Citation Nr: 21026748 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 15-23 668 DATE: May 3, 2021 REMANDED Entitlement to an increased rating for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served honorably in the United States Army from February 1970 to January 1972. This matter returns to the Board of Veterans' Appeals (Board) after its February 2019 remand (Board Remand) for the Veteran to be provided a new VA audiological examination to determine the severity of his service-connected bilateral hearing loss. The matter was remanded to the Department of Veterans Affairs (VA) Regional Office (RO) which is the agency of original jurisdiction (AOJ). After the Board Remand the Veteran was provided the requested VA audiological examination in October 2019 which, after review, the Board finds to be an adequate examination. Thus, the Board finds that the Board Remand instructions were substantially complied with. The Veteran, through his appointed representative, concurs. See Written Brief Presentation, The American Legion, March 10, 2021, page 1 ("The remand instructions have been followed."). However, the Veteran also submitted an audiological examination performed on June 26, 2019, by a private medical provider, D.E.A.-P.H.C., obtained through the office of Dr. G.G. The Board finds this examination to be inadequate and not suitable for rating purposes at this time and remands the matter to request clarification to determine if the examination is adequate, related to the Veteran's claim. The Board regrets the further delay in this matter. 1. Entitlement to an increased rating for bilateral hearing loss is remanded. The Veteran seeks increased ratings, including his initial disability ratings, for his service-connected bilateral hearing loss. The Board finds the June 2019 private audiological examination to be inadequate, as a matter of law, as the examination report itself does not identify the medical provider who actually performed the examination or whether that examiner was appropriately licensed. Further, the examination report did not indicate whether the speech discrimination test performed was the required Maryland CNC test, or if not, whether there was a reason why the required Maryland CNC test was not performed. The requirements for a properly conducted, and thus adequate, audiological examination are set forth in VA regulations. Specifically, 38 C.F.R. § 4.85(a) requires that An examination for hearing impairment for VA purposes must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test (Maryland CNC) and a puretone audiometry test. Examinations will be conducted without the use of hearing aids. However, an audiological examination can be considered adequate without the use of the Maryland CNC speech discrimination test if the examiner certifies that use of the speech discrimination test is not appropriate because of factors such as language difficulties, inconsistent speech discrimination scores, etc. 38 C.F.R. § 4.85(c). When a private examination report "reasonably appears" to contain information necessary to properly decide a claim but is "unclear" or "not suitable for rating purposes," and the information reasonably contained in the report otherwise cannot be obtained, VA has a duty to either (1) ask the private examiner to clarify the report, (2) request that the claimant obtain the necessary information to clarify the report, or (3) explain why such clarification is not needed. See Savage v. Shinseki, 24 Vet. App. 259 (2011); See also 38 U.S.C. § 5103A. Here, after initial review of the June 2019 private audiological examination, the Board finds that if it were to be determined to be adequate and suitable for VA rating purposes, it likely would impact favorably on the benefits due to the Veteran. Thus, remand is required to obtain the missing information and to clarify whether the required Maryland CNC speech discrimination test was used, or if there is a valid reason why it was not. The matters are REMANDED for the following action: 1. Take appropriate action to request the private examiner who issued the September June 2019 audiological examination clarify the following: (a.) Identify the medical provider who performed the audiological examination; (b.) if the audiological examination was performed by a state-licensed audiologist and if so, please provide the license information; (c.) whether the Maryland CNC speech discrimination test was used when conducting the hearing test; and (d.) if the Maryland CNC speech discrimination test was not performed, please provide the reasons why not. If the private medical provider fails to respond to the request, the AOJ should notify the Veteran and provide him the opportunity to obtain the information directly from the medical provider to submit to VA. All action taken should recorded and attached to the Veteran's file. 2. Readjudicate the appeal. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Bannach, 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.