Citation Nr: 20003161 Decision Date: 01/15/20 Archive Date: 01/14/20 DOCKET NO. 18-10 417 DATE: January 15, 2020 ORDER Entitlement to a disability rating in excess of 10 percent for tinnitus is denied. REMANDED Entitlement to a compensable rating for bilateral hearing loss is remanded. Entitlement to service connection for an acquired psychiatric disorder is remanded. FINDING OF FACT Throughout the appeal period, the Veteran’s tinnitus has been assigned a 10 percent rating, the maximum schedular rating authorized under Diagnostic Code 6260; an unusual or exceptional disability picture is not presented by this disability. CONCLUSION OF LAW The criteria for an initial disability rating in excess of 10 percent for tinnitus have not been met. 38 U.S.C. § 1155, 5107; 38 C.F.R. § 4.87, Diagnostic Code 6260. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1983 to January 1986 and from October 1990 to August 1991 with subsequent service in the National Guard. 1. Entitlement to an initial disability rating in excess of 10 percent for tinnitus The Veteran contends that his tinnitus symptoms are more severe than initially rated. Tinnitus is rated under Diagnostic Code 6260, which provides a maximum 10 percent rating. Note (2) codifies the standard VA practice of providing a maximum rating for tinnitus whether the sound is perceived in one ear, both ears, or in the head. See 38 C.F.R. § 4.87, Diagnostic Code 6260; 68 Fed. Reg. 25,823. The Veteran’s service-connected tinnitus has been assigned the maximum schedular rating available for tinnitus. 38 C.F.R. § 4.87, Diagnostic Code 6260. An extraschedular rating may be provided in exceptional cases. See 38 C.F.R. § 3.321. However, constant noise, such as ringing, buzzing, or chirping is contemplated by Diagnostic Code 6260 as such constitutes the basic symptom of tinnitus. The Veteran has not identified any unique or unusual symptoms of his tinnitus. Moreover, even if it were concluded that the Veteran’s tinnitus caused symptomatology that was not contemplated by the schedular rating criteria, there is no evidence suggesting that the Veteran’s tinnitus is productive of any unusual or exceptional symptoms that are consistent with an extraschedular rating. For example, the Veteran has not been hospitalized to treat his tinnitus, and it has not been alleged to have caused marked interference with employment. As his tinnitus does not present an unusual or exceptional disability picture, the Board finds referral for an extraschedular rating is not appropriate. Thun v. Peake, 22 Vet. App. 111 (2008). Therefore, the Board finds that the Veteran is not entitled to a disability rating in excess of 10 percent. REASONS FOR REMAND 2. Entitlement to a higher rating for bilateral hearing loss is remanded. In his November 2017 notice of disagreement, the Veteran asserted that his bilateral hearing loss symptomatology worsened since he was last examined by VA in April 2017. The Veteran should be provided an opportunity to report for a VA examination to ascertain the current severity and manifestations of his bilateral hearing loss. 3. Service connection for an acquired psychiatric disorder is remanded The Veteran contends that his anxiety, depression, and posttraumatic stress disorder (PTSD) are due to his active duty service. An April 2017 VA examiner diagnosed the Veteran with unspecified anxiety disorder with depressive symptoms. The Veteran noted that he came back from the Gulf War in 1991 different. He was angry and noted that he punched a window which led to divorcing his second wife. The examiner found that the Veteran did not meet the criteria for a diagnosis of PTSD. The VA examiner opined that the Veteran’s mental condition, diagnosed as unspecified anxiety disorder is less likely than not caused by or a result of fear of hostile military or terrorist activity as a result of his deployment to Saudi Arabia. The examiner explained that the Veteran maintained employment since his deployment and that he remained active in the National Guard for four years after his deployment to Saudi Arabia. The examiner also opined that it was less likely than not that the Veteran’s anxiety was caused by or a result of military service; however, a rationale was not provided. In June 2018, private psychosocial treatment records were received. The Veteran was treated for PTSD and anxiety second to combat stress. The Veteran reported engaging in physical violence since his deployment to Saudi Arabia. In September 2017, a private physician diagnosed the Veteran with PTSD secondary to direct combat experiences. Based on the above, the Board finds that a remand is necessary to obtain a clear and comprehensive addendum opinion following reexamination of the Veteran to ascertain the nature and etiology of the Veteran’s claimed psychiatric disorders. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected bilateral hearing loss. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. To the extent possible, the examiner should identify any symptoms and functional impairments due to bilateral hearing loss alone and discuss the effect of the Veteran’s hearing loss on any occupational functioning and activities of daily living. If it is not possible to provide a specific measurement, or an opinion regarding symptoms or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). 2. Schedule the Veteran for an examination by an appropriate clinician to determine the etiology of all current psychiatric disorders, including PTSD, anxiety, and depression. The record and a copy of this remand must be reviewed by the examiner. The examiner is requested to provide an opinion as to the diagnosis of all psychiatric disorders found to be present, including, if appropriate, PTSD, anxiety, and depression. As to each diagnosed psychiatric disorder, the examiner should opine whether it is at least as likely as not that such disorder had its onset in service or is otherwise related to the Veteran’s military service. If a psychosis is diagnosed, the examiner should opine as to whether it at least as likely as not (1) began during active service, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service. The examiner should address the Veteran’s contention that he has had continuous anxiety, depression, and angry outbursts since his active service. Further, the examiner should comment on the private treatment records received in June 2018, as well as provide a complete rationale for all opinions expressed and conclusions reached. If it is not possible to provide an opinion regarding symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts) or a deficiency in the record (additional facts are required). S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Costello, 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.