Citation Nr: 19178167 Decision Date: 10/10/19 Archive Date: 10/10/19 DOCKET NO. 15-01 121 DATE: October 10, 2019 ORDER Entitlement to a compensable rating for a bilateral hearing loss disability is denied. REMANDED Entitlement to service connection for an acquired psychiatric condition, to include posttraumatic stress disorder (PTSD) and depression is remanded. FINDING OF FACT Veteran’s bilateral hearing has been manifested by hearing acuity of no worse than Level III in the right ear and no worse than Level III in the left ear. CONCLUSION OF LAW The criteria for a compensable rating for bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran service on active duty from January 1969 to December 1972. The Veteran testified before the undersigned in a videoconference hearing in January 2018. A copy of the hearing transcript has been associated with the record. These claims were previously before the Board in May 2018, at which time they were remanded for further development. Entitlement to a compensable rating for bilateral hearing loss. The Veteran contends that he is entitled to a compensable rating because his hearing has worsened since his last VA examination. Evaluations of defective hearing range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of a controlled Maryland CNC speech discrimination test together with the average hearing threshold level measured by pure tone audiometry tests in the frequencies of 1000, 2000, 3000, and 4000 cycles per second (Hertz). 38 C.F.R. § 4.85, Diagnostic Code 6100. To evaluate the degree of disability from bilateral service-connected hearing loss, the schedule establishes 11 auditory hearing acuity levels designated from Level I for essentially normal hearing acuity through Level XI for profound deafness. 38 C.F.R. § 4.85, Tables VI and VII. An exceptional pattern of hearing impairment occurs when the pure tone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more. 38 C.F.R. § 4.86(a). In that situation, 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. Further, when the average pure tone 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 for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral, and that numeral will then be elevated to the next higher numeral. 38 C.F.R. § 4.86(b). During the appeal period, the Veteran has been administered two VA audiological examinations. At a January 2014 VA examination, the Veteran reported increasing difficulty communicating with clients at work and family at home. The Veteran’s Maryland CNC Word List speech recognition score and pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Avg CNC RIGHT 20 60 60 60 50 94 LEFT 25 55 60 70 52.5 94 Applying the results to Table VI, the findings yield a numeric designation of Level I in the right ear and Level I in the left ear. Entering the resulting bilateral numeric designation of Level I for the right ear and Level I for the left ear to 38 C.F.R. § 4.85, Table VII, equates to a non-compensable disability rating under Diagnostic Code 6100. An exceptional pattern of hearing impairment under 38 C.F.R. § 4.86 was not shown. At his January 2018 hearing before the Board, the Veteran asserted his hearing loss worsened in severity since his January 2014 VA examination. The Board remanded the appeal so that his hearing acuity could be re-tested. A March 2019 VA examination reveals that the Veteran reported difficulty understanding speech in quiet, noise, on the telephone, and on the television. The Veteran’s Maryland CNC Word List speech recognition score and pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Avg CNC RIGHT 35 60 60 75 57.5 86 LEFT 35 60 65 75 58.75 84 Applying the results to Table VI, the findings yield a numeric designation of Level III in the right ear and Level III in the left ear. Entering the resulting bilateral numeric designation of Level III for the right ear and Level III for the left ear to 38 C.F.R. § 4.85, Table VII, equates to a non-compensable disability rating under Diagnostic Code 6100. An exceptional pattern of hearing impairment under 38 C.F.R. § 4.86 was not shown. Based on the evidence above, while a decrease in hearing acuity between the two examinations is shown by comparison, the Veteran’s hearing loss disability has not worsened to a degree warranting a compensable rating. The Board the Veteran’s report of having difficulty understanding speech in quiet, noise, on the telephone, and on the television. The Veteran is competent to report difficulty with his hearing, and the Board in no way calls these observations into question. That stated, disability ratings for hearing loss are derived from a mechanical application of the rating schedule to the numeric designations resulting from audiometric testing. See Lendenmann v. Principi, 