Citation Nr: 21009511 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 13-32 004 DATE: February 22, 2021 ORDER Entitlement to an effective date prior to October 7, 2011 for entitlement to service connection for left upper extremity neuropathy, is denied. Entitlement to an effective date prior to October 7, 2011 for entitlement to service connection for a left wrist disability, is denied. Entitlement to an effective date prior to October 7, 2011 for entitlement to service connection for two left wrist scars, is denied. Entitlement to an effective date prior to October 7, 2011 for entitlement to service connection for hearing loss, is denied. Entitlement to an effective date prior to October 7, 2011 for entitlement to service connection for tinnitus, is denied. Entitlement to a disability rating in excess of 20 percent for left upper extremity neuropathy of the radial nerve from October 7, 2011 to December 10, 2019 is denied. Entitlement to a disability rating in excess of 30 percent for moderate left upper extremity neuropathy of the entire left radicular group from December 10, 2019 is denied. Entitlement to a disability rating in excess of 10 percent for a left wrist disability, is denied. Entitlement to a compensable disability rating for two left wrist scars, is denied. Entitlement to special monthly compensation (SMC) under 38 U.S.C. § 1114(k) for the loss of the use of the left hand is denied. Entitlement to a compensable disability rating for service-connected hearing loss, is denied. REMANDED Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU), is remanded. FINDINGS OF FACT 1. The Veteran was denied service connection for left upper extremity neuropathy in a final January 24, 2000 rating decision and no correspondence pertaining to his claim was received by the VA until October 7, 2011. 2. The Veteran was denied service connection for a left wrist disability in a final January 24, 2000 rating decision and no correspondence pertaining to his claim was received by the VA until October 7, 2011. 3. The Veteran was denied service connection for two left wrist scars in a final January 24, 2000 rating decision and no correspondence pertaining to his claim was received by the VA until October 7, 2011. 4. The Veteran was denied service connection for hearing loss in a final January 24, 2000 rating decision and no correspondence pertaining to his claim was received by the VA until October 7, 2011. 5. The Veteran was denied service connection for tinnitus in a final January 24, 2000 rating decision and no correspondence pertaining to his claim was received by the VA until October 7, 2011. 6. From October 7, 2011 to December 10, 2019, the Veteran’s left upper extremity neuropathy manifested as mild and moderate incomplete paralysis of the left radial nerve. 7. From December 10, 2019, the Veteran’s left upper extremity neuropathy manifested as moderate incomplete paralysis of the entire left radicular group. 8. The Veteran’s left wrist disability manifested as limitation of motion of dorsiflexion less than 15 degrees or of palmar flexion in line with the forearm. 9. The Veteran’s two left wrist scars are not painful or unstable. 10. The Veteran has not lost the use of his left hand. 11. The Veteran’s bilateral hearing loss disability has been manifested by level II hearing acuity in the right ear and level IV hearing acuity in the left ear. CONCLUSIONS OF LAW 1. The January 24, 2000 rating decision is final. 38 U.S.C. § 7105. 2. The claim of entitlement to an effective date prior to October 7, 2011, for a grant of service connection for a left upper extremity neuropathy is denied as a matter of law. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.156, 3.160(d), 3.400, 3.2500; Rudd v. Nicholson, 20 Vet. App. 296 (2006). 3. The claim of entitlement to an earlier effective date prior to October 7, 2011, for a grant of service connection for a left wrist disability is denied as a matter of law. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.156, 3.160(d), 3.400, 3.2500; Rudd v. Nicholson, 20 Vet. App. 296 (2006). 4. The claim of entitlement to an earlier effective date prior to October 7, 2011, for a grant of service connection for two left wrist scars is denied as a matter of law. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.156, 3.160(d), 3.400, 3.2500; Rudd v. Nicholson, 20 Vet. App. 296 (2006). 5. The claim of entitlement to an earlier effective date prior to October 7, 2011, for a grant of service connection for hearing loss is denied as a matter of law. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.156, 3.160(d), 3.400, 3.2500; Rudd v. Nicholson, 20 Vet. App. 296 (2006). 6. The claim of entitlement to an earlier effective date prior to October 7, 2011, for a grant of service connection for tinnitus is denied as a matter of law. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.156, 3.160(d), 3.400, 3.2500; Rudd v. Nicholson, 20 Vet. App. 296 (2006). 7. The criteria for a disability rating in excess of 20 percent for left upper extremity neuropathy of the radial nerve from October 7, 2011 to December 10, 2019, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 3.102, 4.7, 4.123, 4.124a, Diagnostic Code 8714. 