Citation Nr: 21021389 Decision Date: 04/12/21 Archive Date: 04/12/21 DOCKET NO. 15-32 324 DATE: April 12, 2021 REMANDED Entitlement to a compensable disability rating for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty for training (ACDUTRA) from May to October 1993. The Veteran had subsequent service in the Air National Guard until December 1998. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a December 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In connection with this appeal, the Veteran testified before the undersigned Veterans Law Judge in October 2018. A transcript of that hearing has been associated with the claims file and reviewed. In May 2019 the Board remanded the matter for a new VA examination to determine the level of severity of the Veteran’s bilateral hearing loss disability. The Board apologize for the further delay but finds another remand is necessary in order to properly adjudicate the Veteran’s claim. The duty to assist includes providing a medical examination or obtaining a medical opinion when necessary to decide a claim. See 38 C.F.R. § 3.159(c)(4). In November 2013 the Veteran underwent a VA audiological examination for his hearing loss. Speech audiometry revealed speech recognition scores of 86 percent in the right ear and of 80 percent in the left ear. In December 2016 the Veteran underwent another VA audiological examination for his hearing loss. Speech audiometry revealed speech recognition scores of 70 percent in the right ear. In measuring the speech recognition ability in the left ear, the examiner found that it could not be determined because of language difficulties, cognitive problems, inconsistent word recognition scores, etc., that make combined use of puretone average and word recognition scores inappropriate. A VA examination of the Veteran’s hearing loss was last conducted in November 2019. Speech audiometry revealed speech recognition scores of 84 percent in the right ear and of 80 percent in the left ear. Since the November 2019 examination, VA treatment records reflect that the Veteran was seen in October 2020 at the Birmingham VAMC audiology clinic where he complained of difficulty hearing and understanding conversational speech. He also reported that he cannot understand conversations in the presence of any background noise. Importantly, the VA audiologist reported that his word recognition scores were significantly lower than reported at his last examination. While it is not entirely clear from the CAPRI record currently associated with the Veteran’s claims file, speech recognition scores were shown to be between 68 and 76 percent in the right ear and 48 to 68 percent in the left ear. Such scores represent a significant worsening of the Veteran’s speech recognition ability since his last VA examination. Moreover, the VA audiologist reported that audiometric results show “steeply sloping” SNHL in both ears. However, no audiometric results from the examination are included in the claims file at this time. See October 2020 Birmingham VAMC Audiology Note. As there is evidence of a considerable worsening of the Veteran’s speech recognition scores since the last VA examination, the claim must be remanded for a new examination to determine the current severity of the disability. 38 C.F.R. § 3.159; see also Palczewski v. Nicholson, 21 Vet. App. 174, 181 (2007); Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). The matters are REMANDED for the following action: 1. The AOJ should obtain any of the Veteran’s outstanding VA and private medical records and associate them with the claims file. The AOJ should obtain the October 2020 audiometric examination and associate it with the claims file, if possible. All actions to obtain the requested records should be fully documented in the record. If they cannot be located or no such records exist, the Veteran and his representative should be so notified in writing. If possible, the Veteran himself should submit any pertinent new evidence regarding the condition at issue in order to expedite the claim. (Continued on the next page)   2. Schedule the Veteran for an examination by an appropriate clinician to determine the severity of the Veteran’s bilateral hearing loss. 3. After undertaking any other appropriate development deemed necessary, readjudicate the issue on appeal based on the additional evidence of record. If the determination remains adverse to the Veteran, he must be provided with a supplemental statement of the case. An appropriate period of time must then be allowed for a response before the record is returned to the Board for further review. John J. Crowley Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Christopher M. Davidson 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.