Citation Nr: 21072823 Decision Date: 12/06/21 Archive Date: 12/06/21 DOCKET NO. 17-64 772 DATE: December 6, 2021 REMANDED Entitlement to a disability rating in excess of 20 percent for residuals of recurrent dislocations of the left shoulder is remanded. Entitlement to an initial compensable rating for a bilateral hearing loss disability is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1965 to November 1967. In October 2021, the Veteran had a virtual hearing before the undersigned Veterans Law Judge. This case is before the Board of Veterans' Appeals (Board) on appeal from an August 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In an April 2018 letter, the attorney of record withdrew his representation at the behest of the Veteran. During his October 2021 Board Hearing, the Veteran confirmed that he no longer wished to have his private attorney represent him. As the Veteran has not appointed a new attorney, agent, or representative, he is currently not represented. 1. Entitlement to a disability rating in excess of 20 percent for residuals of recurrent dislocations of the left shoulder is remanded. During an October 2021 Board Hearing, the Veteran asserted that his left shoulder disability had worsened since he was last examined by VA in September 2017. He reported that he has no strength in his left shoulder and noted that it was painful to raise his left arm. The Board notes that where the evidence indicates that a service-connected disability has worsened since the last VA examination, and that examination is too remote to constitute a contemporaneous examination, a new examination is required. See 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4); see also Snuffer v. Gober, 10 Vet. App. 400 (1997). As such, the Board finds that the Veteran should be afforded a new VA examination to ascertain the current severity and manifestations of his service-connected left shoulder disability. 2. Entitlement to an initial compensable rating for bilateral hearing loss is remanded. During his October 2021 Board hearing, the Veteran reported that his bilateral hearing loss disability had worsened since his last VA examination in September 2017. As such, because the Veteran asserted that his bilateral hearing loss disability has increased in severity since he was last examined by VA in September 2017, the Board finds that he should be provided an opportunity to report for a VA examination to ascertain the current severity and manifestations of his service-connected bilateral hearing loss disability. The matters are REMANDED for the following actions: 1. Obtain any outstanding VA treatment records and associate them with the claims file. 2. Ask the Veteran to complete a VA Form 21-4142 so he can provide the information necessary to identify and locate private treatment records related to his left shoulder and hearing loss disability. Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected residuals of recurrent left shoulder dislocations. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's left shoulder disability under the rating criteria. The examiner should describe the functional impairment caused by his left shoulder disability. (a) The examiner must test the Veteran's active motion, passive motion, and pain with weight-bearing and without weight-bearing. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). (b) The examiner must also attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. If it is not possible to provide a specific measurement based on direct observation, the examiner should provide an estimate, if at all possible, of the additional impairment due to flare-ups based on the other evidence of record and the Veteran's statements. If it is not possible to provide a specific measurement without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). 4. Schedule the Veteran for an audiological examination by an appropriate clinician to determine the current severity of his bilateral hearing loss disability. The claims file must be reviewed by the examiner. All necessary tests should be performed, and all clinical findings reported in detail. If the examiner is unable to secure valid test results, they should explicitly state why (e.g., cognitive impairment, lack of cooperation by the Veteran), and the examiner should give a rationale in support of this determination. Jennifer White Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Alison M. Mecone, 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.