Citation Nr: 19123723 Decision Date: 04/02/19 Archive Date: 03/29/19 DOCKET NO. 17-52 452 DATE: April 2, 2019 ORDER An increased, compensable disability rating for bilateral hearing loss is denied. FINDING OF FACT Throughout the appeal period, the Veteran’s bilateral hearing loss was manifested by hearing impairment no worse than III in the right ear and II in the left ear. CONCLUSION OF LAW The criteria for an increased, compensable disability rating for bilateral hearing loss have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.321, 4.1, 4.2, 4.6, 4.7, 4.27, 4.85, 4.86, Diagnostic Code (DC) 6100 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1975 to August 1997, which included service during the Vietnam Era. 1. The issue of entitlement to an increased, compensable disability rating for bilateral hearing loss. Laws and Regulations Hearing loss is evaluated through the mechanical application of a veteran’s audiometric test results to the rating tables set forth in the Rating Schedule. Doucette v. Shulkin, 28 Vet. App. 366, 367 (2017). The audiometric testing must be conducted by a state-licensed audiologist and must include a puretone audiometry test as well as a controlled speech discrimination test (Maryland CNC), without the use of hearing aids, for VA compensation purposes. 38 C.F.R. § 4.85(a). The Rating Schedule utilizes three tables to evaluate hearing impairment; Tables VI, VIA, and VII. Table VII is used to determine the percentage evaluation by combining Roman numeral designations for the level of hearing impairment in each ear. These Roman numeral designations are obtained from Tables VI or VIA. Table VI is based on a combination of puretone threshold average and speech discrimination percentage. The Roman numerals range from I to XI. A higher Roman numeral is assigned based on a combination of a higher puretone threshold average and a lower speech discrimination percentage. If the use of speech discrimination is not appropriate, then Table VIA is the appropriate source of the Roman numeral designation, which is based solely on puretone threshold average. 38 C.F.R. § 4.85(c). Puretone threshold average is the average of the puretone thresholds at the 1000, 2000, 3000, and 4000 Hertz (Hz) frequencies. 38 C.F.R. § 4.85(d). Table VIA may also be used for “exceptional patterns of hearing impairment,” where the puretone thresholds at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hz) are 55 decibels (dB) or more, or where the puretone thresholds are 30 dB or less at 1000 Hz and 70 dB or more at 2000 Hz. 38 C.F.R. § 4.86. Analysis The Veteran contends that he is entitled to an increased, compensable disability rating for his bilateral hearing loss. See October 2015 Notice of Disagreement. More specifically, he asserts that he has lost 50 percent of his ability to hear. He now requires a hearing aid for day to day activities, which impacts his quality of life. As in this instance, where an increase in the rating assigned is at issue, the primary concern is the Veteran’s present level of disability. Francisco v. Brown, 7 Vet. App. 55 (1994). In such cases, if factually ascertainable, the effective date assigned may be up to one year prior to the date the application for increase was received. 38 U.S.C. § 5110 (2012). As such, the relevant timeframe for consideration is from June 2, 2014 to the present. See May 2015 Application for Disability Compensation and Related Compensation Benefits (the Veteran initiated a claim for an increased disability rating for bilateral hearing loss, which was received by the VA on June 2, 2015). In assessing the evidence of record, the Board recognizes the Veteran is competent to provide evidence regarding the lay observable symptoms of his hearing impairment. See Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007). However, as an audiometric testing conducted by a state-licensed audiologist is required to evaluate the severity of his hearing impairment for VA compensation purposes and there is no evidence of record establishing that he is a state-licensed audiologist, he is not competent to provide evidence regarding the severity of his hearing loss in terms of puretone thresholds and speech discrimination percentage, the Board must rely on the medical evidence of record. Id. In furtherance, of this claim the Veteran has undergone two VA examinations; first in August 2015, then in November 2017. During the August 2015 examination, he relayed having difficulty understanding normal speech even when it was quiet, and it was impossible with loud noise. Audiometric testing at the time yielded the following results: HERTZ 1000 2000 3000 4000 Average RIGHT 20 dB 45 dB 55 dB 70 dB 48 dB LEFT 25 dB 35 dB 55 dB 65 dB 45 dB The speech recognition score was 80 percent in the right ear and 84 percent in the left ear. The examination did not reveal any exceptional patterns of hearing impairment as defined in 38 C.F.R. § 4.86, or that the speech discrimination test was not appropriate for consideration. Therefore, Table VIA is inapplicable. Utilizing Table VI, the combination of the 48 dB puretone threshold average and the 80 percent speech discrimination for the right ear results in the designation of a Roman numeral III. The combination of the 45 dB puretone threshold average and the 84 percent speech discrimination for the left ear results in the designation of a Roman numeral II. When the Roman numerals II and III are applied to Table VII, the resulting percentage evaluation is zero percent. During the November 2017 examination, the Veteran stated that it was difficult to follow conversations. Audiometric testing at the time produced the following results: HERTZ 1000 2000 3000 4000 Average RIGHT 20 dB 40 dB 50 dB 65 dB 44 dB LEFT 20 dB 45 dB 65 dB 65 dB 49 dB The speech recognition score was 94 percent in the right ear and 96 percent in the left ear. Again, the examination did not reveal any exceptional patterns of hearing impairment as defined in 38 C.F.R. § 4.86, or that the speech discrimination test was not appropriate for consideration. Therefore, Table VIA is still inapplicable. Utilizing Table VI, the combination of the 44 dB puretone threshold average and the 94 percent speech discrimination for the right ear results in the designation of a Roman numeral I. The combination of the 49 dB puretone threshold average and the 96 percent speech discrimination for the left ear also results in the designation of a Roman numeral I. When the Roman numerals I and I are applied to Table VII, the resulting percentage evaluation is zero percent once more. Aside from the VA examinations, the only other audiometric testing of record is a May 2015 VA audiogram. During the appointment, the Veteran reported having trouble understanding when in noisy environments and in groups. Audiometric testing at the time indicated the following results: HERTZ 1000 2000 3000 4000 Average RIGHT 20 dB 35 dB 45 dB 50 dB 38 dB LEFT 25 dB 40 dB 55 dB 65 dB 46 dB The speech recognition score was 100 percent in the right ear and 96 percent in the left ear. The examination did not reveal any exceptional patterns of hearing impairment as defined in 38 C.F.R. § 4.86. Therefore, Table VIA is still inapplicable on this basis. Utilizing Table VI, the combination of the 38 dB puretone threshold average and the 100 percent speech discrimination for the right ear results in the designation of a Roman numeral I. The combination of the 46 dB puretone threshold average and the 96 percent speech discrimination for the left ear results in the designation of a Roman numeral I. When the Roman numerals I and I are applied to Table VII, the resulting percentage evaluation is zero percent. The Board notes the VA audiologist did not indicate whether the speech discrimination test was appropriate for consideration. If the Board assumes the speech discrimination test was not appropriate for consideration and alternatively utilized Table VIA, the 38 dB puretone threshold average for the right ear results in the designation of a Roman numeral I and the 46 dB puretone threshold average for the left ear results in the designation of a Roman numeral II. When the Roman numerals I and II are applied to Table VII, the resulting percentage evaluation is still zero percent. There are no other audiometric tests of record. For this reason, the May 2015 VA Audiogram and the August 2015 and November 2017 Hearing Loss and Tinnitus VA Examination Reports are necessarily the most probative evidence of record. See Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997). Based on the evidence above, the Board finds the preponderance of the evidence weighs against an increased, compensable disability rating for bilateral hearing loss at any time during the appeal period. M. Donohue Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD G. Suh, Associate Counsel