Citation Nr: 21000911 Decision Date: 01/06/21 Archive Date: 01/06/21 DOCKET NO. 13-15 194 DATE: January 6, 2021 REMANDED Entitlement to an initial compensable rating for left ear hearing loss from November 22, 2010 to May 10, 2013 is remanded. Entitlement to a compensable rating for bilateral hearing loss from May 10, 2013 to November 26, 2019, and a rating in excess of 50 percent for bilateral hearing loss since that time is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1965 to March 1971. This case is before the Board of Veterans’ Appeals (Board) on appeal from an October 2012 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO), which denied service connection for right ear hearing loss and granted service connection for left ear hearing loss, assigning a noncompensable initial rating, effective November 22, 2010. The Veteran appealed both claims. Service connection for right ear hearing loss was granted in a December 2018 rating decision, which assigned a noncompensable rating for bilateral hearing loss, effective May 10, 2013, the date of an audiological examination which first diagnosed a right ear hearing loss disability in accordance with VA regulations. In March 2019, the Board remanded the Veteran’s hearing loss claims in part, to obtain an audiological examination. Regrettably, as will be explained below, the Board finds that another remand is necessary to obtain an audiological evaluation that is valid for rating purposes. During the pendency of the appeal, the RO increased the Veteran’s evaluation for bilateral hearing loss to 50 percent disabling effective November 26, 2019, the date of the audiological examination where the RO determined it was factually ascertainable that an increase in disability occurred. See September 2020 rating decision. 1. Entitlement to an initial compensable rating for left ear hearing loss from November 22, 2010 to May 10, 2013, is remanded. 2. Entitlement to a compensable rating for bilateral hearing loss from May 10, 2013 to November 26, 2019, and a rating in excess of 50 percent for bilateral hearing loss since that time is remanded. In November 2019, the Veteran was afforded a VA audiological examination. Puretone threshold testing was conducted and speech discrimination scores were obtained. However, the examiner stated that the pure tone test results were not valid for rating purposes (not indicative of organic hearing loss) because the test reliability was considered poor based on inconsistent responses, poor SRT/pure tone average agreement and air/bone gaps with normal tympanogram. Further, the examiner determined that the use of speech discrimination scores for the right and left ear were not appropriate for this Veteran because of language difficulties, cognitive problems and inconsistent speech discrimination scores that made the combined use of pure tone average and speech discrimination scores inappropriate. In sum, the examiner found that the degree of hearing loss could not be determined due to poor test reliability. Nevertheless, despite the 2019 examiner’s findings that the test results were invalid for rating purposes, the RO increased the rating for the Veteran’s bilateral hearing loss to 50 percent disabling, effective from the date of the 2019 examination. Regardless of the RO’s actions, the Board finds the 2019 audiological examination inadequate to decide the claim. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide a VA examination or obtain an opinion, it must ensure that the examination or opinion is adequate.) On remand, if pure tone test results are considered invalid or an inaccurate depiction of the severity of the Veteran’s bilateral hearing loss, the examiner should include an explanation regarding why valid and reliable audiometric data could not be obtained. The matter is REMANDED for the following actions: 1. Obtain any outstanding VA treatment records and associate them with the claims file. 2. Schedule the Veteran for an audiological examination by an appropriate clinician to determine the current severity of his bilateral hearing loss. The claims file must be reviewed by the examiner. All necessary tests should be performed, and all clinical findings reported in detail. If the examiner is unable to secure valid test results, they should explicitly state why (e.g., cognitive impairment, lack of cooperation by the Veteran), and the examiner should give a rationale in support of this determination. Jennifer White Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Alison M. Mecone, 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.