Citation Nr: 21067855 Decision Date: 11/05/21 Archive Date: 11/05/21 DOCKET NO. 18-31 165 DATE: November 5, 2021 REMANDED Entitlement to service connection for bilateral sensorineural hearing loss (SNHL) is remanded. Entitlement to service connection for diabetic nephropathy, to include as due to a service-connected disability, is remanded. Entitlement to service connection for hypertension, to include as due to diabetic nephropathy, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1963 to September 1965. He filed his claim with the Regional Office located in San Juan, Puerto Rico. In March 2019, this claim was before the Board of Veterans' Appeals. The Board remanded the case for further development. Translation of records not in English A review of the record shows a file containing VA medical records that was received by the Regional Office in April 2021. A portion of these records are not in English and need to be translated into English before the claims on appeal are adjudicated by the Board. For cases originating from the San Juan Regional Office, a remand instruction may be included for the translation of documents if the case is being remanded to the San Juan Regional Office for other reasons. On remand, these documents should be translated into English by official means. New VA examination The prior remand instructions stated records in the claim file that were received in January 2008 needed to be translated into English. After those records were translated, the Veteran was supposed to be scheduled for a VA examination and an addendum opinion. The examination and addendum opinion were provided prior to the records being translated. Therefore, the examiners did not have access to these records and prior remand instructions were not followed. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. A file in the record that was received on April 12, 2021 contains several records that are in Spanish and should be translated into English by official means. 2. Provide the claims file to the September 2020 examiner, or another qualified examiner if that individual is not available, for an addendum opinion in order to determine the etiology of the Veteran's bilateral hearing loss. A copy of the claims file should be made available and reviewed by the examiner. Any clinical testing deemed necessary should be scheduled. After review of the Veteran's claims file, to include his service treatment records, the examiner should determine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's current bilateral hearing loss disability is related to his period of active duty service. In providing an answer to this question, the examiner should consider the Veteran's assertions that he has experienced hearing loss since service and assume as true that the Veteran experienced in-service acoustic trauma. If it is less likely that the Veteran's current hearing loss disability is related to his period of service, the examiner should discuss why this is the case, to include the clinical significance of any "normal" in-service hearing test results, if observed. 3. Provide the claims file to the April 2021 examiner, or another qualified examiner if that individual is not available, for an addendum opinion addressing the nature and etiology of the hypertension and diabetic nephropathy conditions. A copy of the claims file should be made available and reviewed by the examiner. Any clinical testing deemed necessary should be scheduled. The examiner must set forth an opinion as to whether it is it at least as likely as not (a 50 percent probability or higher) that the hypertension and/or diabetic nephropathy had their onset during service or are otherwise related to active service. In addition, irrespective of the answer to the above, the examiner is also requested to provide an opinion as to whether it is at least as likely as not that the hypertension and/or diabetic nephropathy were caused or aggravated by one or more service-connected disabilities (listed as bilateral upper and lower extremity peripheral neuropathy, tinnitus and diabetes mellitus type II). The examiner should note that the term "aggravated by" refers to a chronic or permanent worsening of the underlying condition, as contrasted to mere temporary or intermittent flare-ups of symptoms that resolve and return to the baseline level of disability. If the opinion is that a service-connected disability or combination of service-connected disabilities aggravated the hypertension and/or the diabetic nephropathy, the examiner should specify, so far as possible, the degree of disability resulting from such aggravation. The examiners must provide any and all opinions as to etiology in the form of a probability and must provide a complete rationale for any opinion expressed. The Board notes the anatomical distinctions between the conditions on appeal and recognizes that separate opinions may be necessary in this case. However, the Board leaves this to the discretion to the Regional Office and/or the examining medical facility. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. Chalker, 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.