Citation Nr: 21008964 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 12-23 260 DATE: February 18, 2021 ISSUES 1. Entitlement to an initial compensable rating prior to January 6, 2020, and in excess of 80 percent thereafter, for dermatitis scars. 2. Entitlement to an initial compensable rating prior to January 6, 2020, and in excess of 60 percent thereafter, for dermatitis. 3. Entitlement to an initial compensable rating for hearing loss. 4. Entitlement to an initial compensable disability rating for right foot plantar wart. ORDER From July 31, 1982 to August 29, 2002, an initial 50 percent disability rating, but no higher, for dermatitis scarring is granted. Since August 30, 2002 to January 5, 2020, an 80 percent disability rating, but no higher, for dermatitis scarring is granted. Since January 6, 2020, a disability rating in excess of 80 percent for dermatitis scarring is denied. Prior to August 30, 2002, an initial 30 percent disability rating, but no higher, for dermatitis is granted. Since August 30, 2002 to January 5, 2020, a 60 percent disability rating, but no higher, for dermatitis is granted. Since January 6, 2020, a disability rating in excess of 60 percent for dermatitis is denied. An initial compensable disability rating for hearing loss is denied. REMANDED An initial compensable disability rating for right foot plantar wart is remanded. FINDINGS OF FACT 1. From July 31, 1982 to August 29, 2002, the Veteran’s dermatitis scarring resulted in marked bilateral disfigurement, but not tissue loss. 2. From August 30, 2002, the Veteran’s dermatitis scarring with gross distortion of three or more features or paired sets of features. 3. The highest schedular disability rating available under any applicable diagnostic code for the Veteran’s dermatitis scarring is 80 percent. 4. From July 31, 1982 to August 29, 2002, the Veteran’s dermatitis resulted in constant exudation or itching and extensive lesions, but not ulceration or extensive exfoliation or crusting, or systemic or nervous manifestations. 5. Since August 30, 2002, the Veteran’s dermatitis results in 40 percent of the entire body area affected. 6. The highest schedular disability rating available under any applicable diagnostic code for the Veteran’s dermatitis is 60 percent. 7. The Veteran’s hearing loss has been manifested by no worse than level II hearing loss in both ears. CONCLUSIONS OF LAW 1. From July 31, 1982 to August 29, 2002, the criteria for an initial 50 percent disability rating, but no higher, for dermatitis scarring were met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.118, Diagnostic Code (DC) 7800 (1982, 2003, 2021). 2. From August 30, 2002 to January 5, 2020, the criteria for an 80 percent disability rating for dermatitis scarring are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.118, DC 7800 (1982, 2003, 2021). 3. Since January 6, 2020, the criteria for a disability rating in excess of 80 percent disability rating for dermatitis scarring are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.118, DC 7800 (1982, 2003, 2021). 4. From July 31, 1982 to August 29, 2002, the criteria for an initial 30 percent disability rating, but no higher, for dermatitis were met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.14, 4.118, DC 7806 (1982, 2003, 2021). 5. From August 30, 2002 to January 5, 2020, the criteria for a 60 percent disability rating for dermatitis are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.118, DC 7806 (1982, 2003, 2021). 6. From January 6, 2020, the criteria for a disability rating in excess of 60 percent for dermatitis are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.118, DC 7806 (1982, 2003, 2021). 7. The criteria for an initial compensable disability rating for hearing loss are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.3, 4.7, 4.85, 4.86, DC 6100. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1978 to July 1982. The case is on appeal from a May 2010 and February 2011 rating decisions. In March 2018, the Veteran testified before an undersigned Veterans Law Judge (VLJ) at a Board hearing. Thereafter, in a June 2018 decision, the Board reopened service connection for a left knee disability and remanded service connection for a left knee disability as well as increased rating claims for dermatitis, hearing loss, and a right foot plantar wart. While the case was in remand status, in an April 2020 rating decision, the RO granted service connection for left knee osteoarthritis. As the benefit sought on appeal for the left knee claim has been granted in full, it is no longer before the Board. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997). In addition, the April 2020 rating decision granted a 60 percent disability rating for dermatitis and a separate 80 percent disability rating for dermatitis scarring, both effective January 6, 2020. Although these ratings do represent the maximum schedular disability ratings assignable for these disabilities, they do not represent the maximum ratings assigned for the period that is currently on appeal, namely from the effective date of service connection for the disabilities at issue (July 31, 1982) and the Veteran has not indicated that the current staged ratings are the maximum benefits sought for those periods on appeal. As higher ratings are available for such periods, and a claimant is presumed to be seeking the maximum available rating for disabilities, the claims remains on appeal. See AB v. Brown, 6 Vet. App. 35, 38 (1993). At a November 2020 Board hearing, the Veteran was advised that, because he had testified before two different VLJs, the claims listed on the title page would be addressed in a panel decision decided by both hearing VLJs and a third VLJ. See 38 C.F.R. § 20.604. The Veteran waived the right to attend a hearing before the third VLJ on the panel. See Arneson v. Shinseki, 24 Vet. App. 379, 386 (2011). Therefore, the issues are addressed herein by a three-VLJ panel that includes both hearing VLJs. The Board also notes that the Veteran provided testimony in regard to service connection claims at the November 2020 Board hearing. As such claims were not discussed at the March 2018 Board hearing, they will be the addressed in a separate decision from the November 2020 hearing VLJ. The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008). Increased Ratings General Legal Criteria Ratings are based on a schedule of reductions in earning capacity from specific injuries or combination of injuries. The ratings shall be based, as far as practicable, upon the average impairments of earning capacity resulting from such injuries in civil occupations. 38 U.S.C. § 1155. 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 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. (Continued on next page.) 1. An initial compensable disability rating prior to January 6, 2020, and in excess of 80 percent thereafter, for dermatitis scars. 2. An initial compensable disability rating prior to January 6, 2020, and in excess of 60 percent thereafter, for dermatitis. During the course of the appeal, in a May 2012 rating decision, the RO found that an effective date for service connection for dermatitis of July 31, 1982 is warranted on the basis of clear and unmistakable error. This created a staged initial rating for the skin conditions implicating several rating criteria that have been in effect over the years. Specific Legal Criteria The Veteran’s dermatitis scars are rated under DC 7800 for scars of the head, face, or neck. Effective as of the effective date of service connection for the skin condition (July 31, 1982) and prior to August 30, 2002, under DC 7800, a zero percent rating was assigned for slight impairment; a 10 percent rating was assigned for scars that were moderately disfiguring; a 30 percent disability rating was assigned for severe disfigurement, especially if producing a marked and unsightly deformity of eyelids, lips or auricles; and a 50 percent rating was assigned for complete or exceptionally repugnant deformity of one side of face or marked or repugnant bilateral deformity. 38 C.F.R. § 4.118, DC 7800 (1982). A Note following DC 7800 states when in addition to tissue loss and cicatrization there is marked discoloration, color contrast, or the like, the 50 percent disability rating may be increased to 80 percent, the 20 percent rating to 50 percent, and the 10 percent rating to 30 percent. Id. The Note continues stating the most repugnant, disfiguring conditions, including scars and diseases of the skin, may be submitted for central office rating, with several unretouched photographs. Id. In addition, prior to August 30, 2002, dermatitis was assigned DC 7817, but DC 7819 provided that DC 7817 was to be rated under DC 7806. 38 C.F.R. § 4.118, DCs 7817, 7819. Under DC 7806 a zero percent rating was warranted with slight, if any, exfoliation, exudation or itching, if on a nonexposed area; a 10 percent rating was assigned for exfoliation, exudation, or itching, if on an exposed surface or extensive area; a 30 percent rating was assigned for exudation or itching constant, extensive lesions, or marked disfigurement; and a 50 percent rating was assigned for ulceration or extensive exfoliation or crusting, and system or nervous manifestations, or exceptionally repugnant. 