Citation Nr: 21070766 Decision Date: 11/26/21 Archive Date: 11/26/21 DOCKET NO. 19-04 515 DATE: November 26, 2021 REMANDED Entitlement to a disability rating in excess of 50 percent for posttraumatic stress disorder (PTSD) with cannabis use disorder is remanded. Service connection for hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty in the Army from October 1992 to October 1999. The Veteran testified before the undersigned Veterans Law Judge during a June 2021 hearing and the transcript is of record. These matters are on appeal from June 2018 and July 2018 rating decisions. 1. Entitlement to a disability rating in excess of 50 percent for PTSD with cannabis use disorder is remanded. The Veteran was last afforded a VA examination for her service-connected psychiatric disability in July 2018, more than three years ago. During the June 2021 hearing, the Veteran testified that her psychiatric symptoms had worsened and described them in detail. The record thus raises the possibility that the Veteran's service-connected psychiatric disability could now be more severe than the July 2018 examination report reflects. "Where the record does not adequately reveal the current state of the claimant's disability, a VA examination must be conducted." Schafrath v. Derwinski, 1 Vet. App. 589, 595 (1991). A remand for a new examination is thus warranted. 2. Service connection for hearing loss is remanded. Once VA undertakes the effort to provide an examination when developing a service connection claim, even if not statutorily obligated to do so, it must provide one that is adequate for purposes of the determination being made. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Veteran was afforded a VA examination in May 2018. The clinician conceded noise exposure but opined that the Veteran's bilateral hearing loss was not caused by or a result of that exposure because her hearing was normal at the time of separation from active duty and there was no "permanent significant shift in hearing thresholds" during active duty service. This is not the correct standard. The absence of evidence of a hearing loss disability in service is not fatal to a veteran's claim. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Evidence of a current hearing loss disability and a medically sound basis for attributing such disability to service may serve as a basis for a grant of service connection. See Hensley v. Brown, 5 Vet. App. 155 (1993). In addition, at the time of the examination, only the Veteran's right ear hearing loss met the threshold to be considered disabling for VA purposes; her left ear hearing loss was very slightly below the threshold. 38 C.F.R. § 3.385 (2021). That examination was more than three years ago and, during the June 2021 hearing, the Veteran testified that her hearing loss had worsened since the examination. The record thus raises the possibility that the Veteran's left ear hearing loss could now be more severe than the July 2018 examination report reflects. For these reasons, a remand for a new examination is warranted. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records for the Veteran. The Agency of Original Jurisdiction (AOJ) shall document, in writing, all efforts to obtain these records, to include any formal finding that the records are unavailable. 2. Arrange for the Veteran to have an examination by an appropriate clinician for the purpose of determining the current severity of her service-connected psychiatric disability. The electronic claims file must be made available to the clinician for review. The clinician is to provide a detailed review of the Veteran's pertinent medical history, current complaints, and the nature and extent of any symptoms of her service-connected psychiatric disability. Although an independent review of the claims file is required, the Board calls the clinician's attention to the Veteran's testimony regarding her symptoms during the June 2021 hearing. 3. Schedule the Veteran for an examination with an appropriate clinician for her bilateral hearing loss. The entire claims file and a copy of this remand must be made available to the clinician for review. The clinician must provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's bilateral hearing loss began during active service, is related to an incident of service, or began within one year after discharge from active service. The rationale for any opinion expressed should be provided. Note that an absence of hearing loss in service cannot serve as the sole basis for a negative finding. If an opinion cannot be made without resort to speculation, the clinician should so state and provide reasoning as to why a conclusion would be so outside the norm that such an opinion is not possible. 4. Ensure that the directives specified in this remand have been implemented. If they have not, appropriate corrective action must be undertaken before readjudication. Stegall v. West, 11 Vet. App. 268 (1998). 5. Then, readjudicate the claims. If any decision is unfavorable to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Ryan Frank, 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.