Citation Nr: 21072056 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 19-08 395 DATE: December 2, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for a bilateral eye disability, including vision loss and cataracts, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from March 1961 to May 1964. These matters come before the Board of Veterans' Appeals (Board) on appeal from a July 2018 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge at a February 2021 Virtual hearing. A transcript of this hearing is of record. The Board remanded these matters for further development in May 2021. As discussed below, there has not been substantial compliance with the remand instructions, so the matter must be remanded again. See Stegall v. West, 11 Vet. App. 268 (1998); D'Aries v. Peake, 22 Vet. App. 97, 105 (2008). 1. Entitlement to service connection for bilateral hearing loss is remanded. The May 2021 Board remand instructed that the VA examiner providing an addendum opinion must consider the Veteran's statements regarding the onset and continuity of his hearing loss symptoms. In the Veteran's February 2021 Board hearing he testified that he began noticing his hearing loss in 1963 during service a few hours after returning from his parachute jumps, and that his hearing loss has increased ever since then. The June 2021 VA examiner opined that the Veteran's bilateral hearing loss was less likely than not due to his service, however she failed to mention the Veteran's testimony regarding the onset and continuity of his hearing loss symptoms. The examiner must consider the Veteran's lay statements regarding the onset and continuity of symptomatology. Dalton v. Nicholson, 21 Vet. App. 23 (2007). Additionally, the June 2021 VA examiner did not address the Veteran's July 1962 service treatment records (STRs) indicating an unsuccessful ear irrigation and a bilateral ear irrigation as instructed in the remand directives. Accordingly, another remand is required to obtain an additional VA opinion. 2. Entitlement to service connection for a bilateral eye disability, including vision loss and cataracts, is remanded. The May 2021 Board remand instructed a VA examiner to address the February 2021 private opinion by Dr. S.S. in the VA examiner's opinion on whether the Veteran's bilateral eye disability was service-connected. The February 2021 opinion by Dr. S.S. provided extensive history of the Veteran's bilateral eye disability and opined that it was likely that his condition was caused by his duty as a paratrooper. The VA examiner did not address Dr. S.S.'s positive nexus opinion in either her June 2021 opinion or in her September 2021 addendum opinion. Furthermore, the June 2021 VA examiner did not address the Veteran's separation examination that stated that the Veteran wore glasses for reading. All previous medical examinations during service, including one administered in February 1963, noted that the Veteran did not wear glasses. Therefore, the Board finds that the June 2021 VA examination and the September 2021 addendum opinion by the June 2021 VA examiner are incomplete, and additional development is required. The matters are REMANDED for the following actions: 1. Forward the Veteran's claims file, including a copy of this REMAND, to a VA audiologist (who has not yet provided an opinion in this Veteran's case) to provide an addendum medical opinion addressing the nature and etiology of the Veteran's bilateral hearing loss. A full audiological examination should not be scheduled unless it is deemed necessary by the examiner or otherwise required by the evidence. The examiner must review the claims file in its entirety and the review should be noted in the examination report. Thereafter, the examiner is asked to provide a fully-articulated medical opinion with respect to the following: (a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran's bilateral hearing loss had its onset during active service, within one year of separation, or is otherwise related to any in-service disease, event, or injury, to include conceded noise exposure? The examiner should address (1) the Veteran's contentions that his hearing loss started during service after his parachute jumps and worsened since then; and (2) the Veteran's July 1962 service treatment records noting ear irrigations. 2. Forward the Veteran's claims file, including a copy of this REMAND, to an appropriately qualified physician (M.D.) to address the nature and etiology of the Veteran's bilateral eye disability. A full ophthalmological examination should not be scheduled unless it is deemed necessary by the examiner or otherwise required by the evidence. The examiner must review the claims file in its entirety and the review should be noted in the examination report. Thereafter, the examiner is asked to provide a fully-articulated medical opinion with respect to the following: (a.) Is it at least as likely as not (50 percent or greater probability) that the Veteran's bilateral eye disability, including cataracts and vision loss, is at least as likely as not related to his active duty service? The examiner should address (1) the Veteran's contentions that his bilateral eye disability began during service due to flash grenades, boxing, and/or stress; (2) the Veteran's April 1964 separation examination stating that he needed reading glasses; and (3) Dr. S.S.'s February 2021 private positive opinion. The examiner is reminded that the term "at least as likely as not" does not mean "within the realm of possibility." Rather, it means that the weight of the medical evidence both for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against it. The examiner is advised that the lack of documented treatment for the claimed disability during service cannot serve as the sole basis for a negative finding. The examiner is advised that the Veteran is competent to report his medical history and must be considered and weighed in making the determination as to whether a nexus exists between the claimed diseases and military service. The examiner must provide a complete rationale for any opinion expressed. If the examiner is unable to provide an opinion without resorting to speculation, he or she should fully explain why that is so. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Ahuva D. Sunshine 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.