38 C.F.R. § 4.118, DC 7806 (1982). However, effective August 30, 2002, the criteria to rate dermatitis scars and dermatitis were amended. Under the new criteria for DC 7800, a 10 percent rating is assigned for one characteristic of disfigurement, a 30 percent rating is assigned with visible or palpable tissue loss and either gross distortion or asymmetry of one feature or paired set of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or with two or three characteristics of disfigurement; a 50 percent rating is assigned with visible or palpable tissue loss and either gross distortion or asymmetry of two features or paired sets of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or with four or five characteristics of disfigurement; and an 80 percent rating is assigned with visible or palpable tissue loss and either gross distortion or asymmetry of three or more features or paired sets of features (nose, chin, forehead, eyes (including eyelids), ears (auricles), cheeks, lips), or with six or more characteristics of disfigurement. 38 C.F.R. § 4.118, DC 7800 (2003). Note (1) lists the 8 characteristics of disfigurement: scar 5 or more inches (13 or more cm.) in length; scar at least one-quarter inch (0.6 cm.) wide at widest part; surface contour of scar elevated or depressed on palpation; scar adherent to underlying tissue; skin hypo-or hyper-pigmented in an area exceeding six square inches (39 sq. cm.); skin texture abnormal (irregular, atrophic, shiny, scaly, etc.) in an area exceeding six square inches (39 sq. cm.); underlying soft tissue missing in an area exceeding six square inches (39 sq. cm.); and skin indurated and inflexible in an area exceeding six square inches (39 sq. cm.). Id. Note (2) states to rate tissue loss of the auricle under DC 6207 (loss of auricle) and anatomical loss of the eye under DC 6061 (anatomical loss of both eyes) or DC 6063 (anatomical loss of one eye), as appropriate. Id. Note (3) states to take into consideration unretouched color photographs when evaluating under these criteria. Id. Note (4) states to separately evaluate disabling effects other than disfigurement that are associated with individual scar(s) of the head, face, or neck, such as pain, instability, and residuals of associated muscle or nerve injury, under the appropriate diagnostic code(s) and apply §4.25 to combine the evaluation(s) with the evaluation assigned under this diagnostic code. Id. Note (5): The characteristic(s) of disfigurement may be caused by one scar or by multiple scars; the characteristic(s) required to assign a particular evaluation need not be caused by a single scar in order to assign that evaluation. Id. In addition, effective August 30, 2002, under DC 7806, dermatitis is rated under the General Rating Formula for Skin. Under the Formula, a zero percent rating is assigned with less than 5 percent of the entire body or less than 5 percent of exposed areas affected, and no more than topical therapy required during the past 12-month period; a 10 percent rating is assigned if at least 5 percent, but less than 20 percent of the entire body, or at least 5 percent, but less than 20 percent of exposed areas affected, or when intermittent systemic therapy such as corticosteroids or other immunosuppressive drugs are required for a total duration of less than six weeks during the past 12-month period; a 30 percent rating is assigned if the skin condition covers 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected, or when systemic therapy such as corticosteroids or other immunosuppressive drugs is required for a total duration of six weeks or more, but not constantly, during the past 12-month period; and a 60 percent rating is assigned if the skin condition covers more than 40 percent of the entire body or more than 40 percent of exposed areas affected, or; constant or near-constant systemic therapy such as corticosteroids or other immunosuppressive drugs required during the past 12-month period. 38 C.F.R. § 4.118 (2003). Furthermore, for claims filed prior to August 13, 2018, the United States Court of Appeals for Veterans Claims (Court) held that a systematic therapy is one that that affects the entire body in its treatment of the condition at issue, and that the Board must determine (1) whether a topical treatment affects the body as a whole in treating a veteran’s skin condition; and (2) whether the given treatment is “like” a corticosteroid or other immunosuppressive drug. Burton v. Wilkie, 30 Vet. App. 286 (2018). Only the second question need be addressed if the treatment is clearly systemic. Id. The United States Court of Appeals for the Federal Circuit (Federal Circuit) has found that some applications of topical corticosteroids may constitute systemic therapy under DC 7822 if administered on a large enough scale to affect the body as a whole. Johnson v. Shulkin, 862 F.3d 1351, 1354-56 (Fed. Cir. 2017). The Federal Circuit made clear that this determination should be made based on the facts of each individual case. Id. Effective August 31, 2018, VA regulations explicitly state that systemic therapy is treatment that is administered through any route other than the skin, and topical therapy is treatment that is administered through the skin. 38 C.F.R. § 4.118(a). Additionally, effective August 13, 2018, a new General Rating Formula for the Skin. See 38 