Citation Nr: 21075237 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 18-39 899 DATE: December 17, 2021 ORDER Entitlement to a compensable evaluation for bilateral hearing loss prior to February 21, 2019 on a schedular and extraschedular basis is denied. Entitlement to an increased evaluation in excess of 20 percent for bilateral hearing loss from February 21, 2019 on a schedular and extraschedular basis is denied. FINDINGS OF FACT 1. Throughout the period prior to February 21, 2019, the Veteran's hearing impairment has been no worse than a Level III impairment on the right and a Level III impairment on the left. 2. Throughout the period from February 21, 2019, the Veteran's hearing impairment has been no worse than a Level V impairment on the right and a Level V impairment on the left. 3. The level of severity and symptomatology of the Veteran's bilateral hearing loss disabilities are adequately contemplated by the schedular rating criteria across all periods on appeal. CONCLUSIONS OF LAW 1. The criteria for a compensable evaluation for bilateral hearing loss prior to February 21, 2019 under either schedular or extraschedular criteria have not been met or approximated. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.321, 4.1, 4.3, 4.7, 4.10, 4.85, Diagnostic Code 6100, 4.86 (2021). 2. The criteria for an increased evaluation in excess of 20 percent for bilateral hearing loss from February 21, 2019 under either schedular or extraschedular criteria have not been met or approximated. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.321, 4.1, 4.3, 4.7, 4.10, 4.85, Diagnostic Code 6100, 4.86 (2021). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1967 to May 1967, with subsequent service in the Army National Guard through January 1972. This matter is before the Board of Veterans' Appeals (Board) on appeal from a November 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Houston, Texas. By way of background, in an August 2019 rating decision, the evaluation for the bilateral hearing loss was increased to 20 percent disabling, effective February 21, 2019. The grant of an increased rating during the course of an appeal does not affect the pendency of that appeal. AB v. Brown, 6 Vet. App. 35 (1993). As the Veteran is presumed to be seeking the maximum allowable benefit and the maximum benefit has not yet been awarded, the claim is still in controversy and on appeal. Id. In May 2021, the Veteran, with his spouse, testified at a virtual hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the testimony is associated with the record. When a Veteran files a claim for an increased rating, he or she is presumed to be seeking the maximum benefit under any applicable theory, including TDIU. See generally Roberson v. Principi, 251 F.3d 1378 (Fed. Cir. 2001); Rice v. Shinseki, 22 Vet. App. 447 (2009). In light of this principle, entitlement to special monthly compensation (SMC) has been found to be an inferable issue anytime a veteran is requesting increased benefits. Akles v. Derwinski, 1 Vet. App. 118 (1991). In this case, the Veteran indicated during his hearing with the undersigned VLJ that he is gainfully employed as a county law enforcement officer. There is no further lay or medical evidence that the Veteran is housebound in fact, requires aid and attendance, or that his disabilities result in loss of use of a limb, blindness or deafness. 38 U.S.C. §§ 1114(s), (l), (k); 38 C.F.R. § 3.350(a), (b), (i). The Board thus finds that TDIU and SMC are not inferred by the record, and as such will not be discussed. Increased Schedular Rating for Bilateral Hearing Loss Disability evaluations are determined by the application of the facts presented to VA's Schedule for Rating Disabilities (Rating Schedule) at 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1. If two disability evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. All reasonable doubt as to the degree of disability will be resolved in favor of the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 4.3. In evaluating the severity of a particular disability, it is essential to consider its history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991). Where entitlement to compensation has already 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). That said, higher evaluations may be assigned for separate periods based on the facts found during the appeal period. See Fenderson v. West, 12 Vet. App. 119, 126 (1999). This practice is known as staged ratings. Id. The determination of whether an increased disability rating is warranted is to be based on a review of the entire evidence of record and the application of all pertinent regulations. See Schafrath v. Derwinski, 1 Vet. App. 589 (1991). The Board considers not only the criteria of the currently assigned diagnostic codes, but also the criteria of other potentially applicable diagnostic codes. In general, all disabilities, including those arising from a single disease entity, are rated separately, and all disability ratings are then combined in accordance with 38 C.F.R. § 4.25. However, the evaluation of the same "disability" or the same "manifestations" under various diagnoses is not allowed. See 38 C.F.R. § 4.14. A claimant may not be compensated twice for the same symptomatology as "such a result would overcompensate the claimant for the actual impairment of his [or her] earning capacity." See 38 U.S.C. § 1155; Brady v. Brown, 4 Vet. App. 203, 206 (1993). This would result in pyramiding, contrary to the provisions of 38 C.F.R. § 4.14. However, if a veteran has separate and distinct manifestations attributable to the same injury, they should be compensated under different diagnostic codes. See Esteban v. Brown, 6 Vet. App. 259 (1994); Fanning v. Brown, 4 Vet. App. 225, 230 (1993). 