Citation Nr: 21062295 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 17-42 755 DATE: October 6, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for a left arm disorder is remanded. Entitlement to service connection for hemorrhoids is remanded. Entitlement to service connection for a skin disorder, to include dermatitis is remanded. Entitlement to service connection for a lumbar cyst is remanded. REASONS FOR REMAND The Veteran served in the Army National Guard from September 2007 to February 2008 and from September 2011 to November 2012. This matter comes to the Board of Veterans' Appeals (Board) on appeal from an August 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). REASONS FOR REMAND 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. 3. Entitlement to service connection for a left arm disorder is remanded. 4. Entitlement to service connection for hemorrhoids is remanded. 5. Entitlement to service connection for a skin disorder, to include dermatitis is remanded. 6. Entitlement to service connection for a lumbar cyst is remanded. Although the Board regrets the additional delay, a remand is necessary in order to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claim, so that he is afforded every possible consideration. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c). The Board notes that there may be outstanding VA treatment records which may contain information and evidence relevant to the Veteran's claims. Here, the claims file contains VA treatment records dated through February 2016, over five years ago. To ensure that there is an adequate record upon which to decide the Veteran's claim, a remand is necessary to obtain any updated VA treatment records dated from February 2016, to the present. See Bell v. Derwinski, 2 Vet. App. 611 (1992). Additionally, the Veteran should be provided the opportunity to identify any additional private treatment records that are relevant to his claim and to provide the necessary information in order for VA to assist him in obtaining these potentially relevant records. See 38 C.F.R. § 3.159 (c). Further, VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. Floyd v. Brown, 9 Vet. App. 88, 93 (1996). Here, the Veteran was provided VA examinations in June 2015 in connection with his claims for bilateral hearing loss; tinnitus; a left arm disorder; hemorrhoids; skin disorder; and a lumbar cyst. As these examinations were provided over six years ago and because the Veteran's VA treatment records may not be a current reflection of the nature of the Veteran's claimed disorders, new examinations with etiology opinions must be provided. The matters are REMANDED for the following action: 1. Contact all appropriate resources to verify the specific dates when the Veteran was on active duty, ACDUTRA, and/or INACDUTRA. Document for the claims file what repositories were contacted and why. If necessary, the Veteran should be requested to provide any assistance in obtaining this clarifying information. All verified dates of service and all responses received should be documented in the claims file. Any outstanding service personnel records should be obtained and associated with the claims file. Records concerning service merely denoting the amounts of points he obtained, including cumulatively, are not helpful in this regard insofar as determining exactly when the Veteran was on active duty, ACDUTRA and INACDUTRA. To the extent possible, the AOJ should then prepare a summary of the dates of active duty, ACDUTRA, and INACDUTRA and associate it with the electronic claims file. 2. Then, obtain and associate with the electronic claims file any outstanding VA treatment records dated from February 2016 to Present. 3. Next, request that the Veteran provide the names and addresses of any health care providers who have provided treatment for his claimed disabilities, to include his bilateral hearing loss; tinnitus; a left arm disorder; hemorrhoids; skin disorder; and a lumbar cyst. After acquiring this information and obtaining any necessary authorization, the AOJ should obtain and associate these records with the claims file. 4. BILTERAL HEARING LOSS: Schedule a VA examination in relation to the Veteran's service connection claim for bilateral hearing loss. The claims folder (including a copy of this remand) must be provided to and reviewed by the examiner as part of the examination. A notation to the effect that this review has taken place should be made in the evaluation report. All tests, studies, and evaluations should be performed as deemed necessary by the examiner, and the results of any testing must be included in the examination report. The examiner must first indicate if there is any current left and/or right ear hearing loss disability. For any diagnosed left and/or right ear hearing loss disability, the examiner should provide an opinion as to the following questions: (a) Is it at least as likely as not (a 50 percent or greater probability) that the disorder manifested during, or is otherwise related to, a period of active-duty service and/or ACDUTRA. (b) Is it at least as likely as not (a 50 percent or greater probability) that such disorder is related to an injury during a period of INACDUTRA. In providing an opinion the examiner should take a detailed history from the Veteran regarding the onset of his claimed bilateral hearing loss disorder and any continuity of symptoms since that time. The examiner must also consider the December 2015 VA audiology note, which shows that the Veteran had sensorineural hearing loss and used hearing aids. 3. TINNITUS: Schedule the Veteran for a VA medical examination to determine the nature and etiology of his tinnitus. Then, the examiner should provide an opinion as to the following questions: (a) Is it at least as likely as not (a 50 percent or greater probability) that the disorder manifested during, or is otherwise related to, a period of active-duty service and/or ACDUTRA. (b) Is it at least as likely as not (a 50 percent or greater probability) that such disorder is related to an injury during a period of INACDUTRA. In providing an opinion the examiner should take a detailed history from the Veteran regarding the onset of his tinnitus and any continuity of symptoms since that time. 4. LEFT ARM DISORDER: Schedule the Veteran for a VA medical examination to determine the nature and etiology of his claimed left arm disorder. Then, the examiner should provide an opinion as to the following questions: (a) Is it at least as likely as not (a 50 percent or greater probability) that the disorder manifested during, or is otherwise related to, a period of active-duty service and/or ACDUTRA. (b) Is it at least as likely as not (a 50 percent or greater probability) that such disorder is related to an injury during a period of INACDUTRA. In doing so, the examiner is directed to consider the June 2015 diagnosis of lateral epicondylitis. 5. HEMORRHOIDS: Schedule the Veteran for a VA medical examination to determine the nature and etiology of his hemorrhoids. Then, the examiner should provide an opinion as to the following questions: (a) Is it at least as likely as not (a 50 percent or greater probability) that the disorder manifested during, or is otherwise related to, a period of active-duty service and/or ACDUTRA. (b) Is it at least as likely as not (a 50 percent or greater probability) that such disorder is related to an injury during a period of INACDUTRA. In doing so, the examiner is directed to consider the September 2015 list of active outpatient medications, to include hemorrhoidal suppository inserts, as well as the Veteran's contentions that he has felt an anal lump and discomfort since 2012. 6. SKIN DISORDER: Schedule the Veteran for a VA medical examination to determine the nature and etiology of his skin disorder. Then, the examiner should provide an opinion as to the following questions: (a) Is it at least as likely as not (a 50 percent or greater probability) that the disorder manifested during, or is otherwise related to, a period of active-duty service and/or ACDUTRA. (b) Is it at least as likely as not (a 50 percent or greater probability) that such disorder is related to an injury during a period of INACDUTRA. In doing so, the examiner is directed to consider the June 2015 skin examination in which the Veteran was diagnosed with dermatitis, as well as the Veteran's contentions that he has had a rash for a long time. 7. LUMBAR CYST: Schedule the Veteran for a VA medical examination to determine the nature and etiology of his claimed lumbar cyst. The examiner must first indicate if there is any current lumbar cyst. If diagnosed, the examiner should then provide an opinion as to the following questions: (a) Is it at least as likely as not (a 50 percent or greater probability) that the disorder manifested during, or is otherwise related to, a period of active-duty service and/or ACDUTRA. (b) Is it at least as likely as not (a 50 percent or greater probability) that such disorder is related to an injury during a period of INACDUTRA. 8. After completion of the above, readjudicate the claim. If any benefit requested on appeal is not granted to the Veteran's satisfaction, the Veteran and his representative should be furnished a supplemental statement of the case, which addresses all of the evidence obtained after the issuance of the last statement of the case and provided an opportunity to respond. The case should then be returned to the Board for further appellate consideration, if in order. GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board t. Hanson 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.