C.F.R. § 4.118. Under this formula, a 10 percent rating is assigned for at least one of the following: characteristic lesions involving at least 5 percent, but less than 20 percent, of the entire body affected; or at least 5 percent, but less than 20 percent, of exposed areas affected, or intermittent systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, psoralen with long-wave ultraviolet-A light (PUVA), or other immunosuppressive drugs required for a total duration of less than 6 weeks over the past 12- month period; a 30 percent rating is assigned for at least one of the following: characteristic lesions involving more than 20 to 40 percent of the entire body or 20 to 40 percent of exposed areas affected; or systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required for a total duration of 6 weeks or more, but not constantly, over the past 12-month period; and a 60 percent rating is assigned for at least one of the following: characteristic lesions involving more than 40 percent of the entire body or more than 40 percent of exposed areas affected; or constant or near-constant systemic therapy including, but not limited to, corticosteroids, phototherapy, retinoids, biologics, photochemotherapy, PUVA, or other immunosuppressive drugs required over the past 12-month period. Id. However, the Board notes that, for the Veteran’s dermatitis scarring and dermatitis ratings, the relevant criteria for the period since August 30, 2002 are essentially the same under both the August 30, 2002 criteria and the August 31, 2018 criteria. The Board also notes that each set of rating criteria will both be considered for the period it was in effect for and any later rating period, whichever criteria are most favorable to the Veteran. However, an award warranted under any revised criteria cannot be effective prior to the effective date of the change. See Kuzma v. Principi, 341 F.3d 1327 (Fed. Cir. 2003). Analysis The Veteran is seeking a higher rating for his service-connected dermatitis. During the March 2018 Board hearing, he reported experiencing a rash on his head, neck, chest, back, and arms. He also reported that the rash is sensitive to touch, weather, and clothing. The Veteran further reported feeling disfigured due to the presence of the rash and using prednisone cream for treatment. During the November 2020 Board hearing, he reported the rash is painful and has been present in the same form since service. He also reported that his skin condition had not changed since the most recent compensation examination. The Veteran was afforded a skin examination in February 2012. He reported using a steroid cream to treat dermatitis. The examiner diagnosed the Veteran with dermatitis with the use of topical corticosteroids for less than 6 weeks in the past 12 months. The examiner reported dermatitis present in over 40 percent of the total body area and the exposed body area. Pursuant to the June 2018 Board remand, the Veteran was afforded another skin examination in January 2020. The examiner reported dermatitis present of over 40 percent of his total body area and between 20 percent and 40 percent of his exposed body area. The examiner also provided photographs showing hypopigmentation present on the Veteran’s scalp, neck, both cheeks, arms, and hands. The Veteran has competently reported that his skin condition has consistently presented the same since its onset during service. There is little in the way of medical records detailing the severity during the earlier time periods. However, he has credibly testified to the severity since 1982. Moreover, the visual appearance during the Board hearings and color photographs lend credence to the testimony. The Board finds that an initial 50 percent rating for dermatitis scars from July 31, 1982 to August 29, 2002, and an 80 percent rating thereafter, is warranted. Prior to August 30, 2002, scars of the head, face, or neck resulting in marked bilateral disfigurement are indicative of a 50 disability rating under old DC 7800. However, the Veteran has not claimed, and the evidence does not show, that he experienced tissue loss and cicatrization in order to warrant an 80 percent disability rating for marked discoloration. See 38 C.F.R. § 4.118, DC 7800 (1982); see also Camacho v. Nicholson, 21 Vet. App. 360, 366 (2007). In addition, the August 30, 2002 rating criteria are not applicable prior to such date. Kuzma, 341 F.3d at 1327. Since August 30, 2002, an 80 percent disability rating is warranted based on scarring with gross distortion of three or more features or paired sets of features. 