8. The criteria for a disability rating in excess of 30 percent for left upper extremity neuropathy of the entire left radicular group from December 10, 2019, are not met. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 3.102, 4.7, 4.123, 4.124a, Diagnostic Code 8613. 9. The criteria for a disability rating in excess of 10 percent for a left wrist disability are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.71a, Diagnostic Code 5215. 10. The criteria for entitlement to a compensable disability rating for two left wrist scars are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.3, 4.7, 4.118, Diagnostic Code 7804. 11. The criteria for SMC under 38 U.S.C. § 1114(k) for loss of use of the left hand are not met. 38 U.S.C. §§ 1114(k), 5107; 38 C.F.R. § 3.350(a). 12. The criteria for entitlement to a compensable disability rating for bilateral hearing loss are not met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.85, Diagnostic Code 6100. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1979 to August 1983. This appeal is before the Board of Veterans’ Appeals (Board) from multiple rating decisions from Department of Veterans Affairs (VA) Regional Offices (RO). The pertinent procedural history of this case is as follows: in March 2018 the Board remanded the following claims for further development: entitlement to an effective date prior to October 7, 2011 for (1) left upper extremity neuropathy, (2) a left wrist disability, (3) two left wrist scars, (4) hearing loss, (5) tinnitus; entitlement to a disability rating in excess of (6) 10 percent for a left wrist disability, (7) a compensable rating for two left wrist scars, (8) a compensable rating for hearing loss; and (9) entitlement to TDIU. The March 2018 Board decision also denied the Veteran’s claim for disability in excess of 20 percent for left upper extremity neuropathy. The Veteran subsequently appealed his neuropathy claim denied in the March 2018 Board decision to the U.S. Court of Veteran’s Appeals (CAVC) and in May 2019, CAVC issued a Judgement for Partial Remand (JMPR) after finding the Board did not properly consider the Veteran’s lay statements. The Veteran’s claim returned to the Board and in November 2019, the Board remanded the Veteran’s claim for further development. In May 2019 the AOJ issued a statement of the case (SOC) denying the Veteran’s effective date claims. In July 2019, the AOJ issued a rating decision and supplemental statement of the case (SSOC) that granted the Veteran a 30 percent disability rating for his left upper extremity neuropathy. In September 2020, the AOJ issued another SSOC denying the Veteran’s increased rating claims. All of the Veteran’s claims have since returned to the Board and the Board finds substantial compliance with the March 2018 and November 2019 remand directives. Stegall v. West, 11 Vet. App. 268 (1998). However, the Board notes the March 2018 remand directives in relation to the Veteran’s claim of TDIU will be addressed in the reasons for remand. EFFECTIVE DATE The Veteran seeks entitlement to an effective date prior to October 7, 2011 for the following service-connected disabilities: (1) left upper extremity neuropathy, (2) a left wrist disability, (3) two left wrist scars, (4) hearing loss, (5) and tinnitus. 1. Effective date prior to October 7, 2011 for left upper extremity neuropathy 2. Effective date prior to October 7, 2011 for a left wrist disability 3. Effective date prior to October 7, 2011 for two left wrist scars 4. Effective date prior to October 7, 2011 for hearing loss 5. Effective date prior to October 7, 2011 for tinnitus Prior to adjudicating his claims, the Board will address two initial matters. First, the Veteran challenged the presumption of regularity in receiving notice of the January 24, 2000 rating decision that denied is claims of entitlement to a left wrist disability, left wrist scars, hearing loss, and tinnitus. Specifically, that no notice was received. Under the presumption of regularity in the administrative process, it is presumed that a claimant received proper notice by VA. See Boyd v. McDonald, 27 Vet. App. 63, 71-72 (2014) (holding that under the presumption of regularity, if notice is sent to the claimant's last known address of record, it will be presumed that VA properly discharged its official duties) (citing Clarke v. Nicholson, 21 Vet. App. 130, 133 (2007)). This presumption may only be rebutted with "clear evidence to the contrary." Schoolman v. West, 12 Vet. App. 307, 310 (1999). Such evidence includes "clear evidence that VA did not follow its regular mailing practices or that its practices were not regular." Boyd, 27 Vet. App. at 72 (quoting Crain v. Principi, 17 Vet. App. 182, 186 (2003)). The mere assertion that the notice was not received does not by itself constitute clear evidence rebutting the presumption. Id. However, the presumption of regularity may be rebutted where there is evidence that (1) VA used an incorrect address on the mailing in question or (2) the mailing was returned as undeliverