Citation Nr: 21005642 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 11-13 258 DATE: February 2, 2021 ORDER Entitlement to an initial 50 percent schedular rating, from November 25, 2020, for bilateral hearing loss is granted, subject to the law and regulations governing the award of monetary benefits. Entitlement to initial extraschedular ratings for bilateral hearing loss for the period from June 19, 2011 (rated 30 percent disabling from June 19, 2011 through November 28, 2012, 10 percent disabling, from November 29, 2012 through November 24, 2020, and now 50 percent disabling, from November 25, 2020) is denied. Entitlement to special monthly compensation (SMC) pursuant to 38 U.S.C. § 1114 (k), from August 11, 2009 through June 18, 2011, is granted, subject to the law and regulations governing the award of monetary benefits. Entitlement to SMC pursuant to 38 U.S.C. § 1114 (s) is denied. FINDINGS OF FACT 1. Since November 25, 2020, the Veteran has had at worst level IX hearing in the right ear and level VIII hearing in the left ear. 2. The Veteran’s service-connected bilateral hearing loss disability picture is contemplated by the rating schedule and the assigned rating criteria are adequate. 3. From August 11, 2009 through June 18, 2011, the Veteran’s hearing loss resulted in deafness in both ears. 4. The Veteran is not housebound due to service-connected disability or disabilities, and he has not had a single disability rated at 100 percent with additional disability or disabilities rated at 60 percent or more. CONCLUSIONS OF LAW 1. The criteria for an initial 50 percent schedular rating, but no higher, from November 25, 2020, for bilateral hearing loss are met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.1, 4.2, 4.7, 4.10, 4.21, 4.85, 4.86, Diagnostic Code (DC) 6100. 2. The criteria for initial extraschedular ratings for bilateral hearing loss, from June 19, 2011, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 3.321 (b)(1), 4.1, 4.2, 4.7, 4.10, 4.21, 4.85, 4.86, Diagnostic Code (DC) 6100. 3. The criteria for SMC pursuant to 38 U.S.C. § 1114 (k), from August 11, 2009 through June 18, 2011, are met. 38 U.S.C. § 1114 (k); 38 C.F.R. § 3.350(a)(5). 4. The criteria for SMC pursuant to 38 U.S.C. § 1114 (s) are not met. 38 U.S.C. § 1114 (k), (s); 38 C.F.R. § 3.350(i). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1964 to July 1967. These matters initially came before the Board of Veterans’ Appeals (Board) from an April 2011 rating decision, in which the agency of original jurisdiction (AOJ) awarded service connection for left ear hearing loss and assigned an initial noncompensable disability rating, from April 24, 2009. In February 2013, the AOJ determined that its April 2011 decision to award service connection for only left ear hearing loss was clearly and unmistakably erroneous. The AOJ awarded service connection for bilateral hearing loss and assigned an initial 10 percent disability rating, from August 11, 2009. The Veteran was scheduled for a Board hearing before a Veterans Law Judge (VLJ) in December 2013, but he failed to report to the hearing. To the Board’s knowledge, he has not requested that the requested hearing be rescheduled. The Veteran’s hearing request is therefore considered withdrawn. See 38 C.F.R. § 20.704 (d). In August 2014, the Board awarded an initial 100 percent disability rating, prior to June 18, 2011, and a 30 percent disability rating, from June 18, 2011 through November 28, 2012, for bilateral hearing loss. The Board also denied an initial rating higher than 10 percent, from November 29, 2012, for bilateral hearing loss. The Board’s decision was implemented by the AOJ in an October 2014 rating decision. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In a September 2015 Memorandum Decision, the Court set aside the Board’s August 2014 decision, in part, and remanded to the Board the issues of entitlement to an extraschedular rating for bilateral hearing loss and entitlement to SMC pursuant to 38 U.S.C. § 1114 (k) and (s) for adjudication in compliance with the Court’s decision. The Veteran’s appeal as to that portion of the Board’s decision which determined the initial schedular ratings to be assigned for his bilateral hearing loss was dismissed by the Court. In February 2016, April 2017, and May 2019, the Board remanded these matters for further development. Specifically, the Board instructed the AOJ to ask the Veteran to identify any outstanding treatment records and to complete the appropriate authorization form to allow VA to obtain any outstanding private medical records, obtain all outstanding VA treatment records, afford the Veteran VA examinations/obtain medical opinions to assess the severity of his hearing loss and its effects on his activities of daily living and occupational functioning, and refer the Veteran’s claim to the Director of Compensation Service (Director) for a determination as to whether an extraschedular rating for hearing loss was warranted. Pursuant to the Board’s remand, the Veteran was asked to identify any outstanding treatment records and to complete the