Citation Nr: 18142057 Decision Date: 10/15/18 Archive Date: 10/12/18 DOCKET NO. 16-12 986 DATE: October 15, 2018 ORDER Entitlement to service connection for hearing loss is denied. Entitlement to service connection for tinnitus is denied. Entitlement to a 10 percent disability rating for hypertension is granted. Entitlement to a compensable disability rating for status post fracture distal phalanx 4th digit, of the right hand is denied. FINDINGS OF FACT 1. The Veteran does not have a current hearing loss disability. 2. The credible evidence is against a link between any current tinnitus and active service, to include any noise exposure experienced therein. 3. The service-connected hypertension is manifested by a history of diastolic pressure predominantly 100 or more which requires continuous medication for control. It is not manifested by diastolic pressure predominantly 110 or more or systolic pressure predominantly 200 or more during the appeal period. 4. The service-connected residuals of a fracture distal phalanx 4th digit, of the right hand (major) hand are manifest by no current symptoms or functional impairment. CONCLUSIONS OF LAW 1. The criteria for service connection for hearing loss are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385. 2. The criteria for service connection for tinnitus are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 3. The criteria for a 10 percent disability rating, but no higher, for hypertension have been satisfied. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.104, Diagnostic Code 7101. 4. The criteria for a compensable disability rating for status post fracture distal phalanx 4th digit of the right hand have not been satisfied. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.71a, Diagnostic Codes 5227, 5230. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1986 to March 1995. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). Service Connection The Veteran contends that he has hearing loss and tinnitus because of his active duty service. He asserts that noise exposure from aircraft resulted in hearing loss and tinnitus. He reports that his duties included working on the flight deck being exposed to aircraft noise, including the noise of jet engines. The record establishes that the Veteran served in the Navy in an aviation rating and that he had sea service aboard aircraft carriers. However, the record also reflects that hearing protection was worn during his flight deck duties. His assertions are credible, and the Board accepts that the Veteran experienced this noise exposure during service as he claims. Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Other organic diseases of the nervous system, including sensorineural hearing loss and tinnitus, may be presumed to have been incurred during active military service if the disability becomes manifest to a degree of 10 percent within the first year following active service. 38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309(a). 1. Entitlement to service connection for hearing loss. Impaired hearing is considered a disability for VA purposes when: the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. The Veteran’s service treatment records do not show any complaints of hearing loss or symptoms of tinnitus such as ringing in the ears. Because of his aviation duties around aircraft, he was provided audiometric testing on a regular basis; these tests do not reveal any hearing loss during service. In February 1995 separation examination of the Veteran was conducted. On the report of medical history, he did not indicate having any ear trouble or complaints of hearing loss. His hearing was evaluated by audiometric testing on separation examination and was shown to be normal. In March 2014 a VA audiology Compensation and Pension examination of the Veteran was conducted. Testing revealed that the Veteran’s hearing was normal in both ears by both pure tone and speech discrimination testing. The examiner reviewed the service treatment records and noted that the Veteran had noise exposure during service but that he wore hearing protection and was monitored by a hearing conservation program because of his duties. The Veteran’s argument for service connection for hearing loss is that he worked in an aviation rating in service and that the aircraft noise exposure has caused hearing loss. He has asserted that reports of hearing tests previously conducted were lost because of damage to facilities by Hurricane Katrina. However, the evidence of record contains an adequate VA Compensation and Pension examination which shows that the Veteran does not have a current hearing loss disability as defined at 38 C.F.R. § 3.385. Despite the noise exposure that the Veteran experienced during service he does not have a current hearing loss disability. The preponderance of the evidence is against the claim; without a current disability service connection must be denied. 2. Entitlement to service connection for tinnitus. The Veteran claims entitlement to service connection for tinnitus. Again, his claim is based on the assertion that his military noise exposure has caused tinnitus. The Veteran’s service treatment records do not show any complaints of hearing loss or symptoms of tinnitus such as ringing in the ears. Because of his aviation duties around aircraft, he was provided audiometric testing on a regular basis; these tests do not reveal any hearing loss during service. In February 1995 separation examination of the Veteran was conducted. On the report of medical history, he did not indicate having any ear trouble or complaints of hearing loss. His hearing was evaluated by audiometric testing on separation examination and was shown to be normal. Review of the evidence of record does not show any complaints of, or treatment for tinnitus, in the intervening period between his separation from service and the present. In March 2014 a VA audiology Compensation and Pension examination of the Veteran was conducted. Testing revealed that the Veteran’s hearing was normal in both ears by both pure tone and speech discrimination testing. The examiner reviewed the service treatment records and noted that the Veteran had noise exposure during service but that he wore hearing protection and was monitored by a hearing conservation program because of his duties. The Veteran reported an onset of symptoms of tinnitus beginning 15 years after service. The examiner’s medical opinion was that the Veteran’s tinnitus was not associated with any military noise exposure given the date of onset and findings above. The preponderance of the evidence is against the Veteran’s claim. The only competent evidence of record indicates that the Veteran’s tinnitus is not related to his military noise exposure. There is no evidence of tinnitus during service and the medical opinion of record indicates that tinnitus cannot be associated to noise exposure 15 years earlier. Accordingly, service connection for tinnitus is not warranted and the claim is denied. Increased Ratings Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule) and are intended to represent the average impairment of earning capacity resulting from disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met. 38 C.F.R. § 4.31. 3. Increased rating for hypertension. Service connection for hypertension has been in effect at a noncompensable (0%) disability rating effective from the date of separation from service in March 1995. In January 2013, the Veteran filed the claim which ultimately gave rise to the current appeal. The RO adjudicated the issue as entitlement to an increased rating for hypertension, since service connection was already established at a 0% rating. In his August 2014 notice of disagreement, and in subsequent correspondence, the Veteran mistakenly refers to the issue involving hypertension as being one of service connection, which it is not. Service connection has long been established, albeit at a noncompensable disability rating. Hypertension is rated under Diagnostic Code 7101 for hypertensive vascular disease (hypertension and isolated systolic hypertension). A 10 percent rating contemplates diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. 38 C.F.R. § 4.104, Diagnostic Code 7101 (emphasis added). A 20 percent rating contemplates diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200. A 40 percent rating is warranted for diastolic pressure predominantly 120 or more. Finally, a 60 percent rating contemplates diastolic pressure predominantly 130 or more. Id. The Veteran filed his claim for an increased disability rating in January 2013. In December 2013 a VA Compensation and Pension examination of the Veteran was conducted. Blood pressure readings taken on examination were: 132/84, 128/84, and 130/86. The examiner indicated that the Veteran required continuous medication to treat his hypertension and that the Veteran previously had a history of diastolic blood pressure of predominantly 100 or more. The Veteran’s hypertension did not result in any functional impact on his ability to work. In January 2017 the most recent VA Compensation and Pension examination of the Veteran was conducted. Blood pressure readings taken on examination were: 130/80, 130/90, and 132/80. The examiner indicated that the Veteran required continuous medication to treat his hypertension. The examiner indicated that the Veteran did not have a history of diastolic blood pressure of predominantly 100 or more. Again, it was noted that the Veteran’s hypertension did not result in any functional impact on his ability to work. Recent VA treatment records confirm that the Veteran is prescribed medication to control his hypertension and blood pressure readings are similar to those noted on the Compensation and Pension examination reports. VA and private treatment records dated from 2009 sand 2010 reveal documented blood pressure readings much higher than those at present, including readings as high as 205/132 in May 2009. Because these records are dated prior to January 2012, they are outside the scope of the appeal period. However, these blood pressure readings do support the finding on the 2013 Compensation and Pension examination report that the Veteran had a history of diastolic blood pressure of predominantly 100 or more which required continuous medication to treat. The evidence supports the assignment of a 10 percent disability rating for the Veteran’s service-connected hypertension, because it is shown that he had a history of diastolic blood pressure of predominantly 100 or more which required continuous medication to treat. Accordingly, a 10 percent rating is granted. The preponderance of the evidence is against the claim for a disability rating in excess of 10 percent for hypertension for any period covered by this appeal. Simply put, the evidence does not establish that the Veteran’s hypertension is manifested by diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200, or any greater readings, during the period of the appeal. Accordingly, a rating in excess of 10 percent is not warranted. 4. Status post fracture distal phalanx 4th digit, of the right hand. Service connection for status post fracture distal phalanx 4th digit, of the right hand has been in effect at a noncompensable (0%) disability rating effective from the date of separation from service in March 1995. In January 2013, the Veteran filed the claim which ultimately gave rise to the current appeal. The RO adjudicated the issue as entitlement to an increased rating, since service connection was already established at a 0% rating. In his August 2014 notice of disagreement, and in subsequent correspondence, the Veteran mistakenly refers to the issue involving his right 4th finger hypertension as being one of service connection, which it is not. Service connection has long been established, albeit at a noncompensable disability rating. In December 2013 a VA Compensation and Pension examination of the Veteran hand was conducted. The examiner noted the Veteran’s history status post fracture distal phalanx 4th digit (ring finger), of the right hand, and that the Veteran was right handed. After a full examination, the physician noted that the Veteran had no current symptoms of functional impairment from the in-service fracture to the finger. The findings on the most recent Compensation and Pension examination conducted in January 2017 are identical. The Veteran’s disability is rated under Diagnostic Codes 5227 and 5230. Diagnostic Code 5227 is used to rate ankylosis of the ring or little finger and provides for noncompensable disability ratings (0%) in the case of either the major or minor extremity. 38 C.F.R. § 4.71a, Diagnostic Code 5227. Diagnostic Code 5230 rates limitation of motion of the ring or little finger and again provides for noncompensable disability ratings (0%) in the case of either the major or minor extremity. 38 C.F.R. § 4.71a, Diagnostic Code 5230. The preponderance of the evidence is against the Veteran’s claim for a compensable disability rating for his service-connected residuals of status post fracture distal phalanx 4th digit, of the right hand. First the applicable Diagnostic Codes do not provide for the assigment of a compensable disability rating. Further, the evidence of record does not indicate that there are any current residuals of impairment resulting from the finger fracture during service. Accordingly, a compensable disability rating is not warranted. Nathan Kroes Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Havelka, Counsel