3 Vet. App. 345 (1992). In other words, although the Veteran’s hearing tests show diminished hearing acuity, these results do not show hearing loss to a level of severity warranting a compensable disability rating under the rating criteria. The rating criteria contemplate speech reception thresholds and ability to hear spoken words on Maryland CNC testing. The functional impact that the Veteran describes, is contemplated by the rating criteria. Doucette v. Shulkin, 28 Vet. App. 366 (2017). Accordingly, the preponderance of the evidence is against the claim of entitlement to a compensable rating for hearing loss. In reaching the conclusion above, the Board considered the doctrine of reasonable doubt, however, as the preponderance of the evidence is against the Veteran’s claim, the doctrine is not for application. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND Entitlement to service connection for an acquired psychiatric condition, to include PTSD and depression is remanded. In its May 2018 decision, the Board directed the agency of original jurisdiction (AOJ) to schedule the Veteran for a VA psychiatric examination to determine whether any current or previously diagnosed psychiatric disorder was related to his military service. The Board asked the examiner to clarify the diagnosis or diagnoses of the Veteran’s claimed psychiatric conditions and noted that the Veteran had previously been diagnosed with schizoaffective disorder, alcohol abuse and PTSD by Dr. J.S., a private practitioner, and major depressive disorder by VA treatment providers. The Board requested that the examiner attempt to reconcile prior and current findings to the extent possible. The Veteran underwent VA examination in February 2019, at which time he was diagnosed with an unspecified personality disorder and mild alcohol use disorder. The examiner opined that the diagnosed disorders were less likely than not related to his military service. While the examiner addressed mental health records contained in the Veteran’s VA treatment records, he failed to address or attempt to reconcile the diagnoses set forth in the September 2014 private medical report by Dr. J.S. The examiner also indicated that no identifiable qualifying stressors were endorsed by the Veteran, without further explanation. The Veteran noted in subsequent correspondence that he felt he was not able to explain to the examiner fully his claimed in-service stressors. Thus, the Bard finds that an addendum opinion is necessary prior to adjudication. The matters are REMANDED for the following action: 1. Obtain any records of VA care for hearing loss or a psychiatric disability not currently on file and associate them with the record. 2. Schedule the Veteran for a VA psychiatric examination. All studies, tests, and evaluations deemed necessary by the examiner must be performed. The examiner should take a history from the Veteran as to the nature of his claimed stressors, and the progression of his disability. Upon review of the file, and interview and examination of the Veteran, the examiner should respond to each of the following: (A) Clarify the diagnosis or diagnoses of the Veteran’s claimed psychiatric conditions. In providing a response, please note that the Veteran has previously been diagnosed with schizoaffective disorder, alcohol abuse, and PTSD by Dr. J.S., and major depressive disorder by VA treatment providers. If current diagnoses conflict with prior diagnoses, or do not include prior diagnoses, the examiner should attempt to reconcile prior and current findings to the extent possible. (B) Specifically, if PTSD is diagnosed, please discuss the stressor or stressors upon which the diagnosis is based. (C) For any acquired psychiatric disorder other than PTSD, please discuss whether it is at least as likely as not (i.e., a 50 percent probability or greater) that the disorder had onset in or is otherwise related to the Veteran’s period of service. In responding to the questions above, the examiner should consider (1) the Veteran’s prior medical history (to include during service and after); (2) the Veteran’s contentions that his disability is due to stress from being denied a transfer to serve with his brother during service, and/or from being falsely accused and investigated for bagging and destroying top secret messages during service; and (3) lay statements from the Veteran’s ex-wife and a friend indicating their observation of a change in the Veteran following service in Guam. 3. Then, readjudicate the appeal. If the appeal remains denied, send the Veteran and his representative a supplemental statement of the case. V. Chiappetta Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Bristow Williams, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.