Citation Nr: 21075012 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 14-34 470A DATE: December 17, 2021 REMANDED Entitlement to service connection for hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1957 to December 1958. He died in March 2021. The Appellant is his surviving spouse and has been substituted in this appeal. This case comes to the Board of Veteran's Appeals (Board) on appeal from a May 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In June 2015, the Veteran disagreed with this rating decision. In April 2021, the Board dismissed the claim on appeal without prejudice due to the death of the Veteran. Following the Board's dismissal, the Appellant was accepted as a proper substitute with respect to the pending service connection claim on appeal. Because of this, the claim on appeal is now properly before the Board and the Board may adjudicate the claim on the merits. This case was previously before the Board in September 2017 and August 2021 when it was remanded for additional development. Unfortunately, for the reasons discussed below, another remand is required. See Stegall v. West, 11. Vet. App. 268 (1998). During the period of the appeal, in a September 2021 Rating Decision, the RO granted service connection for a left eye disability and for a skin disability. Therefore, those claims for service connection have been resolved and are no longer before the Board on appeal. See generally Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997); Barrera v. Gober, 122 F.3d 1030 (Fed. Cir. 1997). Entitlement to service connection for hearing loss is remanded. In the September 2020 VA examination report, the VA examiner determined that the Veteran's Pure Tone threshold test results were not valid for rating purposes because the Veteran's thresholds were likely "inorganic." The VA examiner noted that the Veteran was able to converse while the examiner was wearing a mask but presented as having profound hearing loss when testing. The VA examiner also noted that speech discrimination scores were not appropriate. However, the examiner still diagnosed the Veteran's with sensorineural hearing loss. The examiner stated that the Veteran was malingering, so it was not possible to determine the Veteran's actual hearing loss and whether it was etiologically related to active service. In the August 2021 remand, the Board noted that it was unclear what the VA examiner was referring to when stating that the Veteran was malingering. Additionally, it was also unclear what the VA examiner meant by stating that it was not possible to determine the Veteran's actual hearing loss and whether it was noise-induced, despite providing an opinion that the Veteran's hearing loss was less likely than not related to active service. In the August 2021 remand, the Board ordered the RO to obtain an addendum medical opinion clarifying the nature and etiology of the Veteran's hearing loss. In the August 2021 addendum opinion, the VA examiner essentially repeated the previous opinion. The examiner opined that it was less likely than not that the Veteran's hearing loss was related to service. The rationale was that the Veteran's hearing loss was likely inorganic. According to the VA examiner, the Veteran presented with a profound hearing loss, but was able to converse with the examiner while the examiner was wearing a mask and was able to hear speech "far below his thresholds." The Board finds that the August 2021 addendum opinion is inadequate because it is essentially the same as the September 2020 opinion. In the August 2021 remand, the Board found that it was unclear what the examiner meant by stating that it was not possible to determine the Veteran's actual hearing loss and whether it was noise-induced. The VA examiner opined that the Veteran's hearing loss was "inorganic," but still diagnosed him with bilateral sensorineural hearing loss. Because of this, a new VA opinion is necessary to determine whether the Veteran had a diagnosis of hearing loss, and if so, whether it is related to active service, to include as due to noise exposure. The matters are REMANDED for the following actions: 1. Arrange for the Veteran's file to be forwarded to a VA examiner for a clarifying addendum opinion regarding whether the Veteran was diagnosed with sensorineural hearing loss, and if so, whether it was etiologically related to active service, to include as due to noise exposure. The examiner or consulting physician must review the entire record (including all updated records obtained pursuant to the above development order). If the examiner determines that the Veteran was malingering during the September 2020 VA audio examination, an explanation should be given explaining why this conclusion was reached and whether the Veteran actually had hearing loss for VA purposes. If the examiner determines that the Veteran was not malingering and was diagnosed with sensorineural hearing loss for VA purposes, then based on his or her review, the examiner or consulting physician should provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran's hearing loss was either directly related to active military service, to include as due to noise exposure, OR represented the initial manifestation of his disease. 2. A detailed explanation (rationale) is requested for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested). David Gratz Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Abrams, 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.