Citation Nr: 21013405 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 17-06 871 DATE: March 9, 2021 REMANDED Entitlement to a compensable initial rating for bilateral ear hearing loss is remanded. Entitlement to service connection for a bilateral ear disability characterized by dizziness and loss of balance, including residuals of left ear otitis media, bilateral posterior canal benign paroxysmal positional vertigo and displaced ear crystals, to include as secondary to service-connected bilateral ear hearing loss and tinnitus, is remanded. REASONS FOR REMANDS The Veteran served on active duty from October 1972 to July 1974. These matters come before the Board of Veterans’ Appeals (Board) on appeal of an August 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing in January 2021 before the undersigned Veterans Law Judge. A transcript of that hearing has been associated with the record. Based on a review of the medical and lay evidence of record, entitlement to service connection for the otitis media appeal has been expanded as noted above. Clemons v. Shinseki, 23 Vet. App. 1, 12 (2009). 1. Entitlement to a compensable initial rating for bilateral ear hearing loss is remanded. Although the Veteran had a VA examination for hearing loss and tinnitus in July 2019, at the January 2021 Board hearing, the Veteran testified that the severity of his bilateral hearing loss disability has increased since the last VA examination, and that it is “a lot worse.” The Veteran should be provided an opportunity to report for an examination to ascertain the current severity and manifestations of his service-connected bilateral ear hearing loss disability. Weggenmann v. Brown, 5 Vet. App. 281(1993) (VA has a duty to provide an examination when there is evidence that the disability has worsened since the previous examination). 2. Entitlement to service connection for a bilateral ear disability characterized by dizziness and loss of balance, including residuals of otitis media, benign paroxysmal positional vertigo and displaced ear crystals, to include as secondary to service-connected bilateral ear hearing loss and tinnitus, is remanded. At the January 2021 Board hearing, the Veteran testified that he believes that he has otitis media that is due to his service-connected bilateral ear hearing loss and tinnitus. The Veteran testified that he has balance problems due to hearing a very high-pitched noise and that his otitis media is due to his service-connected bilateral ear hearing loss and tinnitus. The record during the appeal period shows an impression of residuals of left ear otitis media in July 1974, a diagnosis of bilateral ear benign paroxysmal positional vertigo in June 2019, and a June 2019 report from a licensed clinical social worker that the Veteran has poor balance due to “crystals that have been displaced.” Although the Veteran was provided with a VA examination for ear conditions, including vestibular and infections conditions, and the examiner noted the Veteran’s diagnosis of bilateral ear benign paroxysmal positional vertigo and that the Veteran had vertigo more than once weekly and an unsteady gait, the examiner did not opine as to whether the Veteran has a bilateral ear disability that is related to his service or is caused or aggravated by his service-connected bilateral ear hearing loss disability and/or tinnitus. As the examination does not contains etiological opinions, it is incomplete. When VA undertakes to provide an exam, it must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Thus, a remand is necessary to obtain the necessary medical opinions. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Schedule the Veteran for an examination to determine the current severity of his service-connected bilateral ear hearing loss disabilities. The examiner should provide a full description of the disabilities and report all signs and symptoms necessary for evaluating the Veteran’s disabilities under the rating criteria. 3. Obtain an opinion from a qualified examiner to determine whether the Veteran has any current left and/or right ear disabilities characterized by dizziness and loss of balance, including residuals of otitis media, benign paroxysmal positional vertigo and displaced ear crystals, that is at least as likely as not related to service. The Veteran need not be reexamined unless the examiner deems it necessary. If a diagnosis cannot be provided, but the Veteran’s left or right ear condition manifests in symptoms that cause functional impairment, then the examiner should consider them a “disability” for the purpose of providing the requested opinion(s) below. The examiner is asked to provide responses to the following: Is any left and/or right ear disability at least as likely as not related to service? Is any left and/or right ear disability at least as likely as not proximately due to left and right ear hearing loss disability and/or tinnitus disabilities? Is any left and/or right ear disability at least as likely as not aggravated, i.e., worsened beyond its natural progression, by his service-connected bilateral ear hearing loss and/or tinnitus disabilities? If any left and/or right ear disability is a chronic disease, including an organic disease of the nervous system under §§ 3.303(b) and 3.309(a), is it at least as likely as not that the disability began during active service, (2) manifested within the applicable time limit under 3.307 after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service? Jennifer White Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Susan Leary, 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.