38 U.S.C. § 1154(a) requires that the VA give "due consideration" to "all pertinent medical and lay evidence" in evaluating a claim to disability benefits. 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 (Fed. Cir. 2007). When analyzing lay evidence, the Board should assess the evidence and determine whether the disability claimed is of the type for which lay evidence is competent. See Davidson, 581 F.3d at 1313; Kahana v. Shinseki, 24 Vet. App. 428 (2011). If the evidence for and against a claim is in equipoise, the claim will be granted. 38 C.F.R. § 4.3. A claim will be denied only if the preponderance of the evidence is against the claim. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 56 (1990). Any reasonable doubt regarding the degree of disability should be resolved in favor of the claimant. 38 C.F.R. § 4.3. Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Evidence and Analysis Assignment of a disability rating for hearing loss is derived by a mechanical application of the rating schedule to the specific numeric designations assigned after audiology testing is completed. Lendenmann v. Principi, 3 Vet. App. 345 (1992). An examination for hearing impairment for VA purposes must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test (Maryland CNC) and a puretone audiometry test. 38 C.F.R. § 4.85. The rating schedule establishes 11 auditory hearing acuity levels based upon average puretone thresholds and speech discrimination. See 38 C.F.R. § 4.85. "Puretone threshold average" as used in Tables VI and VIa is the sum of the puretone thresholds at 1000, 2000, 3000 and 4000 Hertz and divided by four. This average is used in all cases (including those of § 4.86) to determine a Roman numeral designation from Tables VI and VIa. 38 C.F.R. § 4.85(d). Table VI, "Numeric Designation of Hearing Impairment Based on Puretone Threshold Average and Speech Discrimination," is used to determine a Roman numeral designation (I through XI) for hearing impairment based on a combination of the percent of speech discrimination (horizontal rows) and the puretone threshold average (vertical columns). The Roman numeral designation is located at the point where the row and column intersect. 38 C.F.R. § 4.85(b). Table VIa, "Numeric Designation of Hearing Impairment Based Only on Puretone Threshold Average," is used to determine a Roman numeral designation (I through XI) for hearing impairment based only on puretone threshold average. Table VIa is used when the examiner certifies that the use of the speech discrimination test is not appropriate due to language difficulties, inconsistent speech discrimination scores, etc., or when indicated under the provisions of § 4.86. 38 C.F.R. § 4.85(c). Table VII, "Percentage Evaluations of Hearing Impairment," is used to determine the percentage evaluation by combining the Roman numeral designations for hearing impairment in each ear. The horizontal rows represent the ear having better hearing and the vertical columns represent the ear having the poorer hearing. The percentage evaluation is located at the point where the row and the column intersect. 38 C.F.R. § 4.85(e). Special provisions apply in instances of exceptional hearing loss. See 38 C.F.R. § 4.86. When the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) are all 55 decibels or more, the adjudicator must determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa in 38 C.F.R. § 4.85, whichever results in the higher numeral. 38 C.F.R. § 4.86(a). Also, 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 is evaluated separately. 38 C.F.R. § 4.86(b). The Board notes the Veteran was originally granted service connection for bilateral hearing loss in a July 2017 rating decision, with a noncompensable rating effective from June 3, 2016. The Veteran did not appeal that decision. On September 14, 2017, the Veteran made a claim for an increased rating for his bilateral hearing loss. The Board thus considers the relevant period to be from that date of claim. "The relevant temporal focus for adjudicating an increased-rating claim is on the evidence concerning the state of the disability from the time period one year before the claim was filed until VA makes a final decision on the claim." Hart v. Mansfield, 21 Vet. App. 505, 509 (2007) (discussing 38 U.S.C. § 5110 and 38 C.F.R. § 3.400(o)). In this case, the Veteran was provided with four VA audiological examinations