Citation Nr: 21001240 Decision Date: 01/07/21 Archive Date: 01/07/21 DOCKET NO. 07-29 805 DATE: January 7, 2021 REMANDED Entitlement to a compensable disability rating prior to February 16, 2012, in excess of 40 percent from February 16, 2012, and higher than 0 percent from May 25, 2018 for service-connected bilateral hearing loss, to include on an extraschedular basis, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Air Force from June 1971 to June 1975. This matter before the Board of Veterans’ Appeals (Board) is on appeal from a March 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Houston, Texas (Agency of Original Jurisdiction (AOJ)). The Veteran and his son testified at a Travel Board hearing before the undersigned in August 2011. A transcript of the proceeding is of record. This matter was most recently before the Board in November 2018. The Board remanded on the issue of entitlement to a compensable disability rating for service-connected bilateral hearing loss to seek a new VA opinion and to acquire additional treatment records. A review of the file reflects that a new examination was completed and additional medical records were obtained. However, the record does not contain the opinion sought by the Board. The Board specifically requested an opinion that “determine[s] the current nature and etiology of psychiatric impairments due to service-connected bilateral hearing loss,” and asked the examiner to indicate “whether the Veteran’s description of social isolation in an October 2018 correspondence from his attorney…is at least as likely as not attributable to his service-connected bilateral hearing loss [and] if so, the examiner should describe the extent of social and industrial impairment due to any psychiatric symptoms attributable to bilateral hearing loss.” While a VA examination was indeed performed, the examiner did not provide the requested opinion, and, thus, there has been not been substantially compliance with the remand directive in accordance with Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board observes that, recently, the United States Court of Appeals for Veterans Claims (CAVC) issued an en banc decision in Long v. Wilkie, No. 16-1537 (December 30, 2020) which substantially revises the extraschedular analysis. In light of this decision, the Board must revise the prior remand directives. The Board further notes that this case has previously been remanded to determine the type of word list used by Today’s Hearing during hearing evaluations on February 18, 2012 and April 24, 2018. In a response received on May 22, 2018, Today’s Hearing provided reports as follows: [The Veteran] was seen for audiometric assessment on 2/18/12. He presented with concerns of decreased hearing acuity and tinnitus. Results were as follows: Right ear: Moderate to severe sloping sensorineural hearing loss Speech discrimination scores were 0% at 50 SPL dB using taped CID W22 calibrated word list Speech discrimination scores were 91% at 80 SPL dB using taped CID W22 calibrated word list Normal middle ear function Left ear: Moderate to severe sensorineural hearing loss Speech discrimination scores were 0% at 50 dB SPL using taped CID W22 calibrated word list Speech discrimination scores were 71% at 80 SPL dB using taped CID W22 calibrated word list Normal middle ear function [The Veteran] was seen for audiometric assessment on 4/24/18. He presented with concerns of decreased hearing acuity and tinnitus. Results were as follows: Right ear: Moderate to severe sensorineural hearing loss Speech discrimination scores were 67% at 80 SPL dB using taped CID W22 word list Normal middle ear function Left ear: Moderate to severe sensorineural hearing loss Speech discrimination scores were 71% at 80 dB SPL using taped CID W22 word list Normal middle ear function (emphasis added). However, in a response received on February 28, 2019, Today’s Hearing Today’s Hearing provided reports as follows: [The Veteran] was seen for audiometric assessment on 4/24/18. He presented with concerns of decreased hearing acuity and tinnitus. Results were as follows: Right ear: Moderate to severe sensorineural hearing loss. Speech discrimination scores were 67% at 80 dB SPL using taped Maryland cnc word list. Normal middle ear function. He was seen on 2/16/12 for audiogram and speech testing using Maryland cnc word list. Audiogram is included in report. Left ear: Moderate to severe sensorineural hearing loss. Speech discrimination scores were 71% at 80 dB SPL using taped Maryland cnc word list. Normal middle ear function. He was seen on 2/16/12 for audiogram and speech testing using Maryland cnc word list. Audiogram is included in report. (emphasis added). Attached were handwritten notes “Maryland CNC Word List” to the audiogram reports. On remand, the AOJ must obtain clarification from Today’s Hearing regarding the potential discrepancies for the word list used during the February 2012 and April 2018 examinations. The matters are REMANDED for the following action: 1. The AOJ should contact Today’s Hearing and obtain the Veteran’s complete medical file. The AOJ should provide Today’s Hearing with copies of the reports received on May 22, 2018 and February 28, 2019 and ask for an explanation for reporting use of 2 different word lists on the same examinations, and request supporting documentation for the type of word list(s) used. 2. Associate with the claims folder updated VA medical treatment records. 3. Then, the Veteran should be afforded an appropriate VA examination in order to determine the current nature and etiology of psychiatric impairments due to service-connected bilateral hearing loss, if any. The claims file must be made available to and be reviewed by the examiner. The examiner should specifically indicate whether the Veteran description of social isolation in an October 2018 correspondence from his attorney supports a diagnosis of an acquired psychiatric disorder under DSM criteria – reported as missing out on social activities and family events – that it at least as likely as not attributable to his service-connected bilateral hearing loss. If so, the examiner should describe the extent of social and industrial impairment due to any psychiatric symptoms attributable to bilateral hearing loss. The examiner is requested to discuss whether there is any medical reason to accept or reject the Veteran’s contentions that his social isolation results in a diagnosable acquired psychiatric disorder per DSM criteria. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 4. Thereafter, readjudicate the claim to include consideration of an extraschedular rating. If any benefit sought on appeal remains denied, furnish the Veteran and his representative, if any, a supplemental statement of the case and an appropriate period of time to respond. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Victoria A. Banis, 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.