Citation Nr: 21075229 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 13-22 085A DATE: December 17, 2021 ORDER The appeal for entitlement to a total disability based on individual unemployability (TDIU) has been withdrawn. Prior to February 25, 2021, entitlement to an increased rating for service-connected right lower extremity restless leg syndrome is denied. Prior to February 25, 2021, entitlement to an increased rating for service-connected left lower extremity restless leg syndrome is denied. Beginning February 25, 2021, entitlement to a disability rating of 40 percent, but no higher, for service-connected right lower extremity restless leg syndrome is granted. Beginning February 25, 2021, entitlement to a disability rating of 40 percent, but no higher, for service-connected left lower extremity restless leg syndrome is granted. Entitlement to a disability rating in excess of 40 percent for service-connected peripheral neuropathy of the right/dominant upper extremity radiculopathy is denied. Entitlement to a disability rating in excess of 30 percent for service-connected peripheral neuropathy of the left/nondominant upper extremity is denied. Entitlement to a compensable disability rating for service-connected left ear hearing loss is denied. Entitlement to service connection for right ear hearing loss is denied. Entitlement to service connection for a gastrointestinal disorder, claimed as irritable bowel syndrome (IBS) other than GERD, to include as secondary to service-connected psychiatric disabilities, is denied FINDINGS OF FACT 1. In a May 2020 correspondence, the Veteran requested a withdrawal of the appeal of his claims for a TDIU. 2. The preponderance of the evidence of record is against finding that the Veteran has a current hearing loss disability in the right ear for VA purposes. 3. The preponderance of the evidence of record is against finding that the Veteran has a current gastrointestinal disorder (other than GERD) during the appellate period. 4. Prior to February 25, 2021, the Veteran's right and left lower extremity restless leg syndrome more nearly approximated moderate incomplete paralysis. 5. Beginning February 25, 2021, the Veteran's right and left lower extremity restless leg syndrome more nearly approximated moderately severe incomplete paralysis. 6. The Veteran's service-connected right/dominant upper extremity radiculopathy was manifested by mild incomplete paralysis. 7. The Veteran's service-connected left/nondominant upper extremity radiculopathy was manifested by no worse than moderate incomplete paralysis. 8. Audiological testing of the Veteran's hearing acuity in August 2020 when applied to Table VI and Table VII result in a noncompensable rating for the Veteran's left ear hearing loss. CONCLUSIONS OF LAW 1. The criteria for withdrawal of the appeal of entitlement to a TDIU by the appellant have been met. 38 U.S.C. § 7105; 38 C.F.R. § 20.204. 2. The criteria for service connection for right ear hearing loss have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1117, 1118, 1131, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385. 3. The criteria for service connection for a gastrointestinal disorder (other than GERD), to include as secondary to service-connected psychiatric disabilities, have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1117, 1118, 1131, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. Prior to February 25, 2021, the criteria have not been met for a disability rating in excess of 20 percent for service-connected bilateral lower extremity restless leg syndrome. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.124a, Diagnostic code (DC) 8599-8520. 5. Beginning February 25, 2021, the criteria have been met for a disability rating of 40 percent, but no higher, for service-connected bilateral lower extremity restless leg syndrome. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.124a, DC 8599-8520. 6. The criteria for a disability rating in excess of 40 percent for service-connected right/dominant upper extremity radiculopathy have not been met. 38U.S.C. §§1155, 5107; 38C.F.R. §§4.1-4.14. 4.124a, DC 8513. 7. The criteria for a disability rating in excess of 30 percent for service-connected left/nondominant upper extremity have not been met. 38U.S.C. §§1155, 5107; 38C.F.R. §§4.1-4.14. 4.124a, DC 8513. 8. The criteria for a compensable rating for left ear hearing loss have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.383, 3.385, 4.85-4.87, Diagnostic Code 6100. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from active duty from March 2003 to July 2010. This matter comes to the Board of Veterans' Appeals (Board) from a decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In April 2020, the Board remanded the claims for further development. In October 2020, the AOJ increased the rating from 10 percent to 40 percent for peripheral neuropathy of the right upper extremity and from 10 percent to 30 percent for the left upper extremity, effective March 19, 2018 (for the entirety of the appeal period). Also, in April 2021, the AOJ (in relevant part) granted an increased rating from 10 to 20 percent for restless leg syndrome of the bilateral lower extremities, effective February 25, 2021. As the increase (in both rating decisions) did not satisfy the appeal in full, the issues remain on appeal. See AB v. Brown, 6 Vet. App. 35 (1993). The Board notes that in August 2021 Correspondence, the Veteran's attorney, John S. Berry, noted that he wished to withdraw as the Veteran's representative. In a November 2021 Statement in Support of Claim, the Veteran requested that The Berry Law Firm be removed as his power of attorney as he did not wish for the firm to represent him in any further legal matters. Thus, the Board finds that good cause has been shown and that the regulatory requirements to withdraw as representative have been met. 38 C.F.R. § 20.6. To date, the Veteran has not requested or submitted additional documentation establishing new representation. Thus, the Veteran proceeds pro se (unrepresented). 