BVA9500061 DOCKET NO. 93-05 445 ) DATE ) ) On appeal from a decision of the Department of Veterans Affairs Regional Office in Chicago, Illinois THE ISSUES 1. Entitlement to service connection for bilateral defective hearing. 2. Entitlement to service connection for the residuals of otitis media. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD E. A. Artman, Associate Counsel INTRODUCTION The veteran served on active duty in the United States Marine Corps from June 1980 to June 1984 and from August 1984 to May 1989. This matter comes before the Board of Veterans' Appeals (Board) of the Department of Veterans Affairs (VA) on appeal from a July 1991 rating decision of the Chicago, Illinois, Regional Office (RO). REMAND A careful review of the record by the Board shows that the veteran's bilateral hearing loss was present prior to her entering active service. Thus, the question arises as to whether it increased in severity beyond natural progress during service. Pursuant to this appeal, the veteran has argued that her hearing was aggravated by her service, since she was exposed to significant and, in her opinion, damaging amounts of noise as a participant in a Marine Corps band. A DD Form 214 pertaining to the veteran's first period of service documents that she played both flute and piccolo in connection with her duty assignment. Furthermore, our review of the records shows that it was noted on a May 1983 ear, nose and throat consultation report that the veteran had suffered from noise exposure due to her playing in a band and being around aircraft. The service medical records also demonstrate that the veteran was treated for numerous colds and infections which resulted in ear aches throughout her service, suffered from recurrent bouts of bilateral otitis media between 1982 and 1985 and was assessed at an October 17, 1983, sick call as having an Eustachian tube dysfunction. The veteran has submitted records from a private physician, J. William Wright III, M.D., who reports that she had had some serious conditions affecting her hearing prior to her entrance into service in 1980. In an April 23, 1980 letter, Dr. Wright recounts to the veteran how she had informed him at their first meeting in November 1977 that she had had decreased hearing in her right ear since birth, and that she had stated that this decrease had been attributed to a high fever suffered during the immediate post-natal period. He furthered stated that the veteran had had a history of noise exposure at the time of their first meeting. His letter documents that he treated the veteran in 1977 for pain and pressure of the right ear related to reactive hypoglycemia, and that, in May of that year, the veteran once again suffered from a high fever, which resulted in a true rotational vertigo. Dr. Wright notes that, at that time, an examination of the veteran's ears were negative, except for some tenderness on the right mastoid bone. Audiological tests then-performed showed that the veteran had mild-to-moderate high-frequency sensorineural hearing loss, more prevalent in the right ear than the left. Sensorineural loss affecting the low frequencies was also present in the right ear. Speech discrimination scores were depressed in the right ear but remained good in the left ear. Finally, the right ear was found to demonstrate recruitment and a decreased dynamic range deemed consistent with damage in the cochlea of the inner ear on the right side. Based on these findings, Dr. Wright notes that it was his impression that the veteran's hearing loss was a congenital problem, which may or may not have been related to a high fever in early childhood. He recounts that he again treated the veteran in September 1979, at which time she complained of throat drainage and congestion of the right ear. After a thorough examination, which included taking tomograms of the temporal bones, no abnormalities of the middle or inner ears could be detected, but it was discovered that hearing acuity of the right ear had further decreased. In June 1991, the veteran's ears and hearing were examined by VA for purposes of her claims on appeal. At that time, the veteran stated that she had experienced decreased hearing and intermittent tinnitus since her early childhood. Based on these results, a diagnosis of bilateral neurosensory hearing loss and intermittent tinnitus, both of which dated back to childhood, was provided. However, the results of the June 1991 VA examination fail to address the question of the aggravation of this loss in service. Accordingly, this case is REMANDED for the following actions: 1. The RO should take appropriate steps to obtain copies of all treatment records pertaining to the veteran's hearing difficulties since June 1991. All copies received should be associated with the veteran's claims file. 2. The RO also should arrange for a VA examination of the veteran by ear and hearing specialists. With regard to the examination of the veteran's ears, it is imperative that the veteran's claims file be provided to the examiner for review prior to the date of examination. Based on this review and her/his findings, the examiner should provide a detailed opinion as to whether the veteran's preexisting bilateral hearing loss increased in severity beyond natural progression during her period of active service from 1980 to 1989. The examiner also should identify, based on her/his evaluation, all residuals of otitis media which would be attributable to service. All findings, bases and conclusions supporting the examiner's opinions should also be set forth in detail. 3. Based on the evidence obtained pursuant to the development sought above, the RO should take all indicated adjudicatory action. If any of the benefits sought by the veteran on appeal are not granted, a supplemental statement of the case should be issued. After the veteran and her representative have been given an opportunity to respond to the supplemental statement of the case, the claims file should be returned to this Board for further appellate review, if indicated. No action is required by the veteran until she receives further notice. The purpose of this REMAND is to procure clarifying data and to comply with governing adjudicative procedures. The Board intimates no opinion, either legal or factual, as to the disposition of this appeal. STEPHEN L. WILKINS Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1993).