Citation Nr: 21074048 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 17-21 295 DATE: December 14, 2021 REMANDED Entitlement to an initial compensable rating prior to June 21, 2016, and higher than 10 percent thereafter, for bilateral hearing loss, is remanded. Entitlement to an initial compensable rating for right ear otitis media is remanded. Entitlement to service connection for left ear busted ear drum and inner canal infections is remanded. Entitlement to service connection for vertigo secondary to service-connected bilateral hearing loss and right ear otitis media is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1979 to October 1981. In September 2021, the Veteran testified in a virtual hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is of record and has been reviewed. The issue of entitlement to service connection for a back disability will be decided in a separate decision pursuant to the AMA framework. A remand is necessary to provide the Veteran with new VA examinations and to obtain outstanding VA treatment records. Outstanding Records During the September 2021 hearing, the Veteran testified as to relevant recent treatment at the Temple VAMC. These records are not yet associated with the claims file. On remand, the agency of original jurisdiction (AOJ) should associate any outstanding VA treatment records with the claims file. Increased Rating Claims During the September 2021 hearing, the Veteran reported worsening of his symptoms and described symptoms such as discharge that was not present at the time of the last VA examinations in January and February 2019. Accordingly, a new VA examination is necessary prior to analyzing the merits of these claims. Service Connection for a Left Ear Busted Drum Although the most recent VA examination showed normal left eardrum, the Veteran testified that more recently he was told that he had a hole in his left eardrum. Accordingly, a new examination is necessary prior to analyzing the merits of this claim. Vertigo The Board notes that VA is required to develop and adjudicate related claims for secondary service connection for disabilities that are reasonably raised during the adjudication of an increased rating claim for the primary disability. See 38 C.F.R. § 3.160; Bailey v. Wilkie, 33 Vet. App. 188 (2021); Kisor v. Wilkie, 139 S. Ct. 2400, 2415 (2019). Here, the evidence indicates that the Veteran has been diagnosed with vertigo and this condition may be secondary to the service-connected bilateral hearing loss and/or right ear otitis media. Accordingly, a VA examination is necessary to help determine the likely etiology of the diagnosed vertigo. The matters are REMANDED for the following actions: 1. Ensure all outstanding VA treatment records are associated with the claims file, to specifically include those from the Temple VA. 2. Provide the Veteran with a VA audiology examination to determine the current severity of his bilateral hearing loss. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed, including the Maryland CNC test and a pure tone audiometry test. The examiner is requested to review all pertinent records associated with the claims file. 3. Provide the Veteran with an appropriate VA examination to determine the current severity of his right ear otitis media. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file and address the Veteran's lay reports regarding any symptoms associated with the right ear otitis media. (See 09/14/2021 hearing transcript). 4. Provide the Veteran with an appropriate VA examination to help determine the likely etiology of any left eardrum condition and the diagnosed vertigo. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. After a review of the claims file and examination of the Veteran, the examiner is asked to respond to the following: (a) Elicit from the Veteran the history of all signs and symptoms associated with the claimed left eardrum condition, to include, but not limited to, his reports that he had a hole in the eardrum. (b) Identify any currently diagnosed left ear disability, to include any eardrum condition. If no disability is diagnosed, to the extent possible, explain what the Veteran's reported symptoms are attributed to. (c) For each currently diagnosed left ear disability, provide an opinion as to whether it is at least as likely as not (a 50 percent or higher probability) that it had its onset during service or is otherwise related to it. (d) For the diagnosed vertigo, provide an opinion as to whether it is at least as likely as not (a 50 percent or higher probability) that it was caused OR aggravated by the service-connected bilateral hearing loss and/or right ear otitis media. Aggravation under 38 C.F.R. § 3.310 (b) does not require that there be "permanent" worsening of the nonservice connected disability. The examiner must provide separate findings and rationales relating to causation and aggravation. A complete rationale should be provided for all opinions on direct, causation, AND aggravation. 5. Thereafter, readjudicate the remanded claims. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Yaffe, 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.