Citation Nr: 21069765
Decision Date: 11/19/21	Archive Date: 11/19/21

DOCKET NO. 16-59 388
DATE: November 19, 2021

REMANDED

Entitlement to a compensable rating for bilateral hearing loss is remanded.

REASONS FOR REMAND

The Veteran served on active duty in the United States Army from August 1968 to August 1970, to include service in the Republic of Vietnam. 

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2015 rating decision by a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ).  In August 2019, the Board remanded the appeal. 

The Veteran has competently and credibly reported additional symptoms that he attributes to his bilateral hearing loss and tinnitus.  Specifically, he reports headaches, dizziness, and vertigo.  See, e.g., March 2016 Notice of Disagreement (reporting headaches when wearing hearing aids); October 2014 VA treatment note (reporting dizziness, vertigo, and nausea); November 2010 VA treatment note (presenting with intermittent headaches, dizziness).  

The Board finds that additional development is necessary to determine the functional impairment of these symptoms and relationship to the Veteran's bilateral hearing loss, including appropriate VA examinations and medical opinions.  Morgan v. Wilkie, 31 Vet. App. 162, 164 (2019) (Board may need to consider secondary service connection as part of an increased rating claim); Doucette v. Shulkin, 28 Vet. App. 366., Mar. 6, 2017 (addressing potential additional effects of hearing loss, such as dizziness, vertigo, and ear pain).  Updated VA and private treatment records should be secured.  

The matters are REMANDED for the following action:

1. Obtain updated VA treatment records. 

2. With any necessary assistance from the Veteran, obtain any outstanding relevant private treatment records. 

3. After completing directives #1 and #2, schedule the Veteran for an examination to determine the nature and etiology of his reported intermittent headaches, dizziness, nausea, and vertigo.  The claims file should be made available to and should be reviewed by the examiner.  

The examiner should address the following:

(a)	Diagnose all current disabilities manifested by headaches, nausea, and/or vertigo.  

For the purposes of this question, a current disability includes a functional impairment, even in the absence of diagnosed pathology.

Moreover, a current disability includes any disability or functional impairment present since February 2014, even if subsequently resolved.

(b)	For each disability or functional impairment diagnosed in sub-part (a), opine as to whether it is at least as likely as not (a 50 percent or greater probability) that such disability is proximately due to the Veteran's bilateral hearing loss (to include his using of hearing aids) or tinnitus.

(c)	For each disability or functional impairment diagnosed in sub-part (a), opine as to whether it is at least as likely as not (a 50 percent or greater probability) that such disability has been aggravated (worsened beyond natural progression) by the Veteran's bilateral hearing loss (to include his use of hearing aids) or tinnitus.

The examiner's attention is invited to the Veteran's reports of his symptoms in the record and the Veteran's self-report of symptoms at examination.  See, e.g., March 2016 Notice of Disagreement (reporting headaches when wearing hearing aids); October 2014 VA treatment note (reporting dizziness, vertigo, and nausea); November 2010 VA treatment note (presenting with intermittent headaches, dizziness).  

A complete rationale should be given for all opinions and conclusions expressed.  If unable to provide a medical opinion, provide a statement as to whether there is any additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. 

 

S. BUSH

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	D. Saumur, 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.