Citation Nr: 21001752 Decision Date: 01/11/21 Archive Date: 01/11/21 DOCKET NO. 18-11 831 DATE: January 11, 2021 REMANDED Entitlement to a compensable rating for bilateral hearing loss prior to December 17, 2019 and greater than 40 percent thereafter, to include on an extraschedular basis is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1967 to February 1969. Entitlement to a compensable rating for bilateral hearing loss prior to December 17, 2019 and greater than 40 percent thereafter, to include on an extraschedular basis is remanded. The Board is unable to make an informed decision on the issue of increased ratings for bilateral hearing loss, because there has not been substantial compliance with the Board’s December 2019 remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). The December 2019 remand directed the Agency of Original Jurisdiction (AOJ) to provide a VA examination to identify all conditions the Veteran claims are related to his hearing loss, to include stress, anxiety, vertigo, dizziness, vision problems, and cataracts. The February 2020 VA audiological opinion did not address the above-mentioned conditions, because the Veteran did not raise them as complaints associated with his hearing loss. However, during his October 2019 Board hearing the Veteran did associate the conditions of stress, anxiety, vertigo, dizziness, vision problems, and cataracts to his hearing loss. Therefore, the claim needs to be remanded for a new VA examination for the examiner to specifically ask the Veteran and address the symptoms of stress, anxiety, vertigo, dizziness, vision problems, and cataracts the Veteran has associated with his hearing loss. Additionally, the issue of compensation on an extraschedular basis was raised during the December 2019 Board hearing. Therefore, once the above development is completed, the AOJ should determine whether any identified symptoms the Veteran associates with his hearing loss disability that are not considered in the rating criteria for hearing loss, require any additional development, to include referral for extraschedular consideration. The matters are REMANDED for the following action: 1. Schedule the Veteran for the appropriate VA examination (with someone different than the February 2020 examiner, if possible) to assess the severity of his service-connected bilateral hearing loss. Copies of all pertinent medical records should be made available to the examiner for review. All necessary diagnostic testing should be performed using the appropriate DBQ. (a) The examiner should specifically discuss with the Veteran, his complaints of conditions he claims are related to his hearing loss, to specifically include stress, anxiety, vertigo, dizziness, vision problems, and cataracts. (b) For any of the identified manifestations in (a) above, explain whether the identified condition is part of the service-connected hearing loss criteria or a separate disability, or neither. (c) If any of the reported symptoms are found to be a separate disability, opine whether it is at least as likely as not the separate disability is caused or aggravated. by the Veteran’s service-connected bilateral hearing loss. The examiner is informed that aggravation here is defined as any increase in disability. If aggravation is present, the clinician should indicate, to the extent possible, the approximate level of disability (baseline) before the onset of the aggravation. A complete rationale must be provided for all opinions, citing to supporting factual data and medical literature, as appropriate. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training) and note what, if any, additional evidence would permit such an opinion to be made. 2. Then, after the above development, IF any symptom is identified by the examiner that is NOT contemplated by rating criteria for hearing loss, take all necessary action to develop the Veteran’s claim, to include referral to the Director of Compensation for extraschedular consideration. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. G. Perkins, 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.