Citation Nr: 18149449 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 14-18 505 DATE: November 9, 2018 ORDER 1. Entitlement to service connection for right ear hearing loss disability is denied. 2. Entitlement to service connection for chronic obstructive pulmonary disease (COPD), to include as due to exposure to asbestos, is denied. 3. Entitlement to a compensable rating for left ear hearing loss is denied. FINDINGS OF FACT 1. The Veteran’s right ear hearing loss disability is not shown to have had its onset in service, was not manifested to a compensable degree within one year of service discharge, was not diagnosed until many years after service discharge, and is not otherwise related to service. 2. The Veteran’s COPD is not shown to have had its onset in service, was not diagnosed until many years after service discharge, and is not otherwise related to service. 3. The Veteran’s sensorineural hearing loss has been productive of a puretone threshold average of 30 decibels (dB) in the left ear and speech recognition ability of 96 percent in the left ear, at worst, during the appeal period. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a right ear hearing loss disability have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. The criteria for entitlement to service connection for COPD have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for entitlement to a compensable rating for left ear hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code (DC) 6100. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served in the United States Navy from June 1972 to June 1976. The Veteran was afforded a hearing in this case in December 2015. The judge who conducted this hearing is now retired. The Veteran was offered and declined a new hearing in this case. The Board notes that this case was previously remanded for further development in September 2016. Development has been completed, and the case is again before the Board. Service Connection – Generally Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) 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. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010). Where a Veteran served 90 days or more of active service, and certain chronic diseases, such as sensorineural hearing loss, become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. Sensorineural hearing loss is a chronic disease. The Board has thoroughly reviewed all the evidence in the Veteran’s claims file. Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, each piece of evidence of record. The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, regarding the Veteran’s claim on appeal. The Veteran must not assume that the Board has overlooked pieces of evidence that are not explicitly discussed herein. See Timberlake v. Gober, 14 Vet. App. 122 (2000). Under VA regulations, hearing impairment constitutes a disability for VA purposes when auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz (Hz) is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hz 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. For judicial brevity, the audiology charts relevant to both the Veteran’s claim for entitlement to service connection for right ear hearing loss disability and entitlement to a compensable rating for left ear hearing loss disability are included below.   Puretone thresholds documented at separation from service in June 1976 HERTZ 500 1000 2000 3000 4000 RIGHT 20 10 0 0 10 LEFT 25 10 5 15 60 Puretone thresholds documented at a March 2012 VA examination HERTZ 500 1000 2000 3000 4000 RIGHT 10 5 10 10 20 LEFT 10 10 5 40 65 Puretone thresholds documented at a May 2012 health fair hearing test HERTZ 500 1000 2000 3000 4000 RIGHT 5 5 5 10 20 LEFT 15 5 0 40 65 Puretone thresholds documented at a September 2017 VA examination HERTZ 500 1000 2000 3000 4000 RIGHT 10 5 10 5 30 LEFT 5 10 5 20 35 Puretone thresholds documented at a May 2018 VA examination HERTZ 500 1000 2000 3000 4000 RIGHT 10 5 10 10 40 LEFT 10 10 5 30 45 1. Entitlement to service connection for right ear hearing loss disability The Veteran claims that his current right ear hearing loss disability is related to an injury he sustained while in service. As to a current disability, the Veteran has been diagnosed with sensorineural hearing loss in his right ear at a May 2018 VA examination, and the audiological findings are consistent with a hearing loss disability as defined by 38 C.F.R. § 3.385. Thus, the Veteran meets the first element of a claim for direct service connection. As to an in-service disease or injury, the Veteran’s personnel records document that the Veteran was exposed to loud noise on an aircraft carrier while serving in the Navy. Thus, the Veteran meets the second element of a claim for direct service connection. Where the Veteran’s claim for service connection fails is evidence of a nexus between the current right ear hearing loss disability and service. For example, the Veteran’s June 1976 separation examination includes an audiogram, included above, that did not document a hearing loss disability in June 1976 at his separation from service. Service treatment records do not document complaints of right ear hearing loss disability. This is evidence against a finding of service connection for right ear hearing loss disability. The Veteran was afforded an in-person VA examination for right-ear hearing loss in March 2012. The examiner reviewed the Veteran’s file and diagnosed the Veteran with high frequency hearing loss at frequencies of 6000 Hz or higher only, with a puretone threshold average