Citation Nr: 21011711 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 13-07 665 DATE: March 2, 2021 REMANDED Service connection for a right knee disorder is remanded. Service connection for a left knee disorder is remanded. Service connection for bilateral sensorineural hearing loss is remanded. REASONS FOR REMAND The Veteran, who is the appellant, had active duty service from December 1977 to April 1981. The instant case is on appeal from a Department of Veterans Affairs (VA) Regional Office (RO) rating decision that, in pertinent part, denied service connection for a right knee disorder, a left knee disorder, and bilateral sensorineural hearing loss. The case has been before the Board of Veterans’ Appeals (Board) previously. In a November 2017 Board remand, the Board found that new and material evidence was submitted within one year of a May 2010 rating decision, which meant that the May 2010 rating decision concerning service connection for the right knee disorder, left knee disorder, and bilateral sensorineural hearing loss did not become final and was the rating decision on appeal. The Board remanded the three claims for additional examinations and opinions. For the reasons described below, the Board finds that an additional remand is necessary. Preliminarily, the Board notes that the Veteran is unrepresented at this time. In a January 2021 letter, the Board explained to the Veteran that he had previously revoked his stated representative and that, accordingly, there was no valid power of attorney on file. The January 2021 letter stated that the Board would proceed with the Veteran as unrepresented unless he replied to the letter within 30 days. Hearing no response, the Board is now treating the Veteran as unrepresented in his claims. 1. Service Connection for a Right Knee Disorder 2. Service Connection for a Left Knee Disorder The November 2017 remand concluded that a VA examination for the right and left knee was necessary because the prior April 2010 VA examination did not offer a nexus opinion as to both knees (the examiner only gave an opinion as to the left knee) and because the examiner did not provide a rationale for the opinion. It appears that on remand a VA examination was ordered; however, it is unclear exactly what happened after it was ordered. The Supplemental Statement of the Case (SSOC) stated that there was a January 16, 2018 notice of refusal to attend a VA examination. This document does not appear to be in the claims file. Given that the Veteran has a history of homelessness—it is unclear as to whether he is presently homeless—and given that the Veteran is unrepresented, the Board is remanding the case for one more attempt at a VA examination and nexus opinions. If the Veteran refuses to attend the VA examination, please documentation this in the claims file. 3. Service Connection for Bilateral Sensorineural Hearing Loss The November 2017 remand also ordered that the RO coordinate a VA examination related to bilateral sensorineural hearing loss. The Veteran has a present diagnosis of bilateral sensorineural hearing loss and alleged that he had hearing problems during service. For the same reason as the examinations related to the knees, the Board is remanding the case for one more attempt at a VA hearing loss examination and nexus opinion. The Veteran is cautioned that failure to participate in a VA examination scheduled together with an original claim for disability benefits will result in the claim being decided based on the existing record, which could mean denial of the claim. The matters are REMANDED for the following action: 1. Request a VA knees examination with medical opinion. The VA examiner should conduct any necessary testing. After examination, the VA examiner should provide the following opinions: (a.) Does the Veteran have a diagnosable right or left knee disability? If not, does any left or right knee arthralgia cause a functional impairment? (b.) Is there a nexus between any current right knee or left knee disability or arthralgia and the December 1979 right knee pain and trauma that the Veteran sustained during service? 2. Request an audiology examination. After examination, the VA examiner should provide the following opinion: (a.) Is there a nexus between any bilateral sensorineural hearing loss and any in-service injury, disease, or event, to include acoustic trauma? (Continued on the next page)   The VA examiner should note that the Veteran sustained military noise exposure through, at a minimum, his Military Occupational Specialty as a rifleman and that he won the rifle sharpshooter badge. 3. Readjudicate the claims. J. PARKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Smith, 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.