1. TDIU The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204. Withdrawal may be made by the Veteran or by his or her authorized representative. 38 C.F.R. § 20.204. Here, in a correspondence dated in May 2020, the Veteran withdrew from appellate review the issues of entitlement a TDIU. In light of this withdrawal, there remain no allegations of errors of fact or law for appellate consideration on this claim. The Board does not have jurisdiction to review this issue, and it is dismissed. Service Connection To establish service connection a Veteran must generally show: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service." Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "Chronic." When the disease identity is established (leprosy, tuberculosis, multiple sclerosis, etc.), there is no requirement of evidentiary showing of continuity. Continuity of symptomatology is required only where the condition noted during service (or in the presumptive period) is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303 (b). We note that organic disease of the nervous system is a chronic disease, and as such, additional presumptive theories of entitlement are relevant in addition to direct service connection. See 38 C.F.R. §§ 3.303, 3.307, 3.309. Under 38 C.F.R. § 3.303 (b), service connection may be established by demonstrating continuity of symptomatology. Continuity may be established if a claimant can demonstrate (1) that a condition was "noted" during service; (2) evidence of post-service continuity of the same symptomatology; and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. The provisions of 38 C.F.R. § 3.303 (b) only apply to diseases recognized by VA as "chronic." See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); 38 C.F.R. §§ 3.303 (b), 3.309(a). Chronic diseases that become manifest to a degree of 10 percent or more within one year of termination of active duty may be presumed to have been incurred in service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154 (a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). 1. Right ear hearing loss The Veteran asserts that he is entitled to service connection for right ear hearing loss. The determination of whether a Veteran has a hearing loss disability is governed by 38 C.F.R. § 3.385. For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. As an initial matter, the Board notes that the Veteran's service treatment records do not show right ear hearing loss for VA purposes. See January 2003 Enlistment Examination; March 2003 Audiogram; July 2010 Discharge Examination. VA regulations do not preclude service connection for a hearing loss which first met VA's definition of disability after service. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). As to post-discharge audiological findings, a June 2011 VA treatment note shows normal hearing in the right ear. More specifically, pure-tone averages were 12 dB in the right ear; speech reception thresholds were 5 dB in the right ear; and speech discrimination using recorded Maryland CNC word lists were 96 percent in the right ear. The Veteran underwent VA audiometric testing in May 2018, which showed the following results: Hertz 500 1000 2000 3000 4000 Avg. Maryland CNC Right 50 60 65 65 75 61.25 96% Left 50 70 75 70 75 66.25 96% As to the validity of these puretone test results, the examiner noted that the test results were not valid for rating purposes. In this regard, the examiner reasoned that the "speech results and pure tones are inconsistent." As the medical evidence shows that the results from this examination are not valid for purposes of rating and evaluating the right ear, the Board will not consider them. The most recent audiological examination occurred in August 2020, the Veteran underwent VA audiometric testing, which showed the following results: Hertz 500 1000 2000 3000 4000 Avg. Maryland CNC Right 15 10 10 30 25 18.75 98% Left 20 25 30 50 40 36.25 90% Given the above, the VA examination findings show that the Veteran does not have a right ear hearing loss disability as defined by VA. 38 C.F.R. § 3.385. Thus, the Board finds that the preponderance of the evidence of record is against finding that the Veteran has a current hearing loss disability in the right ear for VA purposes. As there is no disability that can be related to active service, the Veteran's claim for service connection for bilateral hearing loss disability must be denied. 38 U.S.C. § 1110. 