of 11 dB for frequencies 1000 through 4000 Hz, and a 100 percent speech discrimination score using the Maryland CNC word list. The examiner documented that the test results were valid for rating purposes. The examiner reasoned that the Veteran claimed to be exposed to noise from jet engines and noise is known to cause hearing loss. The examiner documented that the Veteran’s high frequency hearing loss impacted his ability to work, and made it difficult to hear normal conversation, especially when background noise is present. The examiner opined that the Veteran’s high frequency hearing loss was more likely than not caused by military service. The Board notes that the right ear hearing loss documented at this exam was high frequency hearing loss (at frequencies of 6000 Hz or higher only), and does not constitute a hearing loss disability for VA rating purposes. A May 2012 private audiological examination shows that the puretone threshold average for the Veteran’s right ear from this exam is 10 dB, and does not meet the requirements for a compensable rating for VA purposes. The Maryland CNC word list was not used during this exam, and it is thus not valid for rating purposes. The Veteran submitted a December 2012 statement explaining that he was exposed to loud noise while stationed on a ship and assigned to work on the flight deck. The Veteran stated that he was told that he had significant hearing loss in his left ear (but not his right ear) when he was given a physical exam prior to discharge from service. The Veteran also stated that his hearing loss from the Navy has made it very difficult for him to hear normally and that he has ringing in his ears almost constantly. The Veteran submitted an April 2013 statement explaining that he was assigned to a man-overboard watch during service that required him to wear a mobile phone headset and no ear protection. The Veteran stated that the assignment required him to stand about 25 feet from the flight deck and exposed him to extremely loud noise from jet engines. The Veteran also stated that he has worn hearing protection around loud noise since separation from service. The Veteran was afforded an in-person VA examination for right-ear hearing loss in September 2017. The examiner reviewed the Veteran’s file and diagnosed the Veteran with sensorineural hearing loss of the right ear, with an average puretone threshold of 13 dB and a 100 percent speech discrimination score using the Maryland CNC word list. The examiner reasoned that the Veteran had normal hearing in 1976 when he left military service. The examiner explained that the Veteran’s hearing loss had no impact on his daily life or ability to work. The examiner opined that the Veteran’s hearing loss was less likely than not caused by military service. This is further evidence against a claim for service connection. The Veteran was afforded an in-person VA examination for right-ear hearing loss in May 2018. The examiner reviewed the Veteran’s file and diagnosed the Veteran with sensorineural hearing loss of the right ear, with a puretone threshold average of 16 dB and a 96 percent speech discrimination score using the Maryland CNC word list. The examiner reasoned that the Veteran had normal hearing in 1976 when he left military service. The examiner explained that the Veteran’s hearing loss had no impact on his daily life or ability to work. The examiner opined that the Veteran’s hearing loss was less likely than not caused by military service. This is further evidence against a claim for service connection. Private treatment records dated April 2015 and April 2016 document complaints of hearing loss. The Board acknowledges the Veteran’s December 2015 hearing testimony that his right ear hearing is “fairly normal” and that he was exposed to loud noise while working on the flight deck of an aircraft carrier. The September 2017 and May 2018 VA examiners have opined that the Veteran’s hearing loss is less likely than not related to active service. The March 2012 VA examiner opined that the Veteran’s non-compensable level of hearing loss at the time of the examination was related to active service. The Board finds the opinions of the September 2017 and May 2018 VA examiners most probative of the issue at hand, as the examiners had reviewed the file and provided rationales for their opinions. Regarding the Veteran’s statements, the Veteran is competent to report that he is experiencing right ear hearing loss. However, to the extent that the statements assert a nexus between the Veteran’s current right ear hearing loss and his in-service noise exposure, such statements are afforded little probative value, as the Veteran has not been shown to possess the expertise necessary to render a nexus opinion regarding the etiology of his right ear hearing loss disability. Furthermore, the Veteran’s statements that his right ear hearing loss disability is related to his in-service noise exposure are outweighed by the opinions of the September 2017 and May 2018 VA examiners, who concluded that the Veteran’s current right ear hearing loss disability is less likely than not related to active service. Regarding presumptive service connection, there is no competent evidence that the Veteran’s right ear hearing loss disability manifested to a compensable degree within one year of the Veteran’s discharge from service. See 38 C.F.R. §§ 3.307(a), 3.309(a). In fact, it was not until the 2018 VA audiological examination that the Veteran showed evidence of a current right ear hearing loss disability for VA purposes. As such, service connection is not warranted based on a presumptive basis. For all the reasons laid out above, the Board finds that the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for right ear hearing loss disability. Thus, as the preponderance of the evidence is against the claim, there is no reasonable doubt to be resolved, and the claim is denied. 