Citation Nr: 21025696 Decision Date: 04/28/21 Archive Date: 04/28/21 DOCKET NO. 14-21 060A DATE: April 28, 2021 REMANDED Entitlement to service connection for bilateral hearing loss disability is remanded. Entitlement to service connection for a disability characterized by vertigo and dizziness, to include Benign Paroxysmal Positional Vertigo (BPPV) is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1967 to July 1969. These matters come to the Board of Veterans’ Appeals (Board) from an August 2011 decision of the Agency of Original Jurisdiction (AOJ). The Board previously remanded the matter in July 2019 for VA treatment records and new VA examinations and opinions. The Board notes the Veteran had requested a Board hearing and later, in September 2018, withdrew his hearing request. His request is deemed withdrawn.   1. Entitlement to service connection for bilateral hearing loss disability is remanded. 2. Entitlement to service connection for a disability characterized by vertigo and dizziness, to include Benign Paroxysmal Positional Vertigo (BPPV) is remanded. The Veteran contends his hearing loss disability is related to his service in the Army as a radio operator. See June 12, 2014, VA Form 9. He also contends that his BPPV is related to his noise exposure or hearing loss disability. See March 2021 Informal Hearing Presentation. Although the Board regrets the delay, another remand is necessary to ensure substantial compliance with prior remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board’s July 2019 remand specifically asked for medical opinions by an otolaryngologist (ENT) for the Veteran’s bilateral hearing loss and vertigo claims. The Board also directed the AOJ to obtain all VA treatment records dated from July 2011. Here, the AOJ obtained a February 2020 VA medical opinion for the Veteran’s bilateral hearing loss disability claim that was rendered by an audiologist. Similarly, the AOJ obtained an October 2020 VA medical opinion for the Veteran’s BPPV claim, but it was rendered by a nurse practitioner. Because the AOJ did not arrange for examinations by the medical professional the Board asked for, another remand is required. Also, the record reflects the AOJ obtained some VAMC records, but it is not clear all VAMC records were obtained from July 2011, as there are no records from the Fort Myers VAMC from after 2011. A remand is warranted to confirm that all the available VAMC records from July 2011 have been obtained. The matters are REMANDED for the following action: 1. Confirm that records have been received from all VA treatment facilities at which the Veteran has been seen for the disabilities on appeal since July 2011, to include the Fort Myers VAMC. If further efforts to obtain the records would be futile, a memorandum describing the steps taken should be added to the claims file. 2. Schedule the Veteran for a VA examination to determine the nature and etiology of the Veteran’s right and left ear hearing loss. The examiner who conducts the examination should be an otolaryngologist (ENT). For both right and left ear hearing loss present since the Veteran filed his claim, the examiner should provide an opinion as to whether it at least as likely as not had its onset during service; manifested within one year of discharge from service; or, is otherwise related to service. The examiner should convert the 1967 puretone thresholds to the ISO-ANSI standard prior to providing an opinion. A complete rationale should be provided for any opinion. The opinion should address: (a) the Veteran’s reports in his June 2014 statement of exposure to loud noise from high-frequency radio equipment; (b) the Veteran’s statements to the July 2011 VA examiner regarding in-service noise exposure and hearing protection, noise exposure and hearing protection use after discharge, and his report that he first notice difficulty hearing speech and sounds in the late 1970s; (c) private audiometric tests from 1988, 1999, and 2001; (d) the Veteran’s contentions in his April 2019 and March 2021 Informal Hearing Presentations regarding the IOM report; and (e) the articles cited by the Veteran in his April 2019 and March 2021 Informal Hearing Presentations. 3. Schedule the Veteran for a VA examination to determine the nature and etiology of the Veteran’s current disorders characterized by dizziness and lightheadedness, such as Benign Paroxysmal Positional Vertigo (BPPV). The examiner who conducts the examination should be an otolaryngologist (ENT). The examiner should identify any disorder related to dizziness and lightheadedness, such as vertigo, that the Veteran experienced since filing his October 2010 claim. For each diagnosed disorder characterized by dizziness or vertigo present since the Veteran filed his claim, the examiner should provide an opinion as to: (a) whether it at least as likely as not had its onset during service; manifested within one year of discharge from service; or, is otherwise related to service; and, (b) whether it is at least as likely as not due to or, alternatively, aggravated by service-connected disability. (Continued on the next page)   A complete rationale should be provided for any opinion. The opinion should address the Veteran’s contentions in his April 2019 and March 2021 Informal Hearing Presentations regarding experiencing dizziness in service related to noise exposure and the relationship of any disability characterized by dizziness to his hearing loss. Marissa Caylor Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Dean, Michael S. 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.