Citation Nr: 18140365 Decision Date: 10/03/18 Archive Date: 10/02/18 DOCKET NO. 16-12 362A DATE: October 3, 2018 ORDER Entitlement to an initial rating in excess of 10 percent for tinnitus is denied. REMANDED Entitlement to a compensable initial rating for bilateral hearing loss disability is remanded. Entitlement to an initial rating in excess of 10 percent for ischemic heart disease is remanded. FINDING OF FACT The Veteran’s tinnitus is assigned a single 10 percent rating, which is the maximum evaluation authorized under Diagnostic Code 6260. CONCLUSION OF LAW The criteria for an increased rating for tinnitus have not been met. 38 U.S.C. 1155; 38 C.F.R. 4.87, DC 6260. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active military service from February 1967 to December 1969. These matters come before the Board of Veterans’ Appeals (Board) from a September 2013 rating decision of the Department of Veterans Affairs (VA), Regional Office (RO) in New York, New York. Entitlement to an initial rating in excess of 10 percent for tinnitus Disability evaluations are determined by comparing a Veteran’s present symptomatology with criteria set forth in VA’s Schedule for Rating Disabilities, which is based on average impairment in earning capacity. 38 U.S.C. 1155 38 C.F.R. Part 4. The Veteran’s tinnitus is rated under Diagnostic Code (DC) 6260. The highest possible schedular rating for tinnitus is 10 percent; it is not possible for the Veteran to receive a higher rating under DC 6260. In addition, only a single rating is warranted for tinnitus regardless of whether the tinnitus is unilateral or bilateral. 38 C.F.R. 4.87, DC 6260, Note (2). As the Veteran is already receiving the maximum schedular disability rating for tinnitus, his claim is denied. Sabonis v. Brown, 6 Vet. App. 426 (1994). Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).   REASONS FOR REMAND 1. Entitlement to a compensable initial rating for bilateral hearing loss disability is remanded. The claims file includes an August 2013 VA examination report for the Veteran’s hearing loss disability. A September 2016 VA clinical record reflects that the Veteran felt that his hearing is getting worse. An October 2016 VA clinical record notes stable audiology results from the 2013 evaluation, but fails to provide exact numerical findings. As the appropriate rating is based on precise numerical findings, these findings are more probative than an annotation as to “stable” hearing acuity. The October 2016 record reflects that the audiogram may be viewed under the “tools menu Audiogram Display” however, the Board does not have access to that computer program. In addition, speech recognition scores were noted to be “good bilaterally” but exact percentages (which are used in rating the disability) were not provided. Any VA treatment records are within VA’s constructive possession, and are considered potentially relevant to the issue on appeal. A remand is required to allow VA to obtain them and to obtain an updated VA audiometric examination. The Veteran is in receipt of service connection effective from March 2013. The September 2013 rating decision on appeal lists a May 2012 private audiogram from Hudson Valley Ear, Nose, and Throat P.C. However, this document is not associated with the claims file. Although this record is prior to the rating period on appeal, the history of the disability is for consideration, and, as the claim is being remanded for other reasons, the Veteran should have the opportunity to resubmit this record. 2. Entitlement to an initial rating in excess of 10 percent for ischemic heart disease is remanded. The claims file includes a July 2012 Disability Benefits Questionnaire (DBQ) which reflects that the Veteran has a METs level of greater than 7-10 (which would warrant a 10 percent evaluation under DC 7005) and evidence of cardio hypertrophy (which would warrant a 30 percent evaluation). A July 2012 Hudson Valley Cardiologists record reflects that the Veteran has “excellent exercise capacity”. An August 2013 VA examination report reflects a METS level of 13.5 (which would warrant a noncompensable rating) and that there is no evidence of hypertrophy based on a February 2012 echocardiogram. The examiner found that the body of the private 2012 report with regard to the left ventricle’s size and function, as well as wall thickness, is not consistent with LVH (left ventricular hypertrophy). Subsequent records indicate that the Veteran’s heart disability was asymptomatic (see December 2013, April 2014 Hudson Valley Cardiologists, PC). A February 2015 private record reflects that an EKG would be performed at the Veteran’s next visit; however, results, if any, have not been provided. A remand is required to allow VA to obtain authorization and request these EKG record. Moreover, the RO has not reviewed private records since the September 2013 rating decision. The most recent examination of record is five years old. The “mere passage of time” does not render an old examination inadequate. Palczewski v. Nicholson, 21 Vet. App. 174, 182 (2007). Moreover, the evidence of record does not indicate a worsening of the Veteran’s disability symptoms. However, the Board finds that another examination may be useful in resolving the conflicting evidence as to whether the Veteran has cardiac hypertrophy, or had it any time during the rating period on appeal. The matters are REMANDED for the following action: 1. Ask the Veteran to complete (i) a VA Form 21-4142 for Hudson Valley Cardiologists from February 2015 to present, to include EKGs, and (ii) a VA Form 21-4142 for the May 7, 2012 Hudson Valley Ear, Nose, and Throat audiology record (or to submit these records himself). Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 2. Associate with the virtual record the Veteran’s VA treatment records for the period from September 2013 to present, to include the October 2016 audiogram and speech recognition score findings. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected bilateral hearing loss disability. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected heart disability. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability. To the extent possible, the examiner should identify any symptoms and functional impairments due to his ischemic heart disease alone and discuss the effect of the Veteran’s disability on occupational functioning. The clinician should provide a discussion of why the evidence does, or does not, support a finding of cardiac hypertrophy, and if the Veteran has had cardiac   hypertrophy for any period on appeal (with consideration of the 2012 DBQ and the 2013 VA examination report which provide conflicting evidence.) M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Wishard