38 C.F.R. § 4.118, DC 7800 (2003). An 80 percent disability rating is the maximum available rating under DC 7800. In addition to the facial scarring, an initial 30 percent disability rating prior to August 30, 2002, and a 60 percent disability rating thereafter, for dermatitis is warranted. In this regard, the Veteran competently and credibly reported that his skin condition has remained consistent and has resulted in pain and itching since its onset during service. Prior to August 30, 2002, a 30 percent disability rating is warranted for dermatitis resulting in constant itching. However, a higher rating is not warranted because the evidence does not show ulceration, extensive exfoliation or crusting, or systemic or nervous manifestations. See 38 C.F.R. § 4.118, DC 7806; see also Camacho, 21 Vet. App. at 366. In addition, to the extent that the dermatitis was exceptionally repugnant during this period, the appearance of the dermatitis is already compensated by the scar rating under DC 7800 during such period. 38 C.F.R. § 4.118, DC 7800; see also 38 C.F.R. § 4.14. Furthermore, the August 30, 2002 rating criteria are not applicable prior to such date. Kuzma 341 F.3d 1327. Since August 30, 2002, a 60 percent disability rating is established based on dermatitis resulting in itching and pain present on over 40 percent of the Veteran’s total body area. The Board notes that the Veteran has reported using topical corticosteroids during the appeal period. However, a remand is not necessary to determine if such treatment affected the body as a whole because a 60 percent disability rating is the maximum rating available under DC 7806. 38 C.F.R. § 4.118; DC 7806. In sum, the evidence supports the findings that, from July 31, 1982 to August 29, 2002, the Veteran’s dermatitis scarring resulted in marked bilateral disfigurement, but not tissue loss, and his dermatitis resulted in constant exudation or itching and extensive lesions, but not ulceration or extensive exfoliation or crusting, or systemic or nervous manifestations. Since August 30, 2002, the evidence further supports the findings that dermatitis scarring with gross distortion of three or more features or paired sets of features and symptomatic dermatitis over 40 percent of the Veteran’s entire body area. However, the benefit of the doubt doctrine is not further applicable, and even higher staged ratings are not warranted. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. Although the Board is remanding another claim for additional development, remand is not necessary for these issues, as there is no reasonable possibility that further assistance would substantiate additional higher ratings. See 38 C.F.R. § 3.159(d). 3. An initial compensable disability rating for hearing loss. Specific Legal Criteria The rating schedule for hearing loss provides that evaluations of hearing loss range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of controlled speech discrimination tests together with average hearing threshold levels as measured by pure tone audiometry tests in the frequencies 1000, 2000, 3000 and 4000 cycles per second (Hertz). To evaluate the degree of disability from defective hearing, the rating schedule established eleven auditory acuity levels designated from level I for essentially normal acuity through level XI for profound deafness. 38 C.F.R. § 4.85, DC 6100. 38 C.F.R. § 4.86(a) provides that when the pure tone 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. The provisions of 38 C.F.R. § 4.86(b) provide that when the pure tone 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.   Analysis The Veteran is seeking a compensable rating for his service-connected hearing loss. He filed the present hearing loss claim in September 2009. During the March 2018 Board hearing, he reported being unable to understand speech over the radio. During the November 2020 Board hearing, he reported that he experiences difficulty hearing speech over radios and intercoms while working. He also reported that his hearing loss has not worsened since the most recent compensation examination. The Veteran’s file includes a private hearing evaluation from July 2009, which was prior to the rating period on appeal. The treatment provider marked “poor” for reliability and noted that the Veteran was “malingering.” Additionally, the speech recognition test was by W-22 and not the Maryland CNC. Thus, the Board finds this evidence to be of no probative value as to the severity of the Veteran’s hearing loss. The Veteran was afforded a VA examination for this disability in December 2009. The examiner reported the following air conduction pure tone thresholds, in decibels: December 2009 HERTZ 1000 2000 3000 4000 AVG. RIGHT 25 25 35 25 27.5 LEFT 25 30 30 35 30 The average air conduction pure tone threshold was 27.5 in the right ear and 30 in the left ear. Speech discrimination revealed scores of 100 percent in both the right and left ears. The examiner diagnosed the Veteran with mild bilateral hearing loss. The results correspond to level I hearing loss in each ear. 38 C.F.R. § 4.85, DC 6100. When combined, the results reflect a noncompensable disabling evaluation for the Veteran’s