pertinent to the two appeal periods. The first audiogram was provided in December 2016, and the puretone audiometry test was as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 20 25 35 60 60 LEFT 20 25 30 60 60 Based on these results, the average puretone threshold was 45 decibels for the right ear and 44 decibels for the left ear. See 38 C.F.R. § 4.85(d). Speech recognition was 80 percent in the right ear and 80 percent in the left ear, as measured by the Maryland CNC test. Applying these values to Table VI, the result is a Level III Roman numeral designation for the right ear and a Level III for the left ear. As to functional impairment, the Veteran reported difficulty hearing with the effect of poor social interactions, to include listening to his television and carrying on conversations with people around him. The Veteran received another VA audiological examination in November 2017. HERTZ 500 1000 2000 3000 4000 RIGHT 20 25 35 60 75 LEFT 20 15 35 55 65 Based on these results, the average puretone threshold was 49 decibels for the right ear and 43 decibels for the left ear. See 38 C.F.R. § 4.85(d). Speech recognition was 90 percent in the right ear and 84 percent in the left ear, as measured by the Maryland CNC test. Applying these values to Table VI, the result is a Level II Roman numeral designation for the right ear and a Level II for the left ear. As to functional impairment, the Veteran reported difficulty hearing with the effect of poor social interactions, to include listening to his television and carrying on conversations with people around him. The Veteran received another VA examination in February 2019. HERTZ 500 1000 2000 3000 4000 RIGHT 25 25 45 65 75 LEFT 25 35 35 65 65 Based on these results, the average puretone threshold was 53 decibels for the right ear and 50 decibels for the left ear. See 38 C.F.R. § 4.85(d). Speech recognition was 72 percent in the right ear and 72 percent in the left ear, as measured by the Maryland CNC test. Applying these values to Table VI, the result is a Level V Roman numeral designation for the right ear and a Level V for the left ear. As to functional impairment, the Veteran reported difficulty hearing with the effect of poor social interactions, to include listening to his television and carrying on conversations with people around him. The Veteran received another VA audiogram in September 2021. HERTZ 500 1000 2000 3000 4000 RIGHT 20 30 40 70 80 LEFT 15 20 50 70 80 Based on these results, the average puretone threshold was 55 decibels for the right ear and 55 decibels for the left ear. See 38 C.F.R. § 4.85(d). Speech recognition was 80 percent in the right ear and 80 percent in the left ear, as measured by the Maryland CNC test. Applying these values to Table VI, the result is a Level IV Roman numeral designation for the right ear and a Level IV for the left ear. As to functional impairment, the Veteran reported struggling to communicate and requires lip reading. This examiner noted the Veteran has been recommended for a cochlear implant. Here, the four valid audiograms of the appeal define two different staged ratings for the Veteran's bilateral hearing loss. See Hart, 21 Vet. App. 505. For the initial stage, the Board finds that for the period prior to February 21, 2019, the worst-case audiological testing of record, which is the VA examination of December 2016, reflects that the Veteran has a Level III hearing impairment in the right ear and a Level III hearing impairment in the left ear. When the Level III and Level III designations are mechanically applied to Table VII, the result is a noncompensable rating. 38 C.F.R. § 4.85; Lendenmann, 3 Vet. App. at 345. None of the results reported in the Veteran's claims file meet the requirements for evaluation based on an exceptional pattern of impairment in this period. 38 C.F.R. § 4.86(a)(b). For the period from February 21, 2019, the Board finds that the worst-case audiological testing of record, which is the VA audiological examination of February 2019, reflects that the Veteran has a Level V hearing impairment in the right ear and a Level V hearing impairment in the left ear. When the Level V and Level V designations are mechanically applied to Table VII, the result is a 20 percent rating. 38 C.F.R. § 4.85; Lendenmann, 3 Vet. App. at 345. None of the results reported in the Veteran's claims file meet the requirements for evaluation based on an exceptional pattern of impairment in this period. 