea? 2. Is it at least as likely as not that the mild neurocognitive disorder, is proximately due to his service-connected hearing loss disability? 3. Is it at least as likely as not that the mild neurocognitive disorder, has been aggravated by (i.e. worsened in severity beyond the natural progression of the disability) his service-connected hearing loss disability? In rendering these opinions, the examiner must consider the following: • The Veteran has been awarded the Combat Infantryman Badge and reports that his psychiatric symptoms are related to combat in Korea. As such, examiner is directed to accept the in-service incurrence of the Veteran’s combat-related injury occurred (that is the witnessing of bombing incidents, casualties, and living with insufficient supplies including clean water) and thus, you should accept as fact that an “injury” occurred in service, despite the lack of documentation of psychiatric symptoms in the service treatment records. • The examiner must consider the medical treatise evidence submitted by the Veteran supporting a relationship between his service-connected hearing loss and his psychiatric disability. The literature is included in the claims file and is entitled, Speech in noise: hearing loss, neurocognitive disorders, aging, traumatic brain injury and more. M. Tenner Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Smith, 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. M. Tenner Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Smith, 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.