Citation Nr: 22014276 Decision Date: 03/12/22 Archive Date: 03/12/22 DOCKET NO. 18-04 840 DATE: March 12, 2022 REMANDED Entitlement to service connection for residuals of hemorrhagic fever, to include whether new and material evidence has been received to reopen the claim, is remanded. Entitlement to service connection for residuals, right knee laceration, to include whether new and material evidence has been received to reopen the claim, is remanded. Entitlement to service connection for a stomach condition is remanded. Entitlement to service connection for bilateral hearing loss is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1971 to September 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned at a hearing in June 2021. 1. Entitlement to service connection for residuals of hemorrhagic fever, to include whether new and material evidence has been received to reopen the claim is remanded. 2. Entitlement to service connection for residuals, right knee laceration, to include whether new and material evidence has been received to reopen the claim is remanded. 3. Entitlement to service connection for a stomach condition is remanded. VA's duty to assist requires reasonable efforts to ensure all relevant records have been obtained and associated with the claims file. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159 (c); see also Sullivan v. McDonald, 815 F.3d 786 (Fed. Cir. 2016). The Veteran testified at the June 2021 hearing that he receives treatment for his claimed disabilities from VA; however, the most recent VA medical records are from July 2017. A May 2017 Primary Care Nursing Note indicates the Veteran receives private treatment for pain management. Further, the Veteran's claim's file does not contain his military personnel record. As the contents of these records are unknown, the Board cannot properly adjudicate the issues of new and material evidence for residuals of hemorrhagic fever and a right knee laceration nor the service connection claim for a stomach condition. Therefore, the Board remands these claims, without reopening the service connection claims for residuals of hemorrhagic fever and residuals of a right knee laceration, so VA may attempt to obtain these records because they may be relevant to the Veteran's claims. 4. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends his bilateral hearing loss is a result of in-service noise exposure to artillery and tanks without hearing protection. The Veteran's DD-214 confirms his military occupational specialty as "field artillery." VA previously conceded in-service acoustic trauma. VA provided the Veteran an examination in May 2015 to determine the nature and etiology of his bilateral hearing loss. The audiologist provided a negative nexus opinion for the Veteran's left ear because the Veteran had normal left ear hearing upon entrance and separation from active duty. The audiologist provided a negative nexus opinion for the Veteran's right ear hearing loss because the 1970 entrance audiogram revealed right ear hearing loss at 4000Hz, and the 1972 separation examination did not reveal a significant shift in hearing loss at 4000Hz. The examination is inadequate to adjudicate the Veteran's claim because it does not contain a complete rationale to support the negative nexus opinion. Normal hearing at separation is not fatal to a claim of service connection for hearing loss. See Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Evidence of a current hearing loss disability and a medically sound basis for attributing such disability to service may serve as a basis for a grant of service connection for hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). If the normal hearing at separation precludes establishing service connection for hearing loss, it must be explained why this is so, particularly in light of the grant of service connection for tinnitus based on conceded in-service acoustic trauma. Although not entirely clear, the August 1970 induction audiogram appears to have been conducted using American Standards Association (ASA) units whereas the July 1972 separation audiogram appears to have been conducted using International Standards Organization-American National Standards Institute (ISO-ANSI) units; however, there is no indication in the May 2015 audiogram whether this is correct, and if so, whether the May 2015 audiologist converted the measurements to a common unit. The Board notes Audiological reports were routinely converted from ISO-ANSI results to ASA units until the end of 1975 because the regulatory standard for evaluating hearing loss was not changed to require ISO-ANSI units until September 9, 1975. As the Veteran's induction and separation examinations were conducted in 1970 and 1972, respectively, when both standards were in use, it is unclear whether the results were recorded using ASA units or ISO-ANSI units. Accordingly, the Board will consider the recorded metrics under both standards, relying on the unit measurements most favorable to the Veteran's appeal. A remand is necessary to obtain a conversion of the in-service audiological results, obtain an opinion regarding any threshold shifts noted during service, and obtain the potentially relevant records noted above. The matters are REMANDED for the following action: 1. Obtain any and all VA treatment records and associate those records with the claims file. 2. Request the Veteran's complete service personnel records from the appropriate records repository. Document all requests for information as well as all responses in the claims file. If the records cannot be obtained, provide the Veteran notice of the inability to obtain the records in accordance with 38 C.F.R. § 3.159(e)(1). 3. Ask the Veteran to complete a VA Form 21-4142 for any treatment provider and for any other medical care provider or medical facility which may have records related to the Veteran's hemorrhagic fever, right knee, and stomach treatment. Make two requests for the authorized records from any medical care provider or facility identified unless it is clear after the first request that a second request would be futile. 4. Forward the claims file to an appropriate clinician to determine whether the bilateral hearing loss is related to the Veteran's military service. If the examiner determines that an additional in-person examination is required, one should be scheduled. Following review of the claims file, the examiner should first determine whether the audiological results recorded in the Veteran's service treatment records are in ASA units or ISO-ANSI units. If unable to make this determination, the examiner should consider the records to use ASA units, and the examiner should convert these to ISO-ANSI units. Then, examining both sets of data, the examiner should opine whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that the bilateral hearing loss began in or is otherwise caused by the Veteran's conceded in-service noise exposure. If the examiner concludes that the Veteran's current left ear hearing loss is less likely than not related to military service because the Veteran had normal left ear hearing at separation, the examiner must explain why normal hearing at separation would preclude relating the current hearing loss to military service. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran's reports, he or she must provide a reason for doing so. The examiner's report must include a complete rationale for the opinion provided. M. HYLAND Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Zachery S.C. Luce, 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.