38 U.S.C. § 5107(b). 2. Entitlement to service connection for COPD The Veteran claims that his current COPD is related to an injury he sustained while in service. As to a current disability, an April 2012 VA examination documents that the Veteran was diagnosed with COPD in 2010. Thus, the Veteran meets the first element of a claim for direct service connection. As to an in-service disease or injury, service treatment records document that the Veteran reported trouble breathing in June 1975 and received treatment for possible asthma in August 1975 after reporting a childhood history of asthma and shortness of breath for two to three months that was exacerbated by high humidity and heat. The Veteran’s hearing testimony shows that the Veteran smoked cigarettes from 1970 until 1983, throughout the duration of his time in service and beyond, and that he was exposed to paint fumes and asbestos during the remodeling of the ship he was stationed on in the Navy. Thus, the Board will concede that the Veteran meets the second element for direct service connection. Where the Veteran’s claim for service connection fails is the lack of evidence of a nexus between the current disability and service. For example, service treatment records show that the Veteran denied asthma, shortness-of-breath, and chronic cough at his June 1976 examination at separation from active service. Additionally, clinical evaluation of the Veteran’s lungs and chest were normal at separation. April 2009 private treatment records show that an April 2009 chest x-ray revealed increased interstitial markings throughout the right hemithorax, decreased perfusion at the left base, and several calcified granuloma. The examiner noted that the x-ray was slightly abnormal, and that previous pulmonary nodules, which were calcified and noncalcified, were noted on a chest CT scan in 2004 with restrictive changes in simple spirometry. The medical professional documented that he was unsure if these changes were physiologic or reflective of either undiagnosed interstitial lung disease or possibly even occupational asbestos-induced interstitial fibrosis. The Veteran was afforded a VA examination in April 2012. The examiner reviewed the Veteran’s file and service treatment records, and noted that the Veteran was diagnosed with COPD in 2010. The examiner documented that the Veteran’s condition did not impact his ability to work. The Veteran was afforded a pulmonary function test (PFT) and a chest x-ray in March 2012 in connection with this examination. The examiner documented that the results of both the PFT and the x-ray were normal. The Veteran’s then attorney (the Veteran is no longer represented by this attorney) asserted at the hearing that this exam was inadequate. The Board notes that the Veteran has been afforded a new examination since that time, which the Board finds adequate. May 2012 private treatment records show that the Veteran sought treatment for acute bronchitis and was prescribed antibiotics. The Veteran submitted a December 2012 statement indicating that he was assigned to the paint locker while stationed aboard the ship, where he was assigned to use spray paint including red lead primer and lead based paints. The Veteran stated that the ship was stripped of asbestos, old paint, and other hazardous materials while he was on board. The Veteran asserted that he quit smoking over 25 years before this statement and that the only explanation for his COPD is exposure to hazardous substances while aboard the ship. The Veteran submitted a statement in April 2013 asserting exposure to asbestos while serving aboard the ship USS Ranger in the shipyard in Long Beach, California, in 1975. The Veteran stated that the ship was remodeled while in the shipyard, that he was assigned to the ship during the remodeling process, that large amounts of asbestos were used in the construction of the ship, and that he was exposed to asbestos during this process. The Veteran further asserts that he was assigned to the paint locker on the ship for approximately one year, during which he used spray paint on a weekly basis and used a grinder to remove old paint from the ship, routinely applying red lead primer. He stated that he usually did not wear a mask unless he was spray painting, and that he used other chemicals to help keep the ship clean. The Veteran also stated that he smoked one pack of cigarettes per day from 1970 until approximately 1983 and has not smoked since that time. The Veteran also stated that he was employed as a plumber after discharge from the Navy. The Veteran was afforded a VA examination in July 2013. The examiner reviewed the Veteran’s file and service treatment records, and noted that the Veteran was diagnosed with COPD in 2010. The examiner explained that the Veteran’s service treatment records did not show evidence of respiratory problems or COPD. The examiner opined that the Veteran’s COPD is less likely than not incurred in or caused by military service because the Veteran’s service treatment records do not show evidence of respiratory complaints, treatment, or diagnosis of COPD, and there is insufficient evidence to establish a relationship between the Veteran’s COPD and any event during