Citation Nr: 21062334 Decision Date: 10/07/21 Archive Date: 10/07/21 DOCKET NO. 20-15 997 DATE: October 7, 2021 REMANDED Entitlement to a compensable rating for bilateral hearing loss is denied. REASONS FOR REMAND The Veteran served on active duty from October 1965 to September 1967. In October 2021, the Veteran presented testimony before the undersigned Veterans Law Judge of the Board. 1. Bilateral hearing loss The Veteran is seeking a compensable rating for his bilateral hearing loss. During his October 2021 Board hearing, he testified that he has had to adjust his hearing aids since his last VA examination in November 2017 so he is able to hear. Therefore, the Board finds that a new VA examination is needed to ascertain the current severity and manifestations of his service-connected bilateral hearing loss. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown,6 Vet. App. 377 (1994). Additionally, the Veteran testified that he feels unbalanced when he removes his hearing aids. The Board finds that, on examination, the VA examiner should determine whether the Veteran suffers from any disabilities (such as vertigo or Meniere's disease) that may be associated with his bilateral hearing loss. The matters are REMANDED for the following action: 1. Associate with the file all VA and private treatment for the Veteran dated from January 2020 to the present that have not previously been obtained. 2. Then, schedule the Veteran for a VA audiological examination to ascertain the severity and manifestation of his service-connected bilateral hearing loss. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is also asked to comment as to whether the Veteran suffers from any other disabilities that may be associated with the bilateral hearing loss and result in balance issues, as the Veteran testified in the October 2021 Board hearing. For each identified disorder, the examiner must provide an opinion as to the following: 3. whether the disorder is a separate and distinct disability from the service-connected bilateral hearing loss. 4. If so, whether it is at least as likely as not directly due to the Veteran's military service. 5. whether it is at least as likely as not any diagnosed disorder is caused by his service-connected bilateral hearing loss disability, yes or no? 6. whether it is at least as likely as not that any diagnosed disorder underwent any incremental increase (aggravation) in disability, regardless of its permanence, due to his service-connected bilateral hearing loss disability, yes or no? The term "incremental increase in disability" means additional impairment of earning capacity. Objective measurement, or numerical quantification, is not required to ascertain an increase in disability. The term "at least as likely as not" does not mean "within the realm of medical possibility." Rather, it means that the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of the conclusion (e.g., etiology) as it is to find against the conclusion. The examiner is instructed to review all pertinent records associated with the claims file. It should be noted that the Veteran is competent to attest to factual matters of which he has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. Because it is important "that each disability be viewed in relation to its history [,]" (38 C.F.R. § 4.1 ), copies of all pertinent records in the Veteran's claims file, or in the alternative, the claims file, must be made available to the examiner for review. (Continued on the next page) YVETTE R. WHITE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Berry, 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.