Citation Nr: 18159231 Decision Date: 12/18/18 Archive Date: 12/18/18 DOCKET NO. 16-55 478 DATE: December 18, 2018 ORDER A rating higher than 0 percent (noncompensable) for service-connected bilateral hearing loss is denied. FINDING OF FACT The Veteran’s right ear hearing loss is manifested by a puretone threshold average of 28 decibels in the right ear and a speech discrimination score of 86 percent; his left ear hearing loss is manifested by a puretone threshold average of 48 decibels and a speech discrimination score of 94 percent. CONCLUSION OF LAW The criteria for a rating higher than 0 percent (noncompensable) for service-connected bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 3.102, 3.321, 4.3, 4.85, Diagnostic Code 6100 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1972 to August 1974. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). Increased Rating VA has adopted a Schedule for Rating Disabilities to evaluate service-connected disabilities. 38 U.S.C. § 1155; 38 C.F.R. § 3.321; see generally, 38 C.F.R. § Part IV. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life, including employment. 38 C.F.R. § 4.10 (2017). The percentage ratings in the Schedule for Rating Disabilities represent, as far as practicably can be determined, the average impairment in earning capacity resulting from service-connected disabilities in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1 (2017). Generally, the degrees of disability 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 C.F.R. § 4.1. Diagnostic codes in the rating schedule identify the various disabilities and the criteria for specific ratings. If two disability evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. 38 C.F.R. § 4.7 (2017). Otherwise, the lower rating will be assigned. Id. All reasonable doubt regarding the degree of disability will be resolved in favor of the claimant. 38 C.F.R. § 4.3; see 38 C.F.R. § 3.102. Because the level of disability may have varied over the course of the claim, the rating may be “staged” higher or lower for segments of time during the period under review in accordance with such variations, to the extent the evidence supports a given evaluation under the applicable rating criteria. Hart v. Mansfield, 21 Vet. App. 505, 509-10 (2007); Fenderson v. West, 12 Vet. App. 119, 126 (1999). 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. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. When the evidence supports the claim, or is in relative equipoise, the claim will be granted. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). If the preponderance of the evidence weighs against the claim, it must be denied. Id.; Alemany v. Brown, 9 Vet. App. 518, 519 (1996). Hearing Loss For the reasons that follow, the Board finds that the criteria for a higher evaluation for the Veteran’s service-connected bilateral hearing loss disability are not satisfied. A. Rating Criteria Hearing loss is evaluated under 38 C.F.R. § 4.85, Diagnostic Code (DC) 6100. In evaluating hearing loss, disability ratings are derived from a mechanical application of the rating schedule to the numeric designations assigned after audiometric evaluations are performed. See Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). Hearing loss disability evaluations range from noncompensable to 100 percent based on organic impairment of hearing acuity, as measured by controlled speech discrimination tests using the Maryland CNC word list, in conjunction with the average hearing threshold, measured by puretone audiometric tests in the frequencies 1,000, 2,000, 3,000 and 4,000 cycles per second. 38 C.F.R. § 4.85, DC 6100. The rating schedule establishes eleven auditory acuity levels designated from Level I, for essentially normal hearing acuity, through Level XI for profound deafness. See id. VA audiometric examinations are generally conducted using a controlled speech discrimination test together with the results of a puretone audiometry test. Id. Table VI in 38 C.F.R. § 4.85 is then used to determine the numeric designation of hearing impairment based on the puretone threshold average derived from the audiometry test, and from the results of the speech discrimination test. The horizontal rows in Table VI represent nine categories of the percentage of discrimination based on the controlled speech discrimination test. See id. The vertical columns in Table VI represent nine categories of decibel loss based on the puretone audiometry test. Id. The numeric designation of impaired hearing (Levels I through XI) is determined for each ear by intersecting the horizontal row corresponding to the percentage of discrimination and the vertical column corresponding to the puretone decibel loss. Id. The percentage evaluation is derived from Table VII in 38 C.F.R. § 4.85 by intersecting the vertical column corresponding to the numeric designation for the ear having the better hearing acuity (as determined by Table VI) and the horizontal row corresponding to the numeric designation level for the ear having the poorer hearing acuity (as determined by Table VI). For example, if the better ear has a numeric designation Level of “V” and the poorer ear has a numeric designation Level of “VII,” the percentage evaluation is 30 percent. See id. There are alternative criteria for certain exceptional patterns of hearing loss. Specifically, if puretone thresholds in each of the specified frequencies of 1000, 2000, 3000, and 4000 Hertz are 55 decibels or more, an evaluation will be based either on Table VI or Table VIa in 38 C.F.R. § 4.85, whichever results in a higher evaluation. 38 C.F.R. § 4.86(a) (2017). Each ear will be evaluated separately. Id. When the puretone threshold is 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz, the Roman numeral designation for hearing impairment will be chosen from either Table VI or Table VIa under 38 C.F.R. § 4.85, whichever results in the higher Roman numeral, and that numeral will then be elevated to the next higher numeral. 38 C.F.R. § 4.86(b).   B. Analysis The June 2016 VA examination report shows that on audiometric and speech discrimination testing the Veteran’s right ear hearing had a puretone threshold average of 28 decibels, and a speech discrimination score of 86 percent. His left ear hearing had a puretone threshold average of 48 decibels and a speech discrimination score of 94 percent. Applying these values to Table VI yields a numeric designation of II for the right ear and I for the left ear. The point where designations I and II intersect on Table VII yields a 0 percent rating. Turning to the alternative criteria for exceptional patterns of hearing loss, the June 2016 VA examination report shows that the Veteran’s puretone thresholds were not 55dB or higher at each of the relevant frequencies, and that he did not have a puretone threshold of 70dB or higher at 2000 Hertz. Accordingly, the Veteran’s hearing impairment does not fit the patterns warranting application of the alternative rating criteria. See 38 C.F.R. § 4.86. In sum, the criteria for a rating higher than 0 percent for bilateral hearing loss are not satisfied. In his substantive appeal (October 2016 VA Form 9), the Veteran stated that it was almost impossible for him to talk on the phone, or to his wife directly. He stated that any job he could get would involve the telephone. At the June 2016 VA examination, the Veteran stated that his hearing loss made his daily activities very hard, including business activities, and mentioned hearing the phone ring and having conversations on the phone as examples. The Board is sympathetic, and does not doubt that the Veteran’s hearing loss causes significant challenges, as he describes. The rating assigned hearing loss turns on puretone and speech discrimination testing results, which determine the evaluation. As shown above, the Veteran’s hearing loss does not satisfy the criteria for a higher, compensable evaluation. Regarding the Veteran’s difficulty hearing conversations, especially over the telephone, when a claimant’s hearing loss results in an inability to hear or understand speech or to hear other sounds in various contexts, those effects are contemplated by the schedular rating criteria. Doucette v. Shulkin, 28 Vet. App. 366, 369 (2017). The Veteran’s difficulty hearing and understanding speech is not shown to be more severe than what is contemplated by the rating criteria. Accordingly, his hearing loss does not constitute an exceptional or unusual disability picture. Thus, the Board will not refer the claim for extraschedular consideration. See 38 C.F.R. § 3.321(b); Thun, 22 Vet. App. at 116; Chudy v. O’Rourke, 30 Vet. App. 34, 37-38 (2018). Because the preponderance of the evidence weighs against the claim, a higher rating for the Veteran’s hearing loss must be denied. See 38 U.S.C. 5107; 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 55. P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Rutkin, Counsel