BVA9502728 DOCKET NO. 92-15 898 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to a compensable disability evaluation for bilateral external otitis. 2. Whether new and material evidence has been submitted to reopen the claim of entitlement to service connection for bilateral sensorineural hearing loss. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD Theresa M. Catino, Associate Counsel INTRODUCTION The veteran served on active military duty from May 1942 to November 1945. REMAND In August 1993, the Board of Veterans' Appeals (Board) remanded the case to accord the veteran an examination by an otolaryngologist and to obtain records of treatment for bilateral external otitis and bilateral hearing loss that he asserted on the substantive appeal to have received. In this prior remand, the Board specifically requested that the physicians who treated the veteran on an outpatient basis and the otolaryngologist who examined him render opinions regarding the relationship, if any, between his service-connected external otitis and his nonservice-connected hearing loss. The Board noted the veteran's contentions that the physicians who have treated and examined him agreed that his external otitis caused his hearing loss. A review of the report of the January 1994 VA examination indicates that the examiner conducting this examination vaguely stated that the veteran has intermittent external otitis secondary to hearing aid use. Significantly, however, the examiner did not provide an opinion as to whether the veteran's external otitis caused his hearing loss. Furthermore, the Board notes that three physicians who treated the veteran on an outpatient basis for his hearing problems responded to the RO's request for treatment records. However, none of these three physicians provided the requested opinion concerning the etiology of the veteran's hearing loss. A review of the letter sent to these physicians by the RO indicates that the RO did not request the physicians to render such an opinion. In addition, in a January 1995 statement, the veteran's representative pointed out that the Board's prior instructions were not carried out fully. In particular, the representative stated that the opinion regarding the relationship between the veteran's external otitis and his hearing loss was not obtained. Recently, the United States Court of Veterans Appeals (Court) has upheld the provisions of 38 C.F.R. Part 4, § 4.2, which provide that, if an examination report does not contain sufficient detail, it is incumbent upon the rating board to return the report as inadequate for evaluation purposes. Ardison v. Brown, 6 Vet.App. 405, 407 (1994); Abernathy v. Principi, 3 Vet.App. 461, 464 (1992). In the present case, the examination conducted pursuant to the Board's August 1993 remand is inadequate for the purposes of evaluating the nature, extent, and etiology of any hearing loss that the veteran may have. The Board concludes that further assistance to the veteran is required. Accordingly, the case is REMANDED to the RO for the following: 1. After obtaining the appropriate releases where necessary, the RO should contact Dr. Ray Stewart at the Beltone Hearing Center at 2831 North Federal Highway, Boca Raton, Florida 33431; Dr. Rodney Hawk at 512 Park Hill Court, Hendersonville, North Carolina 28739; and Fredrik Gundersen, M.A., Audiologist at the VA Medical Center in Oakland Park, Florida. These three health care providers should each be requested to provide an opinion as to whether or not the veteran's bilateral external otitis in any way caused any bilateral sensorineural hearing loss he may have. The physicians should provide complete rationale for all conclusions reached and opinions expressed. In addition, these health care providers should provide records of any additional treatment rendered to the veteran since 1993. All responses and treatment records from these health care providers should be associated with the claims folder. If any of these treatment records are unavailable or are duplicates of those already included in the claims file, those facts should be annotated in the claims folder. 2. Following the above, the veteran should be accorded VA audiological and otolaryngology examinations to determine the nature and extent of his service-connected bilateral external otitis and to determine the nature, extent, and etiology of any bilateral sensorineural hearing loss he may have. All necessary tests should be conducted, and the examiners should review the results of any testing prior to completion of the reports. The examinations should be conducted in accordance with the VA Physician's Guide for Disability Evaluation Examinations. The examiners must express opinions as to whether any hearing loss found on examination was in any way caused by the veteran's bilateral external otitis. In addition, the examiners must express opinions as to the extent of any swelling, dry and scaly or serious discharge, or itching resulting from the veteran's bilateral external otitis. The examiners should also make findings, based on information obtained from the veteran and on a review of the claims folder, regarding the extent of any treatment required for his bilateral external otitis. The claims folder and a copy of this remand must be made available to and reviewed by the examiners prior to the examinations. The examiners should review all of the pertinent medical evidence in the claims folder and provide complete rationale for all conclusions reached. 3. The RO should review the examination reports and determine if they are adequate for rating purposes and in compliance with this Remand. If not, they should be returned for corrective action. 4. Thereafter, the RO should formally adjudicate the issues on appeal. 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. J. U. JOHNSON 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).