Citation Nr: 21026107 Decision Date: 04/29/21 Archive Date: 04/29/21 DOCKET NO. 14-03 023 DATE: April 29, 2021 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to an evaluation greater than 20 percent for service-connected lumbosacral disc bulge L5-S1 (low back disability) is remanded. Entitlement to an evaluation greater than 30 percent for service-connected migraine headaches is remanded. Entitlement to an evaluation greater than 10 percent for service-connected hypothyroidism status post thyroidectomy is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from June 1985 to May 2006. For her meritorious service, the Veteran was awarded (among other decorations) the Air Force Commendation and Achievement Medals. This matter is before the Board of Veterans’ Appeal (Board) on appeal from rating decision issued in October 2012, November 2013, and March 2014 by the Department of Veteran Affairs (VA) Regional Office (RO). The Board previously remanded the appeal in February 2018, and the matter has been returned for appellate consideration. During this period, the RO granted service connection for a right knee disability, for dizziness, and for sinusitis, each of which had been included in the Board’s previous remand. These issues are therefore no longer before the Board. The October 2020 rating decision increased the disability rating for the Veteran’s low back disability from 10 percent to 20 percent, effective April 30, 2013. However, as this grant does not represent a total grant of benefits sought on appeal, the claims for increase remain before the Board. AB v. Brown, 6 Vet. App. 35 (1993). 1. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran is seeking service connection for bilateral hearing loss. The Veteran contends that she was exposed to hazardous noise during her service in the Air Force. To that end, the Veteran was afforded a September 2012 VA examination to determine the nature and etiology of her claimed hearing loss. The VA examiner found that the Veteran did not then suffer from hearing loss for VA purposes. The VA examiner also held that that hearing loss was unrelated to the Veteran’s active duty service. The Veteran and her representative, however, challenge the adequacy of the hearing loss results. As they contend that the Veteran’s hearing loss is greater than measured during the VA examination, the Board will remand the issue for an updated VA examination. 2. Entitlement to an evaluation greater than 20 percent for service-connected lumbosacral disc bulge L5-S1 (low back disability) is remanded. 3. Entitlement to an evaluation greater than 30 percent for service-connected migraine headaches is remanded. 4. Entitlement to an evaluation greater than 10 percent for service-connected hypothyroidism status post thyroidectomy is remanded. The Veteran contends her service-connected low back disability, migraine headaches, and hypothyroidism are more disabling than their current evaluations. The Veteran was last afforded VA examinations to determine the severity of her hypothyroidism, low back disability, and migraine headaches in November 2019, December 2018, and March 2014, respectively. The Veteran and her representative have requested new VA examinations to determine the current severity of the Veteran’s disabilities. See March 2021 IHP. Under the circumstances, the Veteran should be afforded new VA examinations to determine the current severity of her service-connected low back disability, migraine headaches, and hypothyroidism. Though the Veteran’s hypothyroidism was the subject of a fairly recent examination, the Veteran contends that she experiences a wide-ranging symptomology due to her hypothyroidism. The Veteran contends that she experiences fatigue, sleep impairment, rapid or irregular heartbeat, muscle weakness, constipation, diarrhea, weight gain, and depression due to her condition. Upon remand, we ask for the VA examiner to determine if any symptomology or residuals of the hypothyroidism are present. The matters are REMANDED for the following action: 1. Schedule the Veteran for an appropriate VA examination to determine the nature and possible relationship to service of her claimed bilateral hearing loss. The evidence of record, to include a copy of this Remand, must be made available to the examiner and the examiner must indicate that the pertinent medical records and lay statements have been reviewed. Following a review of the record, the examiner must determine whether the Veteran currently suffers from bilateral hearing loss for VA purposes, and, if so, whether that hearing loss is related to her active service. The VA examiner must consider the Veteran’s contentions that she was exposed to hazardous noise during her active duty service. 2. Schedule the Veteran for VA examinations to determine the current nature and severity of her service-connected migraine condition. The examination should include all studies, tests, and evaluations deemed necessary by the examiner. The examiner should report all manifestations related to the service-connected disability. 3. Schedule the Veteran for a VA examination to determine the current nature and severity of her service-connected low back disability. For her low back disability, the examiner should provide information regarding the current severity of that disability consistent with the requirements of the corresponding Diagnostic Code. 4. Schedule the Veteran for a VA thyroid examination to determine the current symptoms, level of severity, and functional impairment associated with her hypothyroidism. The claims file should be reviewed by the examiner. The examiner should specifically comment on the thyroid disability based and the current rating criteria under Diagnostic Code 7903. The examiner is asked to address whether Veteran has any residual condition due to her hypothyroidism. Specifically, the examiner is asked to comment on whether the Veteran’s hypothyroidism has resulted in her contended symptoms, to include: (a) Whether the Veteran has fatigability, constipation and mental sluggishness; (b) Whether the Veteran has muscular weakness, mental disturbance, and weight gain; (c) Whether the Veteran has cold intolerance, muscular weakness, cardiovascular involvement, mental disturbance (dementia, slowing of thought, depression), bradycardia (less than 60 beats per minute), and sleepiness; (d) Whether the hypothyroidism manifests as myxedema (cold intolerance, muscular weakness, cardiovascular involvement (including, but not limited to hypotension, bradycardia, and pericardial effusion) and mental disturbance (including, but not limited to dementia, slowing of thought and depression)); (e) And all other residual effects of hypothyroidism (e.g., eye, digestive, mental disorders). Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Higgins, 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.