Citation Nr: 21042822 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 18-11 831 DATE: July 13, 2021 REMANDED Entitlement to a compensable rating for bilateral hearing loss prior to December 17, 2019 and greater than 40 percent thereafter, to include on an extraschedular basis is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1967 to February 1969. The claim was most recently before the Board in January 2021; there has not been substantial compliance with the remand directives and the claim must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to a compensable rating for bilateral hearing loss prior to December 17, 2019 and greater than 40 percent thereafter, to include on an extraschedular basis is remanded. The claim must be remanded again because the April 2021 VA audiological examination is inadequate. Prior VA examinations and VA treatment records document that, during word discrimination testing, the Veteran's left ear is significantly worse than the Veteran's right ear. However, during the April 2021 VA examination, the Veteran was reported to show word discrimination scores at 100 with percent accuracy for both ears. There are no explanations provided why this is so. Additionally, the Board's January 2021 remand instructions identified several symptoms the Veteran reported as being related to his hearing loss, to specifically include anxiety. The opinion on remand was to attempt to identify the nature of the symptoms and possible relationship to the service-connected hearing loss disability. In April 2021, the Veteran was given a VA examination to determine whether his anxiety caused or aggravated by his hearing loss. The opinion submitted provides conflicting opinions as to whether the Veteran's hearing loss caused or aggravated his anxiety. The opinion on remand should clarify whether the Veteran's hearing loss caused or aggravated his anxiety disorder. The matters are REMANDED for the following action: 1. Schedule the Veteran for the appropriate VA examination to assess the severity of his service-connected bilateral hearing loss. Copies of all pertinent medical records should be made available to the examiner for review. All necessary diagnostic testing should be performed using the appropriate DBQ. (a) The examiner should specifically discuss with the Veteran, his complaints of conditions he claims are related to his hearing loss, to specifically include stress, and anxiety. (b) For any of the identified manifestations in (a) above, explain whether the identified condition is part of the service-connected hearing loss criteria or a separate disability, or neither. (c) If any of the reported symptoms are found to be a separate disability, opine whether it is at least as likely as not the separate disability is caused or aggravated. by the Veteran's service-connected bilateral hearing loss. The examiner is informed that aggravation here is defined as any increase in disability. If aggravation is present, the clinician should indicate, to the extent possible, the approximate level of disability (baseline) before the onset of the aggravation. A complete rationale must be provided for all opinions, citing to supporting factual data and medical literature, as appropriate. If the examiner cannot provide an opinion without resort to speculation, the examiner must state why that is and what additional information is needed to provide the opinion. 2. Then, after the above development, IF any symptom is identified by the examiner that is NOT contemplated by rating criteria for hearing loss, take all necessary action to develop the Veteran's claim, to include referral to the Director of Compensation for extraschedular consideration. M.E. Larkin Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. G. Perkins, 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.