BVA9503391 DOCKET NO. 93-09 560 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Wichita, Kansas THE ISSUES 1. Entitlement to service connection for bilateral hearing loss. 2. Entitlement to service connection for tinnitus. REPRESENTATION Appellant represented by: Paralyzed Veterans of America, Inc. WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Theresa M. Catino, Associate Counsel INTRODUCTION The veteran served on active military duty from November 1968 to November 1972. He also served with the United States Army National Guard from December 1977 to December 1978. REMAND The service medical records indicate that the veteran may have had a hearing loss to some extent at his entrance into, and at the time of his discharge from, active military duty. Significantly, however, there is no medical evidence included in the claims folder regarding the question of whether or not these in-service audiometric test results represent a worsening of any hearing loss during service. Moreover, the post-service outpatient treatment records and the VA examination completed in September 1991 do not discuss whether the veteran's present hearing loss disability is in any way related to any in-service hearing loss he may have had. See, Hensley v. Brown, 5 Vet.App. 155, 161-164 (1993). VA has a duty to assist the veteran in the development of facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103(a) (1991). This duty to assist includes the duty to develop facts when the record before the Board is clearly inadequate. EF v. Derwinski, 1 Vet.App. 324 (1991); Littke v. Derwinski, 1 Vet.App. 90 (1990). The development of facts includes a "thorough and contemporaneous medical examination, one which takes into account the records of prior medical treatment, so that the evaluation of the claimed disability will be a fully informed one." Green v. Derwinski, 1 Vet.App. 121, 124 (1991). The Board concludes that further assistance to the veteran is required. Accordingly, the case is REMANDED to the RO for the following: 1. The veteran should be contacted and requested to furnish a complete list of all medical personnel and facilities from which he has received treatment for his hearing loss and tinnitus since his separation from service. After obtaining the appropriate releases from the veteran where necessary, the health care providers should be contacted and requested to provide all treatment records in their possession pertaining to the veteran. If these records are unavailable, or are duplicates of those already on file, those facts should be annotated in the claims folder. Any available records should be associated with the claims folder. 2. Following the above, the veteran should be accorded a VA audiological examination to determine the nature, extent, and etiology of his hearing loss and tinnitus. The examination should be conducted in accordance with the diagnostic procedures outlined in the VA Physician's Guide for Disability Evaluation Examinations. The examiner is specifically requested to express an opinion as to whether the audiometric testing results obtained at the veteran's October 1968 entrance examination represent hearing loss. If the examiner concludes that the veteran had hearing loss at the time of his entrance examination, then the examiner should review all of the service medical records including the November 1972 separation examination and express an opinion as to whether the veteran's preexisting hearing loss worsened during service. Also, if the examiner finds that the veteran's hearing acuity did not worsen during service, he or she must express an opinion as to whether the veteran's present hearing loss is related in any way to any hearing loss found during service. In addition, the examiner must express an opinion as to whether any tinnitus that the veteran may presently have is in any way related to, or caused by, his hearing loss. The claims folder and a copy of this remand must be made available to and reviewed by the examiner prior to the examination. The specialist should provide complete rationale for all conclusions reached. 3. The RO should review the examination report and determine if it is adequate for rating purposes and in compliance with this Remand. If not, it should be returned for corrective action. 4. Thereafter, the RO should formally adjudicate the issues of entitlement to service connection for bilateral hearing loss and for tinnitus, with consideration of Hensley v. Brown, 5 Vet.App. 155 (1993). Following completion of these actions, and, if the decision remains unfavorable, the veteran and his representative should be provided with a supplemental statement of the case and afforded a reasonable period of time in which to respond. Thereafter, the case, in accordance with the current appellate procedures, should be returned to the Board for completion of appellate review. The purpose of this REMAND is to obtain clarifying evidence. No action is required of the veteran until further notice is issued. WILLIAM J. REDDY 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).