Citation Nr: 21064568 Decision Date: 10/20/21 Archive Date: 10/20/21 DOCKET NO. 17-53 814 DATE: October 20, 2021 REMANDED Entitlement to an initial compensable disability rating for bilateral hearing loss is remanded. Service connection for bilateral neuropathy, upper extremities is remanded. Service connection for bilateral neuropathy, lower extremities is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1964 to July 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Newark, New Jersey. This appeal has been advanced on the Board's docket pursuant to 38 U.S.C. § 7107(a)(2); 38 C.F.R. § 20.902(c). Bilateral Hearing Loss The Veteran contends that he is entitled to a compensable rating for his bilateral hearing loss and requests an updated examination. The evidence of record, including a July 2014 private audiological evaluation and a March 2015 VA examination, reflect that the current noncompensable rating is appropriate based on the results of audiometric testing. See 38 C.F.R. § 4.85. The Veteran submitted a November 2017 private audiological evaluation in support of his request for an increased disability rating. However, that evaluation does not meet the requirements of 38 C.F.R. § 4.85(a) inasmuch as it is not clear if the evaluation was conducted by a state-licensed audiologist or if the Maryland CNC test was used to achieve the speech discrimination scores. Moreover, the audiometric testing does not permit a determination of the average decibel loss needed for rating purposes inasmuch results at the 3000 frequency are not reported. See 38 C.F.R. § 4.85(d). Nevertheless, the threshold shifts reported at the 1000, 2000 and 4000 frequencies suggest that the Veteran's hearing loss has worsened in comparison to the March 2015 VA examination. Based on the evidence of worsening, the Board finds that remand is warranted to determine the current nature and severity of the Veteran's bilateral hearing loss. See Barr v. Nicholson, 21 Vet. App. 303 (2007); Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). Bilateral neuropathy, upper and lower extremities The Veteran reported to the February 2015 VA examiner that he experienced intermittent numbness and tingling in his fingers and toes. The examiner concluded that the Veteran's neurologic examination was unremarkable, but that his subjective complaints suggested the possibility of some abnormality of peripheral nerve function. The claim for service connection was denied on the ground that the Veteran did not have a clinical diagnosis of peripheral neuropathy. The Veteran contends that his condition has a serious impact on his mobility and dexterity. In light of the Veteran's contention, and the holding in Saunders defining a disability as the functional impairment of earning capacity, the Board finds that remand is warranted for a medical determination of whether the Veteran's complaints of numbness and tingling in his bilateral upper and lower extremities rise to the level of a disability. See Saunders v. Wilkie, 886 F.3d 1356, 1364 (Fed. Cir. 2018) (holding that pain alone, without a specific diagnosis or otherwise identified disease or injury, may constitute a disability under 38 U.S.C. § 1110). The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA audiological examination for the purpose of evaluating the current severity of the Veteran's bilateral hearing loss. 2. Schedule the Veteran for an examination with an appropriate clinician to determine whether there is any functional impairment of earning capacity (disability) due to the Veteran's complaints of numbness and tingling in his bilateral upper and lower extremities. If there is a disability, the examiner must opine whether it is at least as likely as not (50 percent probability or more) caused by service, including the Veteran's exposure to herbicide agents. A complete rational must be provided for any opinion offered. If the requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge, i.e., no one could respond given the medical science and known facts, or be a deficiency in the record or the examiner, i.e., additional facts are required, or the examiner does not have the necessary knowledge or training. If the inability to provide an opinion without resorting to speculation is due to a deficiency in the record (additional facts required), the RO should develop the claim to the extent necessary to cure any such deficiency. If the inability to provide an opinion is due to the examiner's lack of requisite knowledge or training, then the RO should obtain an opinion from a medical professional who has the knowledge and training needed to render such an opinion. S.C. KREMBS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Snyder, 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.