38 C.F.R. § 4.86(a)(b). As noted previously, in addition to objective test results, the functional effects of a hearing disability must be discussed for an audiological examination report to be adequate. Martinak, 21 Vet. App. at 455. The VA examiners noted the Veteran reported difficulty hearing and the resulting effect of poor social interactions. Thus, the functional impact of the Veteran's hearing loss was considered by the VA examiners. No other medical evidence concerning the Veteran's bilateral hearing loss, specifically valid audiograms from either VA or other sources, is of record for the periods on appeal. The Board has considered the Veteran's lay statements, in which he contends difficulty hearing generally, and difficulty understanding speech during conversations, to include during testimony before the undersigned VLJ in a May 2021 Board hearing. The Board also notes the lay statement of the Veteran's spouse, who noted the Veteran's difficulty hearing to the degree that the home television is "blasting" whenever turned on. She also reported the Veteran has difficulty understanding what people say to him, and that he is often unable to discern what is said unless is directly facing that person. She also reported that he misses sounds while driving, creating some scary experiences. Further, as was indicated above, rating a hearing loss disability involves the mechanical application of rating criteria to the results of specified audiometric studies. Here, the objective medical evidence of record for the period on appeal consists of the four VA audiological examinations, which indicates that the Veteran's bilateral hearing loss is at a noncompensable rating level prior to February 21, 2019, and at a rating of 20 percent for the period from February 21, 2019 forward. See 38 C.F.R. § 4.85. The Board has considered the effective dates of increase in light of Swain v. McDonald, 27 Vet. App. 219 (2015). Under 38 C.F.R. § 3.400(o)(2), an increase in disability compensation is assigned from the "[e]arliest date as of which it is factually ascertainable based on all evidence of record that an increase in disability had occurred if a complete claim or intent to file a claim is received within 1 year from such date, otherwise, date of receipt of claim." In Swain, the CAVC held assigning the effective date of an increased rating is not a mechanical exercise of applying the date of the VA examination that warranted the increase. Id. at 223-24. Rather, the Board must review all relevant evidence of record to determine when the increase in the disability can be ascertained. Id. The Board finds the assignment of February 21, 2019 as the effective date of the increased evaluation, based on the date the increases became factually ascertainable, is consistent with the guidance of Swain. All potentially applicable codes have been considered, and there is no basis to assign an evaluation in excess of the currently assigned ratings for the periods on appeal for the Veteran's bilateral hearing loss. See Schafrath v. Derwinski, 1 Vet. App. 589, 593 (1991). Staged ratings are not warranted beyond that discussed, as the Veteran has had a stable level of symptomatology throughout each appeal period. Any increases in severity beyond the staged ratings created in this Board decision were not sufficient for a higher rating for the reasons discussed above. See Hart, 21 Vet. App. 505. All evidence has been considered and there is no doubt to be resolved. See 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49, 54-56 (1990). Extraschedular Consideration Bilateral Hearing Loss and 38 C.F.R. § 3.321 Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity resulting from diseases and injuries encountered as a result of or incident to military service and their residual conditions in civil occupations. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. While the Ratings Schedule is designed to be robust and adaptive, there will be occasions where the ratings provisions do not adequately describe and compensate a particular disability. When determining whether a claimant is entitled to an extraschedular rating, the Board must determine whether the evidence "presents such an exceptional disability picture that the available schedular evaluations for that service-connected disability are inadequate." Thun v. Peake, 22 Vet. App. 111, 115 (2008), aff'd sub nom. Thun v. Shinseki, 572 F.3d 1366 (Fed. Cir. 2009); see 38 C.F.R. § 3.321(b)(1). An extraschedular rating under 38 C.F.R. § 3.321(b)(1) is based on the fact that the schedular ratings are inadequate to compensate for the average impairment of earning capacity due to the Veteran's disability. Exceptional or unusual circumstances, such as frequent hospitalizations or marked interference with employment, are required. However, to accord justice in the exceptional case where the criteria in VA's Rating Schedule are inadequate to rate a single service-connected disability, the Director of Compensation Service or his or her delegate is authorized to approve an extraschedular evaluation commensurate with the average impairment of earning capacity due exclusively to the disability. The governing norm in these exceptional cases is a finding by the Director of Compensation Service or delegate that application of the regular schedular standards is impractical because the disability is so exceptional or unusual due to such related factors as marked interference with employment or frequent periods of hospitalization. 