service. This is evidence against a finding of service connection. The Veteran was also afforded a PFT and a chest x-ray in July 2013. The medical professional documented that the results of both the PFT and the x-ray were normal. At a December 2015 hearing, the Veteran testified that he was assigned to the paint locker on a Navy ship for one year, during which he was exposed to paint fumes and other respiratory irritants, along with asbestos as the ship was remodeled. At the December 2015 hearing, the Veteran’s then attorney asserted that the April 2012 VA examination was inadequate because it did not consider whether the Veteran’s exposure to chemicals and substances, to include asbestos, could have caused the onset of COPD at a later date. The Board notes that the Veteran has been provided with two other VA examinations since this date that have addressed whether the Veteran’s current COPD had its onset after service as a result of exposure to chemicals or substances, to include lead based paint and asbestos, during service. The Veteran was afforded an in-person VA examination in September 2017. The examiner reviewed the Veteran’s file. The examiner opined that the Veteran has never been diagnosed with and does not have clinical or radiographic evidence of asbestosis or any other lung disease incurred in or caused by an event, injury, or circumstances during his military service, including exposure to paint fumes including red lead-based paint primer and/or environmental dust. The examiner acknowledged the Veteran’s assertion that his current lung condition is due to working in a paint locker for one year while in the Navy and possible asbestos exposure during an August to October 1973 remodeling of the ship he was stationed on, but pointed out that there is no mention of any respiratory injury related to paint fumes or environmental dust in the Veteran’s service treatment records. The examiner explained that the Veteran was diagnosed with COPD around 2010, which was many years after service. The examiner documented that the greatest and overwhelming risk factor for developing COPD is cigarette smoking, and that the Veteran’s current COPD condition was diagnosed in 2010 is clearly and unambiguously attributed to his years of tobacco smoking history and history of childhood asthma. The examiner opined that whereas the Veteran’s two-to-three months of shortness of breath during service in August 1975 may represent an exacerbation of his asthma that clearly and unambiguously existed prior to service, it did not represent a worsening of his condition beyond the natural progression of the condition. The examiner explained that while the Veteran reports that he was exposed to paint fumes and environmental dust (which the Veteran claims was asbestos), there is no evidence in the service treatment records or any private medical records of any pulmonary condition related to exposure to paint fumes and/or environmental dust. The examiner stated that a singular calcified granuloma noted on an April 2009 CT scan is not indicative of past asbestos exposure and is not evidence of asbestosis, as it is an incidental finding of little to no clinical significance. Finally, the examiner explained that there is insufficient evidence to establish a nexus for either direct service connection for COPD or aggravation beyond the natural progression of the Veteran’s asthma in this case. This is further evidence against a claim for service connection for COPD. The Veteran was afforded an in-person VA examination in May 2018. The examiner reviewed the Veteran’s file and noted that the Veteran had been diagnosed with COPD, worked in a paint locker while in the Navy and has a history of possible asbestos exposure. The examiner further noted that an April 2009 CT scan showed a small calcified granuloma in the right lower lobe of the lung that was unremarkable. Radiology films were also interpreted for this exam, and the examiner remarked that they showed no evidence of pulmonary asbestosis, showing only mild chronic obstructive pulmonary disease and no other significant thoracic pathology. The examiner reasoned that tobacco smoking is the most important risk factor for COPD, and that the Veteran was not diagnosed with COPD until 2009, which is over 30 years after he was treated for a cough during service. The examiner noted that he was unable to locate a chest x-ray that was taken in April 2009, but that a CT scan from April 2009 showed only a single calcified granuloma in the right lung. The examiner explained that a calcified granuloma is an incidental finding and is associated with a past infection or inflammation of the lung and is less likely caused by exposure to toxic substances such as paint. Finally, the examiner stated that the Veteran’s medical records do not show a diagnosis of either interstitial lung disease or asbestosis. The examiner opined that the Veteran’s COPD is less likely than not related to military service, to include asbestos exposure and/or toxic paint material and fumes because the Veteran has a significant history of smoking one pack of cigarettes per day for over 30 years, which is the more likely cause of the Veteran’s COPD. This is additional evidence against a relationship between the Veteran’s COPD and service. Multiple medical professionals have determined that the Veteran’s current COPD is not related to the Veteran’s shortness of breath during service or his exposure to paint fumes, chemicals, or dust that the Veteran asserts was asbestos. The Board notes that the only evidence that the Veteran