Citation Nr: 21024530 Decision Date: 04/23/21 Archive Date: 04/23/21 DOCKET NO. 09-17 449 DATE: April 23, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1978 to April 1979. The Board acknowledges that this appeal has a rather complex procedural history. In April 2018, the Board denied entitlement to service connection for bilateral hearing loss, sleep apnea, hypertension, erectile dysfunction, and residuals of a traumatic brain injury (TBI). The Board also found that new and material evidence had been presented to reopen a claim for disability compensation for presbyopia with photophobia and remanded that matter. Additionally, the Board remanded the matters of entitlement to a temporary 100 percent disability rating for hospitalization due to a chronic acquired psychiatric disorder, special monthly compensation, and a total disability rating based on individual unemployability (TDIU). The Veteran and his representative appealed that decision, and in October 2019, the Court of Appeals for Veterans Claims (Court) entered a Memorandum Decision, which vacated and remanded the Board’s previous denial of entitlement to service connection for bilateral hearing loss and affirmed the denials of entitlement to service connection for sleep apnea, hypertension, erectile dysfunction, and residuals of TBI. The Court also noted that the remanded matters were not to be disturbed. In October 2020, the Board remanded the claim for entitlement to service connection for bilateral hearing loss for evidentiary development. It has since been returned to the Board for further consideration. The Board notes that the previously remanded matters described above are still undergoing development. Particularly, it appears that the Veteran and his representative have requested an additional Board hearing. That hearing request remains pending and the issues are therefore not before the Board at this time. Entitlement to service connection for bilateral hearing loss is remanded. Review of the record reveals that remand is required in order to arrange for another VA examination and medical opinion. In this regard, the Court noted that the Board did not discuss a 2010 diagnosis of bilateral hearing loss, substantiated with audiometric testing by Dr. J.B.S. Further testing conducted in 2014 concluded that the Veteran suffered from severe to moderately severe hearing loss, bilaterally. The Court emphasized that the Board based its previous denial on the fact that the Veteran does not have a bilateral hearing loss disability for VA purposes. Pursuant to the Board’s October 2020 remand, another VA audiological examination was scheduled in February 2021. Unfortunately, Puretone threshold testing could not be fully assessed and was instead reported as invalid for rating purposes. The examiner remarked that “Veteran could not continue test. He stated that earphones were making him dizzy and created too much pressure on his head.” Ultimately, the examiner determined that the any bilateral hearing loss disability is less likely than not attributable to service. The examiner reasoned “Separation exam showed normal hearing in both ears. I was unable to complete hearing testing on this veteran because he was unable to perform behavioral tests.” Considering the above, the Board finds that it is still unclear whether the Veteran suffers from a bilateral hearing loss disability for VA purposes. Additionally, the examiner provided a limited rationale and only stated that the Veteran’s separation examination showed normal hearing, bilaterally. In order to satisfy its duty to assist, the Board finds that the Veteran should be afforded another VA audiological examination and corresponding medical opinion to determine if he suffers from hearing loss for VA purposes. The Board emphasizes that complete audiometric testing is necessary in order to determine if a hearing loss disability is present and failure to complete the examination may result in denial of the Veteran’s claim. The matters are REMANDED for the following action: 1. Schedule the Veteran for another VA examination with an audiologist to determine the nature and etiology of his claimed bilateral hearing loss. The audiologist is to be provided access to the Veteran’s electronic claims file. The audiologist is requested to review all pertinent records associated with the claims file, the Veteran’s service treatment records, post-service medical records, and the Veteran’s own assertions. Any indicated diagnostic tests and studies should also be accomplished. It should be noted that the Veteran is competent to attest to factual matters of which he had first-hand knowledge, including observable symptomatology and in-service noise exposure. If there is a medical basis to support or doubt the history provided by the Veteran, the audiologist should provide a fully reasoned explanation. The VA audiologist must opine whether it is at least as likely as not (50 percent or higher degree of probability), that the Veteran’s bilateral hearing loss, if found, manifested in-service or is otherwise causally or etiologically related to his military service, to include potential in-service noise exposure. The significance, if any between recorded findings on entrance and separation should be discussed, even though the hearing was essentially normal at separation. It should be indicated whether the recorded change suggests the early onset of hearing loss. It should also be indicated whether the hearing loss is the type typically seen in cases of acoustic trauma, or is more likely due to advancing age, infection, or other cause. All prior reports (including the treatment reports from 2010 and 2014) should be reconciled, as necessary. The Veteran is hereby notified that complete audiometric testing is necessary in order to determine if a hearing loss disability is present and failure to complete the examination may result in denial of his claim. 2. After the development requested has been completed, the Agency of Original Jurisdiction (AOJ) should review any report to ensure that it is in complete compliance with the directives of this remand. If the report is deficient in any manner, the AOJ must implement corrective procedures at once. MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Miller, 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.