hearing loss. Id. Thereafter, the Veteran was afforded another examination in February 2012. The Veteran reported experiencing trouble understanding speech. The examiner reported the following air conduction pure tone thresholds, in decibels: February 2012 HERTZ 1000 2000 3000 4000 AVG. RIGHT 25 25 20 20 22.5 LEFT 25 25 25 20 23.75 The average air conduction pure tone threshold was 22.5 in the right ear and 23.75 in the left ear. Speech discrimination revealed scores of 92 percent in both the right and left ears. The results correspond to level I hearing loss in each ear. 38 C.F.R. § 4.85, DC 6100. When combined, the results reflect a noncompensable disabling evaluation for the Veteran’s hearing loss. Id. Pursuant to the Board’s June 2018 remand, the Veteran was afforded another examination in January 2020. The Veteran reported experiencing difficulty understanding speech in group settings and simple conversations. The examiner reported the following air conduction pure tone thresholds, in decibels: January 2020 HERTZ 1000 2000 3000 4000 AVG. RIGHT 25 35 25 35 30 LEFT 30 40 30 30 32.5 The average air conduction pure tone threshold was 30 in the right ear and 32.5 in the left ear. Speech discrimination revealed scores of 88 percent in the right ear and 84 percent in the left ear. The results correspond to level II hearing loss in both ears. 38 C.F.R. § 4.85, DC 6100. When combined, the results reflect a noncompensable disabling evaluation for the Veteran’s hearing loss. Id. The Board finds a compensable rating for this disability is not warranted at any point during the appeal. Although the Veteran contends that his hearing loss should be rated at a compensable level, the applicable mechanical hearing testing of record shows that his hearing loss is correctly evaluated as noncompensably disabling. Furthermore, the Veteran’s reports of difficulty understanding speech in various situations are contemplated by the rating criteria. See Doucette v. Shulkin, 28 Vet. App. 366, 369 (2017) (“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 the precisely the effects that VA’s audiometric tests are designed to measure.”). At the most recent Board hearing, the Veteran indicated that his hearing had worsened since the last Board hearing. As a new VA examination was afforded in January 2020 after the March 2018 Board hearing, the Board finds that another VA examination is not warranted. The Board has considered the benefit-of-the-doubt rule, however, the preponderance of the evidence is against a compensable level of hearing loss at any time during the appeal period. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. Therefore, an initial compensable rating for hearing loss is not warranted. Although the Board is remanding another claim for additional development, remand is not necessary for this issue, as there is no reasonable possibility that further assistance would substantiate the claim. See 38 C.F.R. § 3.159(d).   REASONS FOR REMAND An initial compensable disability rating for right foot plantar wart. The Veteran is seeking a compensable rating for a right foot plantar wart. During the March 2018 Board hearing, the Veteran stated that the plantar wart does not affect him at this point. However, during the November 2020 Board hearing, the Veteran reported that the wart is painful when walking and results in favoring his left side. He also submitted a letter written in August 2009 by a private physician. The physician reported that the Veteran has a wart on his right foot that gives him some discomfort. The Veteran was afforded an examination in regard to this disability in March 2010. He reported pain on the bottom of his right foot while standing or walking that ranges from 1 to 5 out of 10 in severity. He also reported experiencing difficulty with prolonged standing and walking. The examiner reported right foot tenderness, but denied the presence of painful motion, edema, disturbed circulation, weakness, atrophy, heat, redness, or instability. Pursuant to the June 2018 Board remand, the Veteran was afforded VA skin and scar examinations for his right foot plantar wart. However, he was not afforded an examination in regard to physical functional impairment caused by the wart. Therefore, a remand is necessary to afford the Veteran an appropriate examination for this condition. See Stegall v. West, 11 Vet. App. 268 (1998). This claim is REMANDED for the following action: Schedule the Veteran for a VA foot examination to assess the physical functional impairment of the service-connected right foot plantar wart. If there are flare-ups, but the examination is not conducted during a flare-up, the functional impact of a flare-up should be estimated. Michael A. Pappas Veterans Law Judge Board of Veterans’ Appeals A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Jimerfield 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.