appropriate authorization form to allow VA to obtain any outstanding private medical records by way of a March 2016 letter. Copies of the authorization forms (VA Forms 21-4142a and 21-4142) were included with the letter. All relevant outstanding treatment records have been associated with the claims file, VA audiological examinations were conducted in March 2016 and November 2019, and information pertaining to the effects of the Veteran’s hearing loss on his activities of daily living and occupational functioning was most recently provided by the audiologist who conducted the November 2019 examination. Also, the Veteran’s case was referred to the Director in April 2016, November 2017, and August 2020 and the Director issued decisions as to the Veteran’s entitlement to an extraschedular rating for bilateral hearing loss in February 2017, February 2019, and October 2020. Therefore, the AOJ substantially complied with the Board’s remand instructions. See Dyment v. West, 13 Vet. App. 141, 146- 47 (1999); Stegall v. West, 11 Vet. App. 268 (1998). As a final preliminary matter, as the Veteran was awarded a total (100 percent) rating from the August 11, 2009 effective date of service connection through June 18, 2011 for his service-connected bilateral hearing loss, the rating for this disability during this period will not be addressed by the Board. See AB v. Brown, 6 Vet. App. 35, 38 (1993). Higher Initial Rating Disability ratings are determined by the application of rating criteria set forth in the VA Schedule for Rating Disabilities (38 C.F.R. § Part 4) based on the average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155. Where service connection has been granted and the assignment of an initial rating is disputed, separate ratings may be assigned for separate periods of time based on the facts found. In other words, the ratings may be “staged.” Fenderson v. West, 12 Vet. App. 119, 125-126 (1999). Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. See 38 C.F.R. § 4.7. In view of the number of atypical instances it is not expected, especially with the more fully described grades of disabilities, that all cases will show all the findings specified. Findings sufficiently characteristic to identify the disease and the disability therefrom, and above all, coordination of rating with impairment of function will, however, be expected. 38 C.F.R. § 4.21. The medical as well as industrial history is to be considered, and a full description of the effects of the disability upon ordinary activity is also required. 38 C.F.R. §§ 4.1, 4.2, 4.10. Hearing loss is rated on the basis of examination results including a controlled speech discrimination test (Maryland CNC), and a pure tone audiometric test of pure tone decibel thresholds at 1000, 2000, 3000, and 4000 Hz with an average pure tone threshold obtained by dividing these thresholds by four. 38 C.F.R. § 4.85. Once these test results have been obtained, employing Table VI, a Roman numeral designation of hearing impairment is ascertained based on a combination of the percent of speech discrimination and pure tone threshold average. Once a Roman numeral designation of auditory acuity level for each ear has been determined, Table VII is used to determine the percentage evaluation for bilateral hearing loss by combining the Roman numeral designations of auditory acuity level for hearing impairment of each ear. Id. There is an alternative method of rating hearing loss in defined instances of exceptional hearing loss. In such exceptional cases, the Roman numeral designation for hearing loss of an ear may be based only on pure tone threshold average, using Table VIA, or from Table VI, whichever results in the higher Roman numeral. Exceptional hearing loss exists when the pure tone threshold at the frequencies of 1000, 2000, 3000, and 4000 Hertz is 55 decibels or more; or where the pure tone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz. In the latter situation, the higher Roman numeral, determined from Table VI or VIA, will then be elevated to the next higher Roman numeral. Each ear will be evaluated separately. 38 C.F.R. § 4.86. Ratings for hearing loss are determined by a mechanical application of the VA rating schedule to the numeric designations assigned based on audiometric test results. Lendenmann v. Principi, 3 Vet. App. 345 (1992). 1. Background The Veteran reported during a June 19, 2011 audiological examination by T. Wilkerson, Au.D. that as a result of his hearing loss, he was unable to hear customers clearly and accurately over the telephone, that he was unable to hear the instructions of his customers and had to constantly ask them to repeat themselves, that he often did not hear the doorbell or his phone when they would ring, and that he missed a lot of incoming business calls. Also, he had to listen to the television at a high volume. Examination revealed that the Veteran’s pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Average RIGHT 30 30 75 80 54 LEFT 30 30 80 90 58 Speech audiometry revealed speech recognition ability of 60 percent in the right ear and 52 percent in the left ear. Using Table VI, the June 2011 examination revealed level VI hearing in the right ear and level VII hearing in the left ear. Combining level VI hearing for the right ear and level VII hearing for the left ear according to Table VII yields a rating of 30 percent. The report of a VA audiological examination dated on November 29, 2012 indicates that the Veteran reported that he was unable to hear numbers or directions clearly due to his hearing loss. Examination revealed that his pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Average RIGHT 40 25 65 75 51 LEFT 30 30 70 85 54 Speech audiometry revealed speech recognition ability of 60 percent in the right ear and 84 percent in the left ear. Using Table VI, the November 2012 VA examination revealed level VI hearing in the right ear and level II hearing in the left ear. Combining level VI hearing for the right ear and level II hearing for the left ear according to Table VII yields a rating of 10 percent. The Veteran reported during a March 2016 VA audiological examination that as a result of his hearing loss, he was sometimes unable to understand conversations, that he was unable to accurately take orders over the telephone, and that he would get numbers, yardages, and days mixed up on the telephone. He also sometimes had trouble hearing his wife and his wife would get disgusted. He was employed in carpet sales. Examination revealed that the Veteran’s pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Average RIGHT 20 20 70 75 46 LEFT 15 20 70 75 45 Speech audiometry revealed speech recognition ability of 92 percent in both ears. Using Table VI, the March 2016 VA examination revealed level I hearing in both ears. Combining level I hearing for both ears according to Table VII yields a rating of 0 percent. The audiologist who conducted the examination explained that bone conduction testing was completed from 500 through 4,000 Hertz and did not reveal any significant air-bone gaps for either ear. Word recognition scores were consistent with pure tone thresholds for both ears and acoustic immittance results were suggestive of normal tympanic membrane mobility for both ears. Hearing sensitivity was within normal limits from 500 to 2,000 Hertz bilaterally and there was severe to profound sensorineural hearing loss from 3,000 to 8,000 Hertz bilaterally. Although the Veteran’s degree of hearing loss may have caused difficulty communicating in adverse listening environments (i.e., amid background noise), it should not have prohibited him from obtaining or maintaining gainful employment. Also, his hearing loss should not have caused frequent hospitalizations. Moreover, the examiner concluded that the severity of the effects of the hearing loss reported during the March 2016 examination was consistent with the severity of the hearing loss disability objectively shown. In May 2017, the audiologist who conducted the March 2016 VA examination re-reviewed the Veteran’s claims file. She provided the same information pertaining to the effects of the Veteran’s hearing loss on his daily activities and occupational functioning that was provided in the March 2016 examination report. The Veteran reported during a November 2019 VA audiological examination that he was unable to understand a lot of conversations due to his hearing loss. Examination revealed that his pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Average RIGHT 20 30 65 75 48 LEFT 25 30 70 80 51 Speech audiometry revealed speech recognition ability of 96 percent in the right ear and 94 percent in the left ear. Using Table VI, the November 2019 VA examination revealed level I hearing in both ears. Combining level I hearing for both ears according to Table VII yields a rating of 0 percent. The examiner who conducted the November 2019 examination explained that as a result of hearing loss, the Veteran would have difficulty understanding speech of some people in quiet, understanding speech at normal conversation levels in the presence of background noise, and understanding speech on the television. His speech discrimination scores were excellent in both ears at the prescribed levels, and this suggested that with some modifications and proper binaural amplification, he would be able to perform activities necessary to secure and/or maintain employment. Therefore, he would be able to secure and maintain employment with regard to his hearing loss. Moreover, understanding speech on the telephone would present a problem for the Veteran and he reported that he was unable to understand a lot of conversations of soft spoken people. He would have difficulty understanding speech at normal conversational levels in the presence of background noise and he reported that he sometimes did not understand what was being said in such situations. He would sometimes have difficulty understanding speech of some people in quiet and he reported that he did not understand a lot of conversations. Also, he would be unable to hear some doorbells, phones, and speech on the television at a comfortable level, and he would experience difficulty understanding speech at normal conversational levels in the presence of background noise and in quiet. For instance, he reported that he sometimes missed what numbers or directions were said. The report of an audiological examination from Fine Hearing Care dated on November 25, 2020 indicates that the Veteran reported that he experienced difficulty hearing in group situations, in noisy environments, and from a distance. Although he was able to hear, it was not clear. Examination revealed that his pure tone thresholds, in decibels, were as follows: HERTZ 1000 2000 3000 4000 Average RIGHT 60 55 80 90 71 LEFT 55 50 70 100 69 Speech audiometry revealed speech recognition ability of 40 percent in the right ear and 44 percent in the left ear. Using Table VI, the November 2020 examination revealed level IX hearing in the right ear and level VIII hearing in the left ear. However, because the puretone thresholds at each of the frequencies of 1000, 2000, 3000, and 4000 Hertz were 55 decibels or more in the right ear, Table VIA is for consideration for this ear. As Table VIA reveals level VI hearing in the right ear, the higher level IX will be used for the right ear. Combining level IX hearing for the right ear and level VIII hearing for the left ear according to Table VII yields a rating of 50 percent. 2. Entitlement to a 50 percent rating, from November 25, 2020, for bilateral hearing loss In this case, the Board acknowledges that the issue of entitlement to a higher initial schedular rating for bilateral hearing loss was adjudicated in the August 2014 Board decision. In its September 2015 Memorandum Decision, with respect to the issue of entitlement to a higher initial rating for bilateral hearing loss, the Court only set aside that portion of the Board’s August 2014 decision which found that referral for consideration of an extraschedular rating was not warranted. Nevertheless, the November 2020 examination report from Fine Hearing Care which was submitted by the Veteran reveals that a 50 percent rating is warranted for the Veteran’s hearing loss. Accordingly, in light of this additional evidence which has been submitted by the Veteran and upon reconsidering all the evidence of record, the Board finds that an initial 50 percent schedular rating for bilateral hearing loss is warranted, from November 25, 2020 (the date of the November 2020 examination from Fine Hearing Care). This is the earliest that it is factually ascertainable that a higher rating is warranted following the November 2019 VA examination. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. 3. Entitlement to extraschedular ratings for bilateral hearing loss for the period from June 19, 2011 (rated 30 percent disabling from June 19, 2011 through November 28, 2012, 10 percent disabling, from November 29, 2012 through November 24, 2020, and now 50 percent disabling, from November 25, 2020) Pursuant to 38 C.F.R. § 3.321 (b)(1), the Under Secretary for Benefits or the Director is authorized to approve an extraschedular rating if the case “presents 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)(1). The question of an extraschedular rating is a component of an appeal for a higher initial rating. See Bagwell v. Brown, 9 Vet. App. 337, 339 (1996). Although the Board may not assign an extraschedular rating in the first instance, it must specifically adjudicate whether to refer a case for extraschedular rating when the issue either is raised by the claimant or is reasonably raised by the evidence of record. Barringer v. Peake, 22 Vet. App. 242, 244 (2008). If the evidence raises the question of entitlement to an extraschedular rating, the threshold factor for extraschedular consideration is a finding that the evidence before VA presents such an exceptional disability picture that the available schedular evaluations for that service-connected disability are inadequate. Therefore, initially, there must be a comparison between the level of severity and symptomatology of a claimant’s service-connected disability with the established criteria found in the rating schedule for that disability. Thun v. Peake, 22 Vet. App. 111 (2008), aff’d sub nom, Thun v. Shinseki, 572 F.3d 1366 (Fed. Cir. 2009). Under the approach prescribed by VA, if the criteria reasonably describe the claimant’s disability level and symptomatology, then the claimant’s disability picture is contemplated by the rating schedule, the assigned schedular evaluation is, therefore, adequate, and no referral is required. In the second step of the inquiry, however, if the schedular evaluation does not contemplate the claimant’s level of disability and symptomatology and is found inadequate, the AOJ or Board must determine whether the claimant’s exceptional disability picture exhibits other related factors such as those provided by the regulation as “governing norms.” 38 C.F.R. § 3.321 (b)(1) (related factors include “marked interference with employment” and “frequent periods of hospitalization”). In this case, the Director issued advisory opinions in February 2017, February 2019, and October 2020 regarding the Veteran’s entitlement to an extraschedular rating for his hearing loss under 38 C.F.R. § 3.321 (b)(1). The Director’s decisions are not evidence, but, rather, are the de facto AOJ decisions, and the Board must conduct de novo review of these decisions. Kuppamala v. McDonald, 27 Vet. App. 443, 458 (2015) (the Board reviews the entirety of the Director’s decision de novo and is thus authorized to assign an extraschedular rating when appropriate). In determining whether a veteran’s symptomatology is adequately contemplated by the rating schedule, the Court has provided some guiding principles as to how to recognize whether symptomatology is exceptional under 38 C.F.R. § 3.321(b)(1). First, symptomology is exceptional only when it is of such nature or severity that conventional rating tools are not adequate to evaluate it properly. Second, the initial step in determining whether symptomatology is adequately contemplated by the rating schedule focuses solely on the functional impairments/symptoms of the disability at issue (as opposed to the functional effects of those impairments/symptoms). Third, if a symptom/impairment is not at all compensable under the rating schedule, then it does not warrant extraschedular consideration. Also, extraschedular consideration is not warranted for any symptom/impairment that clearly lacks a relationship to service or a service-connected disability. Long v. Wilkie, No. 16-1537, 2020 U.S. App. Vet. Claims LEXIS 2371, at *10-15 (Vet. App. Dec. 30, 2020). In this case, with respect to the first prong of Thun, considering the pertinent evidence in light of the applicable criteria and considerations delineated above, the Board finds that the evidence does not establish such an exceptional disability picture as to render the schedular criteria for evaluating hearing loss inadequate. The schedular rating criteria for rating hearing loss provide for disability ratings based on testing during audiological evaluations, to include speech discrimination and pure tone testing. Here, all of the symptoms and functional impairments associated with the Veteran’s hearing loss, as described above, are contemplated by the schedular rating criteria and the conventional rating tools are not adequate to evaluate them properly. In this regard, the Board points out that the applicable schedular rating criteria (38 C.F.R. §§ 4.85, 4.86) specifically provide for ratings based on all levels of hearing loss in various contexts, as measured by both audiometric testing and speech recognition testing. The ability of the Veteran to hear sounds and voices is measured and rated by an audiometric test, as this test measures different frequencies and captures high frequency hearing loss from sources including voices, music, sirens, and certain high-pitched sounds. The ability of the Veteran to understand people is rated by a speech recognition test, as this test measures conversation comprehension, words, and missed conversations. The schedular rating criteria specifically provide for ratings based on all levels of hearing loss, including exceptional hearing patterns, as measured by both audiometric testing and speech recognition testing. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (holding “that the rating criteria for hearing loss contemplate the functional effects of difficulty hearing and understanding speech”). The decibel loss and speech discrimination ranges designated for each level of hearing impairment in Tables VI and VIa of the rating schedule were chosen in relation to clinical findings of the impairment experienced by veterans with certain degrees and types of hearing disability. The regulatory history of 38 C.F.R. §§ 4.85 and 4.86 includes revisions, effective June 10, 1999. See 64 Fed. Reg. 25,202 (May 11, 1999). In forming these revisions, VA sought the assistance of the Veteran’s Health Administration (VHA) in developing criteria that contemplated situations in which a veteran’s hearing loss was of such a type that speech discrimination tests may not reflect the severity of communicative functioning these veterans experienced or that was otherwise an extreme handicap in the presence of any environmental noise, even with the use of hearing aids. VHA had found through clinical studies of veterans with hearing loss that, when certain patterns of impairment are present, a speech discrimination test conducted in a quiet room with amplification of the sounds does not always reflect the extent of impairment experienced in the ordinary environment. The decibel threshold requirements for application of Table VIa were based on the findings and recommendations of VHA. The intended effect of the revision was to fairly and accurately assess the hearing disabilities of veterans as reflected in a real life industrial setting. 59 Fed. Reg. 17,295 (Apr. 12, 1994). The inherent purpose of the schedular rating criteria is to determine, as far as practicable, the severity of functional impact resulting from a service-connected disability, including any resultant occupational and social impairment, and therefore contemplates the Veteran’s difficulties with functioning in a social environment due to hearing loss. Accordingly, the Board finds that the Veteran’s reported hearing related difficulties are factors contemplated in the regulations and schedular rating criteria. See also Doucette, 28 Vet. App. at 366 (holding that “the rating criteria for hearing loss contemplate the functional effects of decreased hearing and difficulty understanding speech in an everyday work environment, as these are precisely the effects that VA’s audiometric tests are designed to measure... an inability to hear or understand speech or to hear other sounds in various contexts... are contemplated by the schedular rating criteria”). In sum, the criteria for rating hearing loss under 38 C.F.R. §§ 4.85 and 4.86 encompass the effects of the Veteran’s hearing loss, to include those described by the Veteran throughout the claim period. Therefore, the ratings assigned for the service-connected hearing loss during the period on appeal contemplate all of the Veteran’s reported and observed symptoms, as set forth above, and the Veteran has not demonstrated any symptomatology/impairments associated with his hearing loss that falls outside the scope of the applicable criteria. Under these circumstances, the Board concludes that the record does not establish that the Veteran’s bilateral hearing loss is so exceptional or unusual as to warrant an extraschedular rating at any point during the claim period. To the extent that this conclusion conflicts with a prior Board determination that remand for referral for extraschedular consideration was warranted, the current decision is based on reconsideration of this conclusion in light of the application of the holdings of the above cases including Long to the facts of this case. 4. Entitlement to SMC pursuant to 38 U.S.C. § 1114 (k) and (s) A veteran who, as the result of a service-connected disability has suffered loss of use of hearing, to include deafness in both ears shall receive special monthly compensation under the provisions of 38 U.S.C. § 1114 (k). The term “loss of use” regarding deafness is defined by 38 C.F.R. § 3.350 (a)(5), as “deafness of both ears, having absence of air and bone conduction will be held to exist where examination in a Department of Veterans Affairs authorized audiology clinic under current testing criteria shows bilateral hearing loss is equal to or greater than the minimum bilateral hearing loss required for a maximum rating evaluation under the rating schedule.” An award of SMC pursuant to 38 U.S.C. § 1114 (s) requires that a veteran have a single service-connected disability rated as 100 percent, and (1) has additional service-connected disability or disabilities independently ratable at 60 percent, separate and distinct from the 100 percent service-connected disability, or (2) is permanently housebound by reason of service-connected disability or disabilities. This permanently housebound requirement is met when the veteran is substantially confined as a direct result of service-connected disabilities to his or her dwelling and the immediate premises or, if institutionalized, to the ward or clinical areas and it is reasonably certain that the disability or disabilities and resultant confinement will continue throughout his or her lifetime. 38 U.S.C. § 1114 (s); 38 C.F.R. § 3.350 (i). In this case, the Veteran has been awarded the maximum 100 percent rating for bilateral hearing loss during the period from the August 11, 2009 effective date of service connection through June 18, 2011. As noted above, the 100 percent schedular rating for bilateral hearing loss disability is the equivalent of deafness in both ears for purposes of 38 U.S.C. § 1114 (k); 38 C.F.R. § 3.350 (a)(5). In light of the evidence set forth above, there is no basis for awarding the Veteran a 100 percent disability rating for his service-connected bilateral hearing loss at any point during the claim period since June 18, 2011. Therefore, SMC pursuant to 38 U.S.C. § 1114 (k), from August 11, 2009 through June 18, 2011, is warranted. With respect to SMC pursuant to 38 U.S.C. § 1114 (s), the Veteran has not had a single service-connected disability rated at 100 percent with additional service-connected disability or disabilities rated at 60 percent or more at any point during the claim period. Moreover, the Veteran has not contended, and the evidence does not otherwise reflect, that he has been permanently housebound by reason of service-connected disability or disabilities at any time during the claim period. Therefore, entitlement to SMC pursuant to 38 U.S.C. § 1114 (s) is not warranted. 38 U.S.C. § 1114 (s); 38 C.F.R. § 3.350 (i). (CONTINUED ON NEXT PAGE) 5. Additional Considerations As a final point, the Board notes that in conjunction with the higher rating matter decided herein, neither the Veteran nor his representative have raised any other related issues, and no other such issues have been reasonably raised by the record. See Doucette, 28 Vet. App. at 369-70 (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). Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Elwood, 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.