Citation Nr: 21039736 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 16-56 942 DATE: July 1, 2021 REMANDED Entitlement to service connection for left ear hearing loss is remanded. REASONS FOR REMAND The Veteran served with the United States Army from January 1991 to May 1991. These matters were previously before Board of Veterans' Appeals (Board) in July 2019, at which time the issue of service connection for left ear hearing loss and PTSD were remanded for further development. Subsequently, in a July 2020 rating decision, the RO granted service connection for PTSD; thus, that issue is no longer for appellate consideration. For the Veteran's claim for left ear hearing loss, the Veteran's appeal has been returned to the Board for further appellate consideration. The Board's July 2019 remand directives and the subsequent actions of the AOJ will be discussed below. Entitlement to service connection for left ear hearing loss is remanded. Although the Board regrets the delay, once again remand is necessary to ensure that there is a complete record on which to decide the Veteran's claim for entitlement to service connection for left ear hearing loss. In particular, remand is required to obtain a medical opinion that complies with the Board's prior remand instructions. See Stegall v. West, 11 Vet. App. 268, 270-71 (1998) (requiring substantial compliance with remand directives). Specifically, in the July 2019 Board remand, the examiner was directed to opine whether it was at least as likely as not that any left ear hearing loss diagnosed during the appeal period was related to in-service noise exposure. See July 2019 Board Decision. Following the July 2019 remand, the Veteran was afforded a VA examination in December 2019. The examiner diagnosed the Veteran with sensorineural hearing loss. The examiner concluded that the Veteran's left ear hearing loss was less likely than not incurred in or caused by the claimed in-service event, including in-service noise exposure. She reasoned that there was no evidence of a permanent threshold shift in the left ear during active duty service. She noted that the Veteran's records of hearing loss leading up to the Veteran's 2013 stapedectomy surgery are compatible with a diagnosis of otosclerosis which is the typically gradual loss of hearing due to the overgrowth of bone in the middle ear space instead of a noise induced condition. Further, the Veteran's evidence of conductive hearing loss due to otosclerosis prior to surgery was returned to hearing thresholds within normal limits after surgery. See December 2019 VA examination. During the December 2019 examination, the examiner failed to address the Veteran's recent diagnosis of sensorineural hearing loss. In this regard, a remand is required for compliance with the Board's remand directives for a VA examination that addresses all of the Veteran's diagnosed hearing loss during the appeal period. Stegall, 11 Vet. App. at 271 (holding that a remand by the Board confers on the Veteran, as a matter of law, the right to compliance with the remand order). The matters are REMANDED for the following action: Obtain a medical opinion from an appropriate examiner regarding the nature and etiology of the Veteran's left ear hearing loss. The examiner should provide an opinion as to whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran's diagnosed hearing loss manifested in or is otherwise causally or etiologically related to the Veteran's military service, including any noise exposure and/or injury. The examiner must address the Veteran's diagnosis of sensorineural hearing loss. See December 2019 VA examination. SARAH B. RICHMOND Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Emily A. Kotroco 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.