Citation Nr: 21023123 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 16-01 713 DATE: April 20, 2021 REMANDED Entitlement to service connection for left-ear hearing loss is remanded. Entitlement to service connection for a condition claimed as left ear otitis media, to include left ear TM perforation and monomeric TM, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1975 to October 1975. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In October 2020, the Board remanded the claims for VA etiology opinions. Unfortunately, though the directed VA opinions were provided, the Board finds that the opinions are inadequate and that further remand is therefore required. Regarding service connection for left-ear hearing loss, the Veteran’s service treatment records show that after his first month in service a Medical Board report found “deafness, bilateral” and subsequently discharged him “by reason of enlisted in error, failure to meet enlistment physical standards.” As discussed in the Board’s October 2020 decision, the presumption of soundness has not been rebutted, and therefore the Veteran is considered of sound health as to left-ear hearing loss at the time of induction to service. The October 2020 Board decision directed for a new VA opinion to consider these facts, and though a new VA examination and etiology opinion was provided in November 2020, the examiner stated, “At th[e] time [of separation] there was no indication of any concerns for hearing loss [] in the left ear. There is no report of complaint/treatment for hearing decrease in the left ear STRs or at separation.” This statement failed to acknowledge and discuss the finding of “deafness, bilateral” by the Medical Board leading to the Veteran’s discharge from service. Thus, a new opinion is required. See, e.g., Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008). Regarding service connection for a left-ear condition claimed as otitis media, the Board’s October 2020 decision, noting evidence of currently diagnosed “TM perforation and monomeric TM” in the left ear, directed for a VA etiology opinion that considered this condition. Though a new VA opinion was provided in October 2020, it only discussed otitis media and did not consider “TM perforation and monomeric TM.” A remand by the Board confers on the Veteran, as a matter of law, the right to compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). Therefore, remand is required for an etiology opinion addressing the current “TM perforation and monomeric TM” condition. Id. The matters are REMANDED for the following action: 1. Obtain an addendum opinion regarding the etiology of the Veteran’s left-ear hearing loss. The clinician is asked to opine whether the Veteran’s current left-ear hearing loss at least as likely as not was incurred in service or is otherwise related to service. In rendering his or her opinion, the clinician must consider and discuss the in-service diagnosis of “deafness, bilateral” that led to the Veteran’s discharge from service, as well as the Veteran’s report of in-service noise exposure from grenade explosions and loud yelling. 2. Obtain an addendum opinion regarding the etiology of left-ear “TM perforation and monomeric TM.” The clinician must answer all of the following: (a)(i) Did left-ear “TM perforation and monomeric TM” clearly and unmistakably (undebatable) exist prior to the Veteran’s service? (a)(ii) If left-ear “TM perforation and monomeric TM” did preexist service, then was the condition clearly and unmistakably NOT aggravated (permanently worsened beyond the natural course of the disease) during service? (b) If left-ear “TM perforation and monomeric TM” did not clearly and unmistakably preexist service, then is it at least as likely as not that the condition was incurred in service or is otherwise related to service? 3. After the above development and any other development deemed necessary is completed, readjudicate the Veteran’s claims. K. Parakkal Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Davis, 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.