Citation Nr: 20005489 Decision Date: 01/23/20 Archive Date: 01/22/20 DOCKET NO. 19-10 735 DATE: January 23, 2020 ORDER Entitlement to service connection for tinnitus is denied. Entitlement to an initial rating in excess of 30 percent for interstitial lung disease (ILD) is denied. FINDINGS OF FACT 1. The preponderance of the evidence is against finding that the Veteran’s tinnitus began during active service or is otherwise related to an in-service injury or disease. 2. The evidence shows that the Veteran’s Forced Vital Capacity (FVC) was 74 percent of the predicted value and Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) was 64 percent of the predicted value, post-bronchodilator. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for tinnitus have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for entitlement to an initial rating in excess of 30 percent for interstitial lung disease (ILD) have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1, 4.7, 4.96, 4.97, Diagnostic Code (DC) 6825. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from March 1977 to March 1981. 1. Entitlement to service connection for tinnitus The Veteran seeks service connection for tinnitus. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. Because tinnitus is “subjective,” its existence is generally determined by whether the claimant claims to experience it. See Charles v. Principi, 16 Vet. App. 370 (2002). The Veteran is competent to say he has tinnitus. However, the Board concludes that the preponderance of the evidence weighs against finding that the Veteran’s tinnitus began during service or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). In a November 2019 VA examination, the Veteran reported having recurrent tinnitus which “started after the military.” The examiner noted that the Veteran worked on the flight deck on an aircraft carrier during the military and worked on aircrafts after the military in aircraft maintenance. The examiner opined his tinnitus is less likely than not caused by or a result of military noise exposure. The rationale was that enlistment and separation audiograms were normal without changes during service and that the “[V]eteran claim[ed] tinnitus began after service.” The Board notes that the Veteran has not said the tinnitus began during his active duty service or within one year of separation from service. In this regard, the Board finds the examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Accordingly, service connection for tinnitus is not warranted. 2. Entitlement to an initial rating in excess of 30 percent for ILD Disability evaluations are determined by evaluating the extent to which a Veteran’s service-connected disability adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing his symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.10. The Veteran’s service-connected interstitial lung disease is rated as 30 percent disabling under 38 C.F.R. § 4.97, DC 6825, pertaining to diffuse interstitial fibrosis (interstitial pneumonitis, fibrosing alveolitis). 38 C.F.R. § 4.97, DC 6825. Respiratory disorders are rated under 38 C.F.R. § 4.97, DCs 6600 through 6817 and 6822 through 6847. Pursuant to 38 C.F.R. § 4.96(a), ratings under those diagnostic codes will not be combined with each other. Rather, a single rating will be assigned under the diagnostic code which reflects the predominant disability with elevation to the next higher evaluation only where the severity of the overall disability warrants such elevation. 38 C.F.R. § 4.96(a). Under the General Rating Formula for interstitial lung disease, diffuse interstitial fibrosis is rated under 38 C.F.R. § 4.97, DC 6825 (interstitial pneumonitis, fibrosing alveolitis) and provides for a 30 percent disability evaluation where pulmonary function test scores (PFTs) show any of the following: Forced Vital Capacity (FVC) of 65- to 74-percent predicted, or; Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) of 56- to 65-percent predicted. A 60 percent disability evaluation is warranted where PFTs show any of the following: FVC of 50- to 64-percent predicted, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum exercise capacity of 15 to 20 ml/kg/min oxygen consumption with cardiorespiratory limitation. A 100 percent evaluation is warranted where PFTs show any of the following: FVC less than 50-percent predicted, or; DLCO (SB) less than 40-percent predicted, or; maximum exercise capacity less than 15 ml/kg/min oxygen consumption with cardiorespiratory limitation, or; cor pulmonale or pulmonary hypertension, or; requires outpatient oxygen therapy. 38 C.F.R. § 4.97, DC 6825. 38 C.F.R. § 4.96(d)(4) provides that post bronchodilator studies are required when PFTs are done for disability evaluation purposes except when the results of pre-bronchodilator PFTs are normal or when the examiner determines that post bronchodilator studies should not be done and states why. Moreover, VA has indicated that post-bronchodilator findings for PFTs are the standard in pulmonary assessment and are the values reported in this decision. See 61 Fed. Reg. 46720, 46723 (Sept. 5, 1996). PFTs are required to evaluate these conditions except: (1) when the results of a maximum exercise capacity test are of record and are 20 ml/kg/min or less. If a maximum exercise capacity test is not of record, evaluation is based on an alternative criteria; (ii) when pulmonary hypertension (documented by an echocardiogram or cardiac catheterization), cor pulmonale, or right ventricular hypertrophy has been diagnosed; (iii) when there have been one or more episodes of acute respiratory failure; or, (iv) when outpatient oxygen therapy is required. 38 C.F.R. § 4.96(d)(1). When there is a disparity between the results of different PFTs so that the level of evaluation would differ depending on which test result is used, VA will use the test result that the examiner states most accurately reflects the level of disability. 38 C.F.R. § 4.96(d)(6). In this case, the Board finds that a rating in excess of 30 percent is not warranted under any of the applicable diagnostic codes. The PFT results, along with other required symptoms, have not been shown to be severe enough to meet the criteria for a 60 percent or higher rating. The Veteran was provided with a VA examination and a PFT in November 2017. The PFTs show FVC at 74 percent and DLCO (SB) at 64 percent, post-bronchodilator. The examiner indicated the DLCO (SB) test reflects the Veteran’s level of disability. Moreover, the examiner noted that the respiratory condition does not require the use of oral or parenteral corticosteroid medications, does not require the use of inhaled medications, does not require the use of oral bronchodilators, does not require the use of antibiotics, and does not require outpatient oxygen therapy. The Veteran was provided with a VA examination in February 2019. However, the examiner only provided the pre-bronchodilator percentage predictions as the Veteran “declined to do breathing treatment.” The examiner noted that the Veteran’s respiratory condition does not require the use of oral or parenteral corticosteroid medications, does not require the use of inhaled medications, does not require the use of oral bronchodilators, does not require the use of antibiotics, and does not require outpatient oxygen therapy. The Board finds that the criteria for a 60 percent rating are not met or more closely approximated. PFT as part of the November 2017 VA examination showed FVC at 74 percent and DLCO (SB) at 64 percent, post-bronchodilator. There are no PFT results showing FVC of 50- to 64-percent predicted, or; DLCO (SB) of 40- to 55-percent predicted, or; maximum exercise capacity of 15 to 20 ml/kg/min oxygen consumption with cardiorespiratory limitation. As such, a higher disability rating is not warranted. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Jones Council 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.