Citation Nr: 21067776 Decision Date: 11/05/21 Archive Date: 11/05/21 DOCKET NO. 14-38 587 DATE: November 5, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for benign paroxysmal positional vertigo is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1962 to September 1966. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In February 2018, the Veteran appeared and testified at a video conference hearing before the undersigned Veterans Law Judge. This matter was previously remanded by the Board in May 2018 for further development. In an April 2020 decision, the Board denied service connection for the issues now on appeal. The Veteran appealed that decision to the Court of Appeals for Veterans Claims (Court). In February 2021, the Court granted the parties' Joint Motion for Remand and remanded the issues back to the Board finding that the August 2019 VA examination on which the Board relied was inadequate. In June 2021, the Board remanded the claims for a new examination in light of the February 2021 Joint Motion for Remand. Unfortunately, the Board finds that further remand is necessary. Entitlement to service connection for bilateral hearing loss is remanded. Regarding the Veteran's claim for service connection for bilateral hearing loss, the Board notes the August 2021 VA examiner observed the Veteran's hearing was within normal limits at his separation. However, the Veteran separated from service in September 1966, and the audiometric testing is presumed to be the ASA standard, not the ISO-ANSI used since 1971. Where necessary to facilitate data comparison for VA purposes, including under 38 C.F.R. § 3.385, audiometric data originally recorded using ASA standards will be converted to ISO-ANSI standard by adding between 5 and 15 decibels to the recorded data as follows: Hertz 250 500 1000 2000 3000 4000 6000 8000 add 15 15 10 10 10 5 10 10 At entrance, pure tone thresholds, in decibels, were as follows according to the ASA standard: HERTZ 500 1000 2000 3000 4000 RIGHT -10 -10 0 -5 -10 LEFT -5 -10 -10 0 -5 Upon conversion to the ISO-ANSI standard, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 5 0 10 5 -5 LEFT 10 0 0 10 0 At separation, pure tone thresholds, in decibels, were as follows according to the ASA standard: HERTZ 500 1000 2000 3000 4000 RIGHT 5 5 5 10 0 LEFT 5 5 5 5 -5 Upon conversion to the ISO-ANSI standard, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 20 15 15 20 5 LEFT 20 15 15 15 0 Upon remand the examiner should use the converted audiometric findings to determine any level of hearing loss. Further, the examiner should address the threshold shift and determine if it is indicative of hearing loss in service. Entitlement to service connection for benign paroxysmal positional vertigo is remanded. Regarding the claim as to entitlement to service connection for benign paroxysmal positional vertigo, the Board notes that subsequent to the most recent examination for benign paroxysmal positional vertigo, the Veteran was granted service connection for tinnitus. This was based on an examiner's opinion, which among other things linked consider the Veteran sustained damage to the ear inner hair cells during service. As the evidence of record suggests benign paroxysmal positional vertigo is an ear disorder caused by ear damage, and VA conceded that ear damage occurred in service, remand is warranted to obtain an opinion that considers this newly favorable evidence. On remand the examiner also should address the Veteran's testimony regarding onset of benign paroxysmal positional vertigo. The matters are REMANDED for the following action: 1. Return the claims file to an appropriate VA examiner for an addendum opinion as to whether the Veteran's bilateral hearing loss is due to service. The claims file should be made available to and be reviewed by the examiner in conjunction with the examination. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. The examiner should opine whether the Veteran's bilateral hearing loss was due to service. In so discussing, the examiner is to address the differences in the results of the Veteran's hearing tests conducted at service entrance and service separation, and if the Veteran's hearing acuity was within normal limits after converting his hearing thresholds from the ASA to ISO-ANSI standard. 2. Return the claims file to an appropriate VA examiner for an addendum opinion as to whether the Veteran's benign paroxysmal positional vertigo is related to service. The claims file should be reviewed by the examiner in conjunction with the examination. The need for another examination is left to the discretion of the medical professional offering the addendum opinion. The examiner is to opine whether the Veteran's benign paroxysmal positional vertigo is at least as likely as not due to an injury in service, including ear damage that is considered to have caused the Veteran's service-connected tinnitus. In addressing the above, the examiner should also specifically discuss the Veteran's lay statements regarding onset of symptoms and any continuity of symptomatology since onset and/or since discharge from service. The examiner should also consider any other pertinent evidence of record, as appropriate. All findings should be reported in detail and all opinions must be accompanied by a clear rationale. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Uller, 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.