38 C.F.R. § 3.321(b)(1). The Board must refer the Veteran's claims to the Under Secretary for Benefits or Director of Compensation Service for this special consideration when the issue is raised either by the Veteran or by the evidence of record. See Thun v. Peake, 22 Vet. App. 111, 115 (2008); Barringer v. Peake, 22 Vet. App. 242 (2008). Only after the Director has determined whether an extraschedular evaluation is warranted does the Board have jurisdiction to adjudicate the merits of the extraschedular aspect of the claims. The Director's decision is not evidence, but, rather, the de facto AOJ decision, and the Board must conduct de novo review of this decision. See Wages v. McDonald, 27 Vet. App. 233, 238-39 (2015) (holding that the Board conducts de novo review of the Director's decision denying extraschedular consideration); Kuppamala v. McDonald, 27 Vet. App. 447 (2015). In other words, the Director's opinion is not binding on the Board. Here, the Board remanded the Veteran's bilateral hearing loss disability for extraschedular rating consideration in its remand of July 2021. The Director, Compensation Service, provided a memorandum opinion dated November 4, 2021 regarding the possibility of extraschedular consideration of the Veteran's bilateral hearing loss disability. Here, the objective medical evidence of record for the period on appeal indicates that the Veteran's bilateral hearing loss is at a noncompensable rating level prior to February 21, 2019, and at a rating of 20 percent for the period from February 21, 2019 forward. Here, the Director opined that, as of the date of the opinion, November 4, 2021, that the medical evidence failed to show that higher evaluations were warranted for the bilateral hearing loss. The Director's rationale was that VA examinations in the period on appeal indicate there is no impairment in/of earning capacity due to exceptional or unusual factors related to marked interference with employment or frequent periods of hospitalization. This November 2021 opinion noted the recent VA examinations for the Veteran's bilateral hearing loss, starting in December 2016. The Veteran reported difficulty hearing and understanding others and he must have background noise present to help him fall asleep at night. A review of VA treatment records does not show any reports of hospitalization for his bilateral hearing loss. An exceptional case is said to include such factors as marked interference with employment or frequent periods of hospitalization as to render impracticable the application of the regular schedular standards. It is found that based on the Veteran's VA examinations, combined with VA treatment records, the Veteran's case is not considered an exceptional case. The Veteran's hearing loss disability is manifested by difficulty hearing and understanding speech, which is precisely the type of impairment that the rating criteria is intended to measure. A comparison of the Veteran's hearing loss and associated functional impairment and the schedular criteria does not show such an exceptional or unusual disability picture with such related factors as marked interference with employment or frequent periods of hospitalization as to render impractical the application of the regular schedular standards. 38 C.F.R. § 3.321(b). The Veteran's experiences are corresponding with the average impairment in earning capacity represented by his current ratings for hearing loss. He is currently gainfully employed. The Director, Compensation Service concluded his opinion by saying that evidence does not support an increased evaluation for the Veteran's bilateral hearing loss disability on a schedular or extra-schedular basis for any time period. In its holding in Thun v. Peake, 30 Vet. App. 34 (2018), the United States Court of Appeals for Veterans Claims articulated a three-step inquiry for determining whether a Veteran is entitled to an extraschedular rating. The first requirement is that the evidence must present such an exceptional disability picture that the available schedular evaluations for the service-connected disability are inadequate. The Veteran reports difficulty hearing and understanding speech from his bilateral hearing loss disability. The rating schedule accounts for both types of symptomatology. The second directive in Thun is that if the schedular evaluation does not contemplate the claimant's level of disability and symptomatology and is found inadequate, the evidence must show that the claimant's exceptional disability picture exhibits other exceptional or unusual factors such as marked interference with employment or frequent periods of hospitalization. There is no indication of exceptional or unusual factors demonstrating an exceptional disability picture in this case. The Veteran reports difficulties with hearing voices at normal loudness, and has difficulty understanding people unless he is directly facing them. VA examiners have noted that while there is functional impact from the decreased hearing thresholds, his bilateral hearing loss disability does not impact employability. There has been no marked interference with his employment, no significant impacts on occupational functioning, and no periods of hospitalization or other periods of lost work as to render impracticable the application of the regular schedular