was exposed to asbestos during service is the Veteran’s lay statements, and the Veteran is not competent to state that the dust he was exposed to during the remodeling of the ship was asbestos. Even if the Board were to concede that the Veteran was exposed to asbestos during active service, multiple VA examiners have concluded that the Veteran has not been diagnosed with asbestosis, and that his current COPD is more likely than not related to cigarette smoking rather than exposure to any substance or chemical during service to include asbestos or lead based paint. Notably, the only evidence that the Veteran’s current COPD is related to his in-service exposure to dust and chemicals are lay statements. To the extent that the Veteran’s statements assert a nexus between the Veteran’s current COPD and his in-service injury or exposure to dust and chemicals, such statements are afforded little probative value, as the Veteran has not been shown to possess the expertise necessary to render a nexus opinion regarding the etiology of his COPD. Furthermore, the Veteran’s statements that his COPD is related to his in-service exposure to dust and chemicals are outweighed by multiple opinions by VA medical professionals, who concluded that the Veteran’s current COPD is less likely than not related to active service. For all the reasons laid out above, the Board finds that the preponderance of the evidence is against the Veteran’s claim of entitlement to service connection for COPD. Thus, as the preponderance of the evidence is against the claim, there is no reasonable doubt to be resolved, and the claim is denied. 38 U.S.C. § 5107(b). Increased Rating – Generally Disability evaluations are determined by evaluating the extent to which a veteran’s service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities. 38 C.F.R. Part 4. The percentage ratings represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and the residual conditions in civilian occupations. Generally, the degree of disabilities specified are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities and the criteria for specific ratings. If two disability evaluations are potentially applicable, the higher evaluation will be assigned to the disability picture that more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. However, the evaluation of the same disability under various diagnoses, known as pyramiding, is prohibited. 38 C.F.R. § 4.14. Whether the issue is one of an initial rating or an increased rating, separate ratings can be assigned for separate periods of time based on the facts found, a practice known as “staged” ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007). With respect to the Veteran’s increased rating claim on appeal, the Board has considered the relevant temporal period, including one year prior to his increased rating claim, as well as whether any additional staged rating periods are warranted. A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. See 38 U.S.C. § 5107. When the evidence supports the claim or is in relative equipoise, the claim will be granted. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). If the preponderance of the evidence weighs against the claim, it must be denied. Id. 3. Entitlement to a compensable rating for left ear hearing loss Ratings of hearing loss range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of speech discrimination tests combined with the average hearing threshold levels as measured by puretone audiometry tests in the frequencies 1000, 2000, 3000, and 4000 cycles per second. To rate the degree of disability for service-connected hearing loss, the Rating Schedule has established eleven auditory acuity levels, designated from level I, for essentially normal acuity, through level XI, for profound deafness. 38 C.F.R. § 4.85(h), Table VI. In order to establish entitlement to a compensable rating for hearing loss, it must be shown that certain minimum levels of the combination of the percentage of speech discrimination loss and average puretone decibel loss are met. The assignment of disability ratings for hearing impairment is derived by a mechanical application of the Rating Schedule to the numeric designations assigned after audiometric evaluations are rendered. Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). The criteria for rating hearing impairment use controlled speech discrimination tests (Maryland CNC) together with the results of puretone audiometry tests. These results are then charted on Table VI, Table VIA, in exceptional cases as described in 38 C.F.R. § 4.86, and Table VII, as set out in the Rating Schedule. 38 C.F.R.§ 4.85. When defective hearing is service connected in only one ear, in order to determine the percentage rating from Table VII, the non-service-connected ear will be assigned a Level I designation, pursuant to the provisions of 38 C.F.R. § 4.85. An exceptional pattern of hearing loss occurs when the puretone threshold at 1000, 2000, 3000, and 4000 Hertz is 55 decibels or more, or when the puretone threshold is 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. 38 C.F.R. § 4.86 At a December 2015 hearing, the Veteran asserted that his left ear hearing loss had become worse since his last VA examination. The Board notes that the Veteran has been afforded new VA examinations, in September 2017 and May 2018, since this testimony was given. The Veteran was afforded an in-person VA examination for left-ear hearing loss in March 2012. The examiner reviewed the Veteran’s file and diagnosed the Veteran with sensorineural hearing loss of the left ear, with a 96 percent speech discrimination score using the Maryland CNC word list and a puretone threshold average of 30 for the 1000 to 4000 hertz range. The examiner documented that the test results were valid for rating purposes. The examiner opined that the Veteran’s hearing loss was at least as likely as not caused by or a result of an event in military service. The examiner reasoned that the Veteran claimed to be exposed to noise from jet engines and noise is known to cause hearing loss. The examiner documented that the Veteran’s hearing loss impacted his ability to work, and makes it difficult to hear normal conversation, especially when background noise is present. As shown in the tables above, a May 2012 private audiological examination shows a puretone threshold average of 28 dB in the left ear, which shows a non-compensable level of hearing loss in the Veteran’s left ear. The Veteran submitted a December 2012 statement explaining that he was exposed to loud noise while stationed on a ship and assigned to work on the flight deck. The Veteran stated that he was told that he had significant hearing loss in his left ear when he was given a physical exam prior to discharge from service. The Veteran also stated that his hearing loss from the Navy has made it very difficult for him to hear normally and that he has ringing in his ears almost constantly. As an aside, the Board notes that the Veteran has received entitlement to service connection for tinnitus with a 10 percent rating. The Veteran submitted a statement in April 2013 explaining that he was assigned to a man-overboard watch during service that required him to wear a sound powered phone and no ear protection. The Veteran stated that assignment required him to stand about 25 feet from the flight deck and exposed him to extremely loud noise from jet engines. The Veteran stated that he was diagnosed with considerable hearing loss in his left ear prior to service discharge, and that he has worn hearing protection around loud noise since separation from service. The Veteran was afforded an in-person VA examination for left-ear hearing loss in September 2017. The examiner reviewed the Veteran’s file and diagnosed the Veteran with sensorineural hearing loss of the left ear, with a 100 percent speech discrimination score using the Maryland CNC word list and a puretone threshold average of 18 for the 1000 to 4000 hertz range. The examiner explained that the Veteran’s hearing loss had no impact on his ability to work. The Veteran was afforded an in-person VA examination for left-ear hearing loss in May 2018. The examiner reviewed the Veteran’s file and diagnosed the Veteran with sensorineural hearing loss of the left ear, with a 96 percent speech discrimination score using the Maryland CNC word list and puretone threshold average of 23 for the 1000 to 4000 hertz range. The examiner explained that the Veteran’s hearing loss had no impact on his ability to work. Private treatment records dated April 2015 and April 2016 document complaints of hearing loss. During the appeal period, the Veteran’s sensorineural hearing loss has been productive of a puretone threshold average of 30 dB in the left ear and speech recognition ability of 96 percent in the left ear, at worst. The Board has considered the Veteran’s statements and complaints, as well his statements made during his hearing and those of his attorney; however, the Board has determined that the evidence which shows the Veteran’s speech discrimination findings using the Maryland CNC test and puretone threshold findings is the most probative evidence in evaluating the Veteran’s left ear hearing loss disability. As noted above, Table VI in 38 C.F.R. § 4.85 combines the puretone average and the speech recognition scores to produce a numeric designation for each ear, which is inserted into Table VII in 38 C.F.R. § 4.85 to determine the correct disability level. Because the Veteran’s left ear had a puretone average of 30 dB and a speech discrimination score of 96 percent, and no worse, at any period on appeal, the Veteran’s left ear hearing loss receives a designation of I. The intersection of designations I and I on Table VII establishes that the Veteran’s hearing loss disability is entitled to a noncompensable rating for all periods on appeal. See 38 C.F.R. § 4.85, DC 6100. After applying the formula located in 38 C.F.R. § 4.85, DC 6100 for the March 2012, September 2017, and May 2018 VA audiological examinations, the Board concludes that the Veteran’s left ear hearing loss disability did not warrant a rating in excess of zero percent at any time during the appeal. The preponderance of the evidence, including the VA examination reports, is against a compensable disability rating for left ear sensorineural hearing loss for the entire period on appeal. The impairment associated with the Veteran’s disability is contemplated by the rating criteria, which consider the average impairment resulting from a service-connected disability. See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Absent audiometric and speech discrimination scores showing that the Veteran’s bilateral ear hearing loss disability meets the schedular criteria in excess of the disability rating already assigned, his hearing loss does not warrant a higher rating. See 38 C.F.R. § 4.85. As the preponderance of the evidence is against the Veteran’s claim, the benefit-of-the-doubt rule does not apply, and the claim is denied. See 38 U.S.C. § 5107. A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Caruso, Associate Counsel