completed, as the appellant refused to respond.
. Despite the incomplete nature of theexamination, the appellant was diagnosed with hearing loss. R. at 278.In July 2007, a scheduled VA audiological examination was canceled because the appellantfailed to report for the examination. R. at 404. In August 2007, the appellant underwent a VAgeneral medical examination, during which he reported a history of hearing problems since 1971,due to the hand grenade explosion in service. R. at 314-16. In June 2009, the appellant submitteda statement that there was "no way" he would undergo any future examinations. R. at 86-89.Thereafter, he failed to report to a scheduled July 2009 examination. R. at 90. The appellant wasonce again scheduled to undergo a VA audiological examination in January 2010. R. at 62. He wasnotified by letter in January 2010 of the procedure to follow if he was unable to appear for thescheduled examination. R. at 58. In a January 2010 response, the appellant stated: "I'm not gonnaever go through any more ear exam's ever." R. at 56-57. As a result, the scheduled January 2010examination was canceled. R. at 61.In August 2010, the Board denied the appellant's claim of entitlement to service connectionfor hearing loss. R. at 2-19. This appeal followed.
Establishing service connection generally requires medical or, in certain circumstances, layevidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury;and (3) a nexus between the claimed in-service disease or injury and the present disability.
See Davidson v. Shinseki
, 581 F.3d 1313 (Fed. Cir. 2009);
Hickson v. West
, 12 Vet.App. 247, 253(1999);
Caluza v. Brown
, 7 Vet.App. 498, 506 (1995),
aff'd per curiam
, 78 F.3d 604 (Fed. Cir. 1996)(table)
A finding of service connection, or no service connection, is a finding of fact reviewed under the "clearly erroneous" standard in 38 U.S.C. § 7261(a)(4).
See Swann v. Brown
, 5 Vet.App. 229,232 (1993). "A factual finding 'is "clearly erroneous" when although there is evidence to support it,the reviewing court on the entire evidence is left with the definite and firm conviction that a mistakehas been committed.'"
Hersey v. Derwinski
, 2 Vet.App. 91, 94 (1992) (quoting
United States v.United States Gypsum Co.
, 333 U.S. 364, 395 (1948)). The Court may not substitute its judgment3