standards. Finally, the third Thun requirement is that when an analysis of the first two steps reveals that the rating schedule is inadequate to evaluate a claimant's disability picture, and the existing disability picture has attendant thereto related factors such as marked interference with employment or frequent periods of hospitalization, a determination must be made as to whether the claimant's disability picture requires the assignment of an extraschedular rating. In this case, the rating schedule is adequate to evaluate the Veteran's bilateral hearing loss. The evidentiary record fails to demonstrate any exceptional or unusual disability picture for the service-connected bilateral hearing loss in any appeal period that renders application of the regular rating criteria impractical. The primary symptoms, decreased hearing thresholds and difficulty understanding others, are either explicitly listed or contemplated by the regular rating criteria under the applicable diagnostic codes for the bilateral hearing loss contained under 38 C.F.R. § 4.85. It is conceded that the bilateral hearing loss disability has impact in the Veteran's daily life; however, it does not demonstrate an exceptional or unusual disability picture that cannot be adequately evaluated by the applicable regular rating criteria. Nonetheless, this still does not demonstrate an exceptional or unusual disability picture which is required of the first Thun element. Consideration of such factors as impact upon employment are relegated to the second Thun element and rendered irrelevant unless an exceptional or unusual disability picture is demonstrated under the first Thun element, which is not shown in this case. See Yancy v. McDonald, 27 Vet. App. 484 (2016). The Board notes the Director's opinion, but also that it is not bound by any determination of the Director. Anderson v. Shinseki, 22 Vet. App. 423 (2009). Continuing, the Board notes the earlier detailed analysis for the Veteran's bilateral hearing loss, where it compared "the level of severity and symptomatology of the claimant's service-connected disability with the established criteria found in the rating schedule for that disability." See 38 C.F.R. § 3.321(b)(1). As described above, both (1) the specific symptoms and their severity that have been attributed to the service-connected disability, particularly those symptoms that are not obviously contemplated by the rating criteria and (2) the specific rating criteria involved in explaining why the Board found that the Veteran's symptoms and their severity are contemplated by the rating criteria. Anderson v. Shinseki, 22 Vet. App. 423, 426 (2009) (citing 38 U.S.C. § 7104(d)(1); Allday v. Brown, 7 Vet. App. 517, 527 (1995); Gilbert v. Derwinski, 1 Vet. App. 49, 56-57 (1990)). Therefore, having considered the medical and lay evidence of record, the Board finds an increased extraschedular rating is not warranted for the Veteran's bilateral hearing loss disability at any time during the appeal. As noted earlier, the Board denied increased evaluations for Veteran's bilateral hearing loss at a noncompensable rating level prior to February 21, 2019, and at a rating of 20 percent for the period from February 21, 2019 forward, under schedular criteria based on the medical and lay evidence in the Veteran's claims file. Given the consideration of all the evidence, then, the Board finds that the levels and severity of his bilateral hearing loss symptomatology have been adequately compensated by the schedular rating criteria in Diagnostic Code 6100, and no other diagnostic code is more appropriate for the Veteran's bilateral hearing loss disability. In this case, application of the schedular rating criteria to the Veteran's bilateral hearing loss disability is not impractical because both the applicable Diagnostic Code and other regulatory provisions explicitly contemplate the Veteran's symptomatology and disability level, including special considerations for evaluating factors of disability and functional impairment when evaluating the Veteran's hearing. See 38 C.F.R. § 4.85, Diagnostic Code 6100. There are no patterns of exceptional hearing loss noted from medical examinations pursuant to 38 C.F.R. § 4.86. In other words, the rating criteria reasonably describe the Veteran's disability picture. Thun v. Peake, 22 Vet. App. 111, 115 (2008); Anderson v. Shinseki, 22 Vet. App. 423, 426 (2009). Therefore, the Board finds that the preponderance of the evidence weighs against the assignment of rating in excess of the noncompensable rating prior to February 21, 2019, or a rating in excess of 20 percent for the period from February 21, 2019 forward on an extraschedular basis pursuant to 38 C.F.R. § 3.321(b)(1) throughout the appeal period and the claim must be denied. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 2 Vet. App. 49, 53 (1990). Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366, 369 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). MICHAEL A. PAPPAS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Setter, 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.