Citation Nr: 21006041 Decision Date: 02/03/21 Archive Date: 02/03/21 DOCKET NO. 19-37 612 DATE: February 3, 2021 REMANDED Entitlement to service connection for neurosyphilis, to include as due to service-connected bilateral hearing loss, is remanded. REASONS FOR REMAND The Veteran had active military service from October 1950 to August 1954 and January 1965 to July 1965. This matter is on appeal from an August 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran, in his December 2019 Form 9, Appeal to the Board, requested a videoconference Board hearing. Before the January 2021 scheduled Board hearing, the Veteran canceled. Thus, the Board considers the request for a hearing withdrawn. 38 C.F.R. § 20.704 (d). Entitlement to service connection for neurosyphilis, to include as due to service-connected bilateral hearing loss, is remanded. The Veteran contends that his neurosyphilis is due to service. In the alternative, he has espoused the theory that it may be due to his service-connected bilateral hearing loss. The Veteran’s service treatment records (STRs), dated in April 1965, show that the Veteran was hospitalized for 30 days and subsequently diagnosed with a hysterical personality. Additionally, at the separation physical in July 1965, the clinician noted the Veteran’s bilateral defective auditory acuity. In support of the claim, the Veteran’s wife provided numerous publications linking the early symptoms of irritability, forgetfulness, personality changes, and hearing problems to neurosyphilis. The Veteran’s wife also argues that although she is not a medical doctor, she has worked many years in the medical field and has assisted doctors with their publications. As such, she has developed medical expertise to opine on a link to service. VA has a duty to assist a claimant in obtaining evidence necessary to substantiate a claim. 38 C.F.R. § 3.159. This duty includes obtaining a medical examination or opinion, if one is necessary, to decide on the claim. 38 C.F.R. § 3.159 (c)(4). Considering the Veteran’s arguments, including the secondary service connection claim and the numerous publications provided by the Veteran and his wife, the Board has determined that the “low threshold” necessary to establish entitlement to a VA medical examination in connection with the Veteran’s claim of service connection for neurosyphilis has been satisfied. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir 2007). Thus, a remand warranted. Accordingly, the issue is REMANDED for the following action: 1. Provide the Veteran’s claims file to a qualified clinician so that an examination may be provided to determine the nature and etiology of his neurosyphilis. A physical or telehealth examination of the Veteran is only required if deemed necessary by the clinician. The entire claims file and a copy of this remand must be made available to the clinician to review. Although an independent review of the claims file is required, the Board calls the clinician’s attention to the following: a. STRs dated in April 1965 noting a diagnosis of hysterical personality. b. July 1965 separation physical noting bilateral defective auditory acuity. c. Articles/journals of record provided by the Veteran. d. May 2019 correspondence and arguments therein. e. December 2019, Form 9, and arguments therein. The clinician asked to opine on the following: a. Whether it is at least as likely as not (probability of 50 percent or greater) that the Veteran’s neurosyphilis had its onset in and/or is otherwise etiologically related to his period of active service. b. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s neurosyphilis is proximately due to or the result of service-connected bilateral hearing loss disability. c. Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s neurosyphilis is aggravated beyond its natural progression by service-connected bilateral hearing loss disability. The clinician must provide a complete rationale for his or her opinion(s) in the examination report. If any of the above-requested opinions cannot be made without resort to speculation, the clinician must state this and provide a rationale for such a conclusion. 2. Then, readjudicate the claims. If any decision is unfavorable to the Veteran, issue a supplemental statement of the case and allow the applicable time for response. Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Stevens, 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.