Citation Nr: A21017992 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 210204-139190 DATE: November 8, 2021 ORDER A higher 10 percent rating, though no greater, is granted for mastoiditis. FINDING OF FACT The Veteran's chronic mastoiditis as likely as not results in regular suppuration. CONCLUSION OF LAW Resolving all reasonable doubt in his favor, the criteria are met for entitlement to a higher 10 percent rating, though no greater, for his mastoiditis. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.3, 4.7, 4.85, 4.87, Diagnostic Code (DC) 6200. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1959 to October 1963. This appeal to the Board of Veterans' Appeals (Board) is from a January 2021 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). On his February 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement (NOD)), the Veteran elected the Hearing docket. So, later in February 2021, a "virtual" teleconference hearing was scheduled. However, a VA Report of General Information from that same day shows that VA contacted him separately by phone concerning his scheduled hearing because the presiding Judge was having connectivity issues. During this phone call, the Veteran indicated he was withdrawing his hearing request wanted the Board, instead, to render a decision based on the evidence already of record. The VA representative explained the Veteran's rights to a hearing and assured him that both the Judge and his attorney were in the virtual waiting room ready to start the hearing; however, he "was very adamant about not having a hearing" and stated that he no longer wanted to continue the process. Therefore, in deciding this appeal, the Board may only consider the evidence of record at the time of the RO, i.e., Agency of Original Jurisdiction (AOJ) decision that he has appealed, and any evidence that he or his representative submitted within 90 days following receipt of the withdrawal of the hearing request. See 38 C.F.R. § 20.302(b). Increased Rating A higher 10 percent rating, though no greater, is granted for the mastoiditis The Veteran contends that his right ear mastoiditis is more severe than is contemplated by his existing noncompensable (0 percent) rating. Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities (Rating Schedule), which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10. When evaluating the severity of a disability, it is essential the disability is considered in the context of its entire recorded history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where entitlement to compensation already has been established and an increase in the disability rating is at issue, the present level of disability is of primary importance. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). But if the factual findings show distinct time periods when the service-connected disability exhibits symptoms that would warrant different ratings, then separate ratings may be assigned for separate periods of time based on the facts found. This practice is known as "staged" ratings and is employed for initial or established ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). If the disability more closely approximates the criteria for the higher of two ratings, the higher rating will be assigned; otherwise, the lower rating is assigned. 38 C.F.R. § 4.7. In general, it is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. When, after careful consideration of all procurable and assembled data, 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. The Veteran's mastoiditis is rated under DC 6200, which indicates that a 10 percent rating is warranted for chronic suppurative otitis media, mastoiditis, or cholesteatoma (or any combination) during suppuration, or with aural polyps. 38 C.F.R. § 4.87. DC 6200 also calls for separate evaluations for hearing impairment and complications such as labyrinthitis, tinnitus, facial nerve paralysis, or bone loss of the skull. Id. However, to this end, the Veteran already has a separate, albeit noncompensable, rating for his right ear hearing loss. The Board remanded that claim in a separate decision issued on November 3, 2021, also an additional claim for a total disability rating based on individual unemployability (TDIU). The Veteran has had a 100 percent combined schedular rating effectively since May 3, 2021. Turning back now to the medical and lay evidence relevant to this claim at hand for a higher (compensable) rating for the mastoiditis, the record shows that, although outside of the period on appeal, in October 2018, the Veteran presented to VA complaining of increased right ear pain and drainage occurring once per week. He also stated that he had a history of chronic right ear infections, which is supported by the medical evidence of record. A VA treatment record from December 2019 shows the Veteran was diagnosed with a possible right ear infection. A February 2020 VA treatment record shows he was diagnosed with another right ear infection. A March 2020 VA treatment record shows he continued to suffer from a right ear infection and that the infected mastoid cavity required debridement (cleaning). A May 2020 VA treatment record shows he presented for mastoid debridement and that he had been taking prescription ear drops. In June 2021, the Veteran underwent a VA ear conditions examination. Upon examination, his right ear mastoid cavity had no pus but was slightly dark pink. The examiner explained that there were no signs of then "active" infection, meaning at the time of that evaluation. Nevertheless, based on the medical and lay evidence of record, the Board finds that the Veteran's mastoiditis certainly during the years prior in 2018, 2019 and 2020, resulted in chronic ear infections, including suppuration. As such, a higher 10 percent rating under DC 6200 is warranted, though no greater. 38 C.F.R. §§ 4.3, 4.7. KEITH W. ALLEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Pak 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.