Citation Nr: 18140204 Decision Date: 10/02/18 Archive Date: 10/02/18 DOCKET NO. 15-24 916 DATE: October 2, 2018 ORDER Entitlement to an initial compensable disability rating for left ear hearing loss is denied. FINDING OF FACT The Veteran’s left ear hearing loss results in a hearing impairment no worse than a Level I designation. CONCLUSION OF LAW The criteria for an initial compensable disability rating for left ear hearing loss have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.85, Diagnostic Code 6100. REASONS AND BASES FOR FINDING AND CONCLUSION The criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule) are intended to represent the average impairment of earning capacity resulting from disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where service connection has already been established and an increase in the disability rating is at issue, it is the present level of disability that is of primary concern. See Francisco v. Brown, 7 Vet. App. 55 (1994). In determining the present level of a disability for any increased evaluation claim, the Board must consider the application of staged ratings. The Rating Schedule provides rating tables for the evaluation of hearing impairment. 38 C.F.R. § 4.85. Table VI assigns a Roman numeral designation (I through XI) for hearing impairment based on a combination of percent speech discrimination and the puretone threshold average (the sum of the puretone thresholds at 1000, 2000, 3000 and 4000 Hertz, divided by four). Table VII is used to determine the percentage evaluation by combining the Table VI Roman numeral designations for hearing impairment in each ear. 38 C.F.R. § 4.86 provides for exceptional patterns of hearing impairment. When the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral. 38 C.F.R. § 4.86(a). When the puretone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation from either Table VI or Table VIA, whichever results in the higher numeral. 38 C.F.R. § 4.86(b). That numeral is then elevated to the next higher Roman numeral. Each ear is evaluated separately. The Rating Schedule provides rating tables for the evaluation of hearing impairment. 38 C.F.R. § 4.85. Table VI assigns a Roman numeral designation (I through XI) for hearing impairment based on a combination of percent speech discrimination and the puretone threshold average (the sum of the puretone thresholds at 1000, 2000, 3000 and 4000 Hertz, divided by four). Table VII is used to determine the percentage evaluation by combining the Table VI Roman numeral designations for hearing impairment in each ear. 38 C.F.R. § 4.86 provides for exceptional patterns of hearing impairment. When the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral. 38 C.F.R. § 4.86(a). When the puretone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation from either Table VI or Table VIA, whichever results in the higher numeral. 38 C.F.R. § 4.86(b). That numeral is then elevated to the next higher Roman numeral. Each ear is evaluated separately. In a December 2009 VA examination, the Veteran reported that he had difficulty understanding speech. Speech recognition was 100 percent in the left ear. On examination, puretone thresholds were as follows: HERTZ 500 1000 2000 3000 4000 AVG. LEFT 10 15 20 30 40 26 Applying the values above to Table VI results in a Level I Roman numeral designation for the left ear. Application of this designation to Table VII results in a noncompensable rating, pursuant to 38 C.F.R. § 4.85(f). The exceptional hearing pattern criteria are not met. In a November 2013 VA examination, the Veteran reported that most conversations sound muffled. Speech recognition was 96 percent in the left ear. On examination, puretone thresholds were as follows: HERTZ 500 1000 2000 3000 4000 AVG. LEFT 15 15 25 25 25 23 Applying the values above to Table VI results in a Level I Roman numeral designation for the left ear. Application of this designation to Table VII results in a noncompensable rating, pursuant to 38 C.F.R. § 4.85(f). The exceptional hearing pattern criteria are not met. In a private October 2014 audiogram, the audiologist commented that moderate sensorineural hearing loss was present up to 2000 Hertz, with higher frequency range within normal limits. Speech recognition was 100 percent in the left ear. On examination, puretone thresholds were as follows: HERTZ 500 1000 2000 3000 4000 AVG. LEFT 35 35 40 25 25 31.25 Applying the values above to Table VI results in a Level I Roman numeral designation for the left ear. Application of this designation to Table VII results in a noncompensable rating, pursuant to 38 C.F.R. § 4.85(f). The exceptional hearing pattern criteria are not met. A January 2015 VA treatment record noted that word recognition was excellent at 100 percent in the left ear. Puretone thresholds in the left ear were normal from 250-4000 Hertz with mild sensorineural hearing loss from 250-8000 Hertz. In a private July 2015 audiogram, speech recognition was 96 percent in the left ear. On examination, puretone thresholds were as follows: HERTZ 500 1000 2000 3000 4000 AVG. LEFT 25 25 35 35 40 33.75 Applying the values above to Table VI results in a Level I Roman numeral designation for the left ear. Application of this designation to Table VII results in a noncompensable rating, pursuant to 38 C.F.R. § 4.85(f). The exceptional hearing pattern criteria are not met. To the extent the Veteran feels he cannot hear well and is entitled to a 50 percent disability rating, he Board notes that he is certainly competent to describe his hearing loss. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However, a veteran’s description of his service-connected disability must be considered in conjunction with the clinical evidence of record. In determining the actual degree of disability, an objective examination is more probative of the degree of the Veteran’s impairment as the opinions and observations of the Veteran alone are not sufficient to address the rating criteria under 38 C.F.R. § 4.85, DC 6100. The Board additionally emphasizes that disability ratings for hearing loss are derived by a mechanical application of the rating schedule. See Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). In Martinak v. Nicholson, 21 Vet. App. 447, 455 (2007) the United States Court of Appeals for Veterans Claims held that in addition to dictating objective test results, a VA audiologist must fully describe the functional effects caused by a hearing disability in his or her final report. Here, the November 2013 VA examiner noted that the Veteran has difficulty understanding speech. See Martinak, 21 Vet. App. at 455. In sum, the evidence does not show that the Veteran’s left ear hearing loss resulted in a hearing impairment greater than a Level I designation under Table VI, at any time during the appeal period. Accordingly, the Board finds that the criteria for a compensable disability rating for left ear hearing loss has not been met, and the claim must be denied. BISWAJIT CHATTERJEE Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Vang, Associate Counsel