Citation Nr: 19123782 Decision Date: 03/29/19 Archive Date: 03/29/19 DOCKET NO. 17-49 315 DATE: March 29, 2019 ORDER A rating in excess of 30 percent for bilateral hearing loss is denied. FINDING OF FACT The Veteran’s hearing loss has been manifested by no worse than Level VI hearing impairment bilaterally. CONCLUSION OF LAW The criteria for a rating in excess of 30 percent for bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.85, 4.86a, Diagnostic Code 6100. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1966 to May 1968. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2016 rating decision by the Department of Veterans Affairs (VA). The Veteran was granted a 30 percent rating in the July 2016 rating decision as of March 1, 2016. However, in recognition of a previous informal claim, he was later granted a 30 percent rating as of February 10, 2016, in a September 2016 rating decision. Increased Rating Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. See 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. While the Board typically considers only those factors contained wholly in the rating criteria, it is appropriate to consider factors outside the specific rating criteria when appropriate in order to best determine the level of occupational and social impairment. Where there is a question as to which of two separate evaluations shall be applied, the higher evaluation will be assigned if the disability more closely approximates the criteria required for that particular rating. 38 C.F.R. § 4.7. When a reasonable doubt arises regarding the degree of disability, such doubt will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. 1. Entitlement to a rating in excess of 30 percent for bilateral hearing loss The Veteran is seeking a rating in excess of 30 percent for his bilateral hearing loss. He states that his hearing loss affects his comfort and mode of living. Even though he has hearing aids, there are times when they do not help him. He further states that his hearing disability coupled with his speaking disability is a true hardship and handicap. Ratings for hearing loss, which range from noncompensable to 100 percent, are based on an organic impairment of hearing acuity as demonstrated by the results of speech discrimination tests together with the average hearing threshold levels as measured by pure tone audiometry tests in the frequencies of 1,000, 2,000, 3,000, and 4,000 Hertz (Hz). The degree of disability from service-connected hearing loss is rated based on 11 auditory acuity levels with Level I, representing essentially normal acuity, through Level XI, representing profound deafness. See 38 C.F.R. § 4.85. An alternative rating method may be used when the pure tone threshold at each of the four specified frequencies (1,000, 2,000, 3,000, and 4,000 Hertz) is 55 decibels or more, or when the pure tone threshold is 30 decibels or less at 1,000 Hz and 70 decibels or more at 2,000 Hz. 38 C.F.R. § 4.86. VA will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa based on whichever results in the higher numeral. Id. In hearing loss rating cases, an examination for VA purposes must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test (Maryland CNC) and a pure tone audiometry test. Examinations are conducted without the use of hearing aids. 38 C.F.R. § 4.85(a). The Board determines that a rating in excess of 30 percent is not warranted for the Veteran’s bilateral hearing loss. On the authorized audiological evaluation in April 2016, pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Avg. RIGHT 30 85 95 90 75 LEFT 35 80 85 80 70 The use of the word recognition score was found to not be appropriate for the Veteran because of language difficulties, cognitive problems, inconsistent word recognition scores, etc., that made combined use of puretone average and word recognition scores inappropriate. As a result of the lack of word recognition scores, the Board must utilize Table VIa. See 38 C.F.R. 4.85(c). When utilizing Table VIa, the Veteran exhibits Level VI hearing impairment bilaterally. After applying these results to Table VII, a 30 percent rating is for application. The Veteran underwent an additional authorized audiological evaluation in August 2017. His pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Avg. RIGHT 25 90 90 85 73 LEFT 35 85 85 80 71 Like before, the use of the word recognition score was found to not be appropriate for the Veteran because of language difficulties, cognitive problems, inconsistent word recognition scores, etc., that made combined use of puretone average and word recognition scores inappropriate. Specifically, the Veteran suffers from severe apraxia. As a result of the lack of word recognition scores, the Board must utilize Table VIa. See 38 C.F.R. 4.85(c). When utilizing Table VIa, the Veteran exhibits Level VI hearing impairment bilaterally. After applying these results to Table VII, a 30 percent rating is for application. Therefore, a rating in excess of 30 percent is not warranted for the Veteran’s bilateral hearing loss disability. In considering the appropriate disability rating, the Board has also considered the Veteran’s statements that his disability is worse than the rating he currently receives. In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). In this case, the Veteran has credibly asserted that his hearing loss causes hardship and handicap to his everyday life. However, the severity of the Veteran’s hearing loss is greatly compounded by his severe apraxia. It is the combination of these two disabilities rather than the Veteran’s hearing loss alone that causes his difficulties. Unfortunately, because the Veteran’s apraxia is not a service-connected disability, the Board is unable to take it into consideration. Competency of evidence differs from weight and credibility. While the Veteran is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, he is not competent to identify a specific level of disability according to the appropriate diagnostic codes. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) (“although interest may affect the credibility of testimony, it does not affect competency to testify”).   On the other hand, such competent evidence concerning the nature and extent of the Veteran’s disability has been provided by the medical personnel who have examined him during the current appeal and who have rendered pertinent opinions in conjunction with the evaluations. The medical findings (as provided in the examination reports) directly address the criteria under which the disability is evaluated. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Borman, Associate Counsel