2. IBS The Veteran asserts that he is entitled to service connection for a gastrointestinal condition, to include IBS, to include as secondary to his service-connected psychiatric disabilities. Following a review of the evidence of record, the Board finds that the preponderance of evidence weighs against granting service connection for a gastrointestinal disorder, to include IBS. Here, at no point in time during the pendency of this appeal has the Veteran been diagnosed with a gastrointestinal disorder other than GERD for which he is already service connected. Further, the record does not contain any medical treatment for any other gastrointestinal disorder. Additionally, no evidence of treatment for any such condition during, or since, military service has been presented. The Veteran was provided a VA Stomach and Duodenal Conditions (Not Including GERD or Esophageal Disorders) examination in July 2020. As to a diagnosis, the VA examiner stated that the Veteran did not currently have and has never had any stomach or duodenum condition. The examiner found that the Veteran did not have a current diagnosis of irritable bowel syndrome or for any diagnosed stomach or duodenum condition. The Board also notes that the Veteran's VA treatment records are largely silent for gastrointestinal complaints, although the Veteran did report experiencing diarrhea in August 2019 related to medication taken for his diabetes mellitus. Private treatment records, dated within the appeal period, are negative for gastrointestinal complaints. Based on the above, the Board finds the record does not support a finding that the Veteran has a current gastrointestinal disorder. While the Board acknowledges the Veteran's occasional gastrointestinal symptoms, such has not been characterized as a disorder. Accordingly, without a current disorder, service connection must be denied. Increased Rating 1. Restless leg syndrome RLE 2. Restless leg syndrome LLE The Veteran asserts that he is entitled to a higher disability ratings for his service-connected right and left lower extremity restless leg syndrome disabilities. The Veteran's bilateral lower extremity disabilities are rated as 10 percent prior to March 19, 2018 and 20 percent thereafter with both periods rated under DC 8599-8520. When an unlisted disease, injury, or residual condition is encountered, requiring rating by analogy, the diagnostic code number will be "built-up" as follows: the first 2 digits will be selected from that part of the schedule most closely identifying the part, or system, of the body involved; the last 2 digits will be "99" for all unlisted conditions. 38 C.F.R. § 4.27 (2019). Restless leg syndrome is rated by analogy under Diagnostic Code 8520, which provides ratings for neuritis of the sciatic nerve. Under this diagnostic code, mild incomplete paralysis of the affected nerve is rated as 10 percent disabling; moderate incomplete paralysis of the affected nerve is rated as 20 percent disabling; moderately severe incomplete paralysis of the affected nerve is rated as 40 percent disabling; severe incomplete paralysis of the affected nerve with marked muscular atrophy is rated as 60 percent disabling; and complete paralysis of the affected nerve is rated as 80 percent disabling. 38 C.F.R. § 4.124a, DC 8520. The words "mild," "moderate," "moderately severe," and "severe" as used in the various diagnostic codes are not defined in the VA Schedule for Rating Disabilities. Rather than applying a mechanical formula, the Board must evaluate all the evidence. 38 C.F.R. § 4.6. In addition, use of terms such as "severe" by VA examiners and others, although an element of evidence to be considered, is not dispositive. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6. The term "incomplete paralysis" indicates a degree of lost or impaired function substantially less than complete paralysis, regardless of cause. When the symptoms are wholly sensory and do not include paralysis, then the disability rating assigned should not be higher than for mild (or moderate, at most) symptoms. 38 C.F.R. § 4.124a, Diseases of the Peripheral Nerves. The Veran was afforded VA examinations in June 2011 and February 2017. In the February 2017 Central Nervous System Examination, an examiner noted a diagnosis of Restless Leg Syndrome. The Veteran reported that after discharge, he developed a crawling sensation and constant movement of the legs while sleeping. The Veteran further reported a sensation of pins and needles most times in both legs, a crawling sensation, and frequent kicking at night. He also noted that the sensation begins in the upper thigh and progresses down to the top and sole of his feet. He did not require continuous medication for control. He did not have muscle weakness in either extremity. On objective neurological examination, gait and muscle strength was normal in both lower extremities. Deep tendon reflexes were normal at 2+ and there was no muscle weakness noted. There were no other pertinent physical findings, complications, conditions, signs, or symptoms related to the condition. The Veteran did not use an assistive device to ambulate. Imaging studies were not performed. As to functional impact, the examiner stated that the Veteran's central nervous system disorder impacted his ability to work, noting that the Veteran reported that he was unable to sit or stand for prolonged periods. In a September 2018 statement, the Veteran asserted that his right and left lower extremity restless leg syndrome had worsened beyond mild and that he could not sit or stand for more than one hour at a time. In an April 2020 decision, the Board of Veterans' Appeals (Board) remanded the Veteran's claim for a new examination. The Veteran was afforded a new VA examination in February 2021, at which time the examiner acknowledged that the Veteran had restless leg syndrome affecting both lower extremities. The Veteran reported that his current symptoms include a continuation of symptoms of pain and numbness. He also stated that he cannot stand for prolonged periods of time and that his sleep is impacted. Upon examination, the examiner stated that the Veteran had severe intermittent pain, severe paresthesias and/or dysesthesias, and severe numbness in his bilateral lower extremities. Muscle strength testing was normal. The Veteran did not have muscle atrophy. Deep tendon reflexes were normal in the bilateral lower extremities. Sensation testing for light touch was noted to be "all normal," yet sensation testing was noted to be Absent in both lower leg/ankles and both foot/toes. The Veteran did not have trophic changes. The Veteran's gait was normal. The examiner further noted that the Veteran had incomplete, moderate incomplete paralysis of the sciatic nerve and anterior crural (femoral) nerves. The Veteran did not use an assistive device. The examiner also noted that on physical examination, it was "noted with a decrease in vibrational sensation and light touch of both feet and toes right and lower left leg. Cold sensation was also decreased right and left feet and toes." EMG studies were not performed, and the examiner noted that there were not any other significant diagnostic test findings and/or results. The examiner noted that the Veteran's condition impacted his ability to work in that he was unable to drive and that he was unable to walk or stand for prolonged periods due to the numbness in his legs. The examiner also stated that the Veteran also trips due to both neuropathy and his restless legs. He also had poor sleep quality due to his restless legs. The Board finds that a 40 percent rating is warranted beginning February 25, 2021 (the date of the Veteran's last VA examination). The Board finds that a rating in excess of 40 percent from this date is not warranted, however, as there is no evidence showing that there is complete paralysis of the sciatic nerve or evidence that the foot dangles and drops with no active movement. Prior to February 25, 2021, the most probative evidence of record shows that higher ratings are not warranted. In this regard, the Board acknowledges the Veteran's claim that he was entitled to a higher rating. However, the Veteran is not competent to determine the severity of this condition. 3. Peripheral neuropathy, left upper extremity 4. Peripheral neuropathy, right upper extremity The Veteran asserts that he is entitled to a disability rating in excess of 40 percent for his service-connected peripheral neuropathy of the right upper extremity and in excess of 30 percent for his service-connected peripheral neuropathy of the left upper extremity. The Veteran's bilateral upper extremity disabilities are rated under DC 8513. Under Diagnostic Code 8513, mild incomplete paralysis is rated as 20 percent for both the major (dominant) and minor (non-dominant) extremity. Moderate incomplete paralysis is rated as 40 percent for the major extremity and 30 percent for the minor extremity. Severe incomplete paralysis is rated as 50 percent for the major extremity and 40 percent for the minor extremity. Complete paralysis, all shoulder and elbow movements lost or severely affected, hand and wrist movements not affected is rated as 70 percent for the major extremity and 60 percent for the minor extremity. 38 C.F.R. § 4.124a. As the Veteran is right-handed, the Veteran's right upper extremity is the dominant extremity, and the left upper extremity is the non-dominant extremity. The Veteran was given a VA examination in May 2018. Here the Veteran was diagnosed with diabetic peripheral neuropathy bilateral upper extremities. The examiner noted that the Veteran is right hand dominant. The Veteran was noted as experiencing moderate bilateral upper extremity constant pain, severe bilateral upper extremity intermittent pain, severe bilateral upper extremity paresthesias and/or dysesthesias, and severe bilateral upper extremity numbness. The Veteran was also noted as experiencing decreased vibrational sensitivity and decreased sensitivity to cold sensation in his bilateral upper extremities. The examiner found that the Veteran had mild incomplete paralysis of the median nerve in the bilateral upper extremities. The Veteran was given a second VA examination in July 2019. The examiner noted that the Veteran is right hand dominant. The Veteran was noted as experiencing moderate bilateral upper extremity constant pain, severe bilateral upper extremity intermittent pain, severe bilateral upper extremity paresthesias and/or dysesthesias, and severe bilateral upper extremity numbness. The Veteran was also noted as experiencing decreased vibrational sensitivity and decreased sensitivity to cold sensation in his bilateral upper extremities. The examiner found that the Veteran had moderate incomplete paralysis of the median nerve in the bilateral upper extremities. The Board finds that a disability rating in excess of 40 percent for service-connected right/dominant upper extremity radiculopathy is not warranted. In this regard, there is no evidence of severe incomplete paralysis of the dominant upper extremity. Neither the May 2018 nor July 2019 examiners concluded that the upper extremity radiculopathy resulted in severe incomplete paralysis. There was also no evidence of trophic changes. Given the above, the criteria for a disability rating in excess of 40 percent for the right/dominant upper extremity radiculopathy have not been met. Turning to the left/non-dominant extremity, the Board finds that a disability rating in excess of 30 percent for the service-connected connected left/non-dominant upper extremity radiculopathy is not warranted. Specifically, there is no evidence of severe incomplete paralysis of the non-dominant extremity. Neither the May 2018 nor July 2019 examiners concluded that the upper extremity radiculopathy resulted in severe incomplete paralysis. There was also no evidence of trophic changes. Accordingly, the criteria for a disability rating in excess of 30 percent for the left/non-dominant upper extremity radiculopathy have not been met. The Board acknowledges the Veteran's sincere belief that a higher rating is warranted for his service-connected peripheral neuropathy of the bilateral upper extremities. However, without the appropriate medical training and expertise, he is not competent to provide a probative (persuasive) opinion on the severity of this disability in relation to the applicable rating criteria. 5. Left ear hearing loss The Veteran asserts that he is entitled to a compensable disability rating for his service-connected left ear hearing loss. Hearing loss is rated under DC 6100. In evaluating service-connected hearing loss, disability ratings are derived by a mechanical application of the rating schedule to the numeric designations assigned after audiometric evaluations are performed. See Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). Evaluations of defective hearing range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of a controlled Maryland CNC speech discrimination test together with the average hearing threshold level measured by pure tone audiometry tests in the frequencies of 1,000, 2,000, 3,000, and 4,000 cycles per second. 38 C.F.R. § 4.85, Diagnostic Code 6100. To evaluate the degree of disability from service-connected bilateral hearing loss, the rating schedule establishes 11 auditory hearing acuity levels designated from Level I for essentially normal hearing acuity through Level XI for profound deafness. 38 C.F.R. § 4.85, Tables VI and VII. VA audiometric examinations are conducted using a controlled speech discrimination test together with the results of a puretone audiometry test. The vertical lines in Table VI (in 38 C.F.R. § 4.85) represent nine categories of the percentage of discrimination based on the controlled speech discrimination test. The horizontal columns in Table VI represent nine categories of decibel loss based on the puretone audiometry test. The numeric designation of impaired hearing (Levels I through XI) is determined for each ear by intersecting the vertical row appropriate for the percentage of discrimination and the horizontal column appropriate to the puretone decibel loss. The percentage evaluation is found from Table VII (in 38 C.F.R. § 4.85) by intersecting the vertical column appropriate for the numeric designation for the ear having the better hearing acuity and the horizontal row appropriate to the numeric designation level for the ear having the poorer hearing acuity. When the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA whichever results in the higher numeral. Each ear will be evaluated separately. 38 C.F.R. § 4.86 (a). When the puretone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa whichever results in the higher numeral. That numeral will then be elevated to the next higher Roman numeral. Each ear will be evaluated separately. 38 C.F.R. § 4.86 (b). The Veteran underwent VA audiometric testing in May 2018, which showed the following results: Hertz 500 1000 2000 3000 4000 Avg. Maryland CNC Right 50 60 65 65 75 61.25 96% Left 50 70 75 70 75 66.25 96% As to the validity of these puretone test results, the examiner noted that the test results were not valid for rating purposes. In this regard, the examiner reasoned that the "speech results and pure tones are inconsistent." As the medical evidence shows that the results from this examination are not valid for purposes of rating and evaluating the right ear, the Board will not consider them. The most recent audiological examination occurred in August 2020, which showed the following results: Hertz 1000 2000 3000 4000 Avg. Maryland CNC Right 10 10 30 25 18.75 98% Left 25 30 50 40 36.25 90% Neither ear has puretone threshold disparity at 1000 Hertz and 2000 Hertz level as described by 38 C.F.R. § 4.86 (b), nor has the decibel loss of 55 or more at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz), therefore, Table VIa is not applicable here. Applying the results to Table VI, the findings yield a numeric designation of Level I for the right ear and Level II for the left ear. Applying these numbers to Table VII resulted in a 0 percent disability rating under Diagnostic Code 6100. The Board acknowledges the Veteran's sincere belief that a higher rating is warranted for his service-connected hearing loss of the left ear. However, without the appropriate medical training and expertise, he is not competent to provide a probative (persuasive) opinion on the severity of his left ear hearing loss in relation to the applicable rating criteria. As the audiometric testing does not support a compensable rating under DC 6100, a compensable rating for the Veteran's left ear hearing loss is denied. TIFFANY HANSON Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Edward G. Lent 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.