Citation Nr: 21076778 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 14-38 400 DATE: December 27, 2021 REMANDED Entitlement to an initial compensable rating for a bilateral hearing loss disability prior to December 10, 2020 and in excess of 80 percent thereafter is remanded. Entitlement to service connection for a hematologic disorder, to include leukopenia, neutropenia, and anemia, is remanded. REASONS FOR REMAND The Veteran, who is the appellant in this case, served on active duty from April 1966 to March 1968, including service in the Republic of Vietnam. These matters come before the Board of Veterans' Appeals (Board) on appeal from a September 2012 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In his October 2014 VA Form 9, the Veteran requested a hearing before the Board. However, the Veteran withdrew his request for a Board hearing in a May 2021 VA 21-0820 Report of General Information. This matter was previously remanded by the Board in July 2021. After reviewing the contentions and evidence of record, the Board has recharacterized and expanded the Veteran's claim as one for a hematologic disorder, to include leukopenia, neutropenia, and anemia. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009); Brokowski v. Shinseki, 23 Vet. App. 79 (2009). This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.902(c) and 38 U.S.C. § 7107(b). 1. Entitlement to an initial compensable rating for a bilateral hearing loss disability prior to December 10, 2020 and in excess of 80 percent thereafter is remanded. The Veteran asserts he is entitled to an initial compensable rating for his bilateral hearing loss disability prior to December 10, 2020 and a disability rating in excess of 80 percent thereafter. The Board finds that additional development is necessary prior to appellate review of this claim. VA audiology notes dated June 2017 and May 2021 reflect that the Veteran underwent audiological testing. The examining audiologists provided summaries of the results; however, the full audiogram results are not in the electronic claims file available to the Board. Additionally, it is not clear whether the Maryland CNC word list was used to determine speech discrimination scores, as required by 38 C.F.R. § 4.85(a). To afford the Veteran every possible consideration, on remand, the RO should attempt to obtain the June 2017 and May 2021 audiogram results and request clarification as to whether the Maryland CNC word list was used to determine speech discrimination scores. The RO should document all attempts to obtain this evidence, and, if the audiograms are unavailable, a formal finding of unavailability should be made. 2. Entitlement to service connection for a hematologic disorder, to include leukopenia, neutropenia, and anemia, is remanded. The Veteran asserts that he is entitled to service connection for a hematologic disorder, to include as due to exposure to herbicide agents during his service in the Republic of Vietnam. The Veteran has current hematologic diagnoses of leukopenia, neutropenia, and anemia. See private treatment records dated May 2008 to March 2019; VA treatment records dated November 2017 and June 2018. Additionally, the Veteran had active service in the Republic of Vietnam during the Vietnam era. As such, he was presumptively exposed to herbicide agents. To date, the VA has not obtained a competent medical examination and opinion addressing this claim. Given the Veteran's current hematologic diagnoses and his presumptive exposure to herbicide agents during service, a VA examination should be afforded to him. McClendon v. Nicholson, 20 Vet. App. 79 (2006). Accordingly, the matters are REMANDED for the following actions: 1. Obtain the results of the VA audiograms conducted on June 12, 2017 and May 17, 2021 and associate them with the electronic claims file for the Board's review. Additionally, request clarification from the audiologists who examined the Veteran on June 12, 2017 and May 17, 2021 as to whether the Maryland CNC word list was used to determine speech discrimination scores. All attempts to obtain this evidence should be documented. If the audiograms are unavailable, a formal finding of unavailability should be sent to the Veteran and his representative and a copy should be associated with the record. ** ATTENTION: The Board is NOT requesting the June 12, 2017 or May 17, 2021 audiology notes, which have already been associated with the claims file. Rather, the Board is requesting the full results of the audiograms that were conducted on those dates. 2. Provide the Veteran a VA examination, if possible, to determine the nature and likely etiology of his claimed hematologic disorder, to include leukopenia, neutropenia, and anemia. The claims file, including a copy of this Remand, must be made available to, and be reviewed by, the examiner. ** IF an in-person examination is not possible given the circumstances surrounding the recent pandemic, refer the case to an appropriate examiner for a thorough review of the record, possible telephone/virtual interview with the Veteran, and medical opinion. After a thorough review of the claims file and examination of the Veteran (if possible), the examiner is asked to: (a) Identify all current hematologic disorders. (b) For each currently diagnosed hematologic disorder, provide an opinion as to whether it at least as likely as not (50 percent probability or greater) had its onset during or is otherwise related to the Veteran's active service, to include his presumptive exposure to herbicide agents during service in the Republic of Vietnam. A complete rationale must be provided for all opinions rendered. (Continued on the next page) 3. Then, after ensuring that the above-requested development has been substantially complied with, readjudicate the remanded claims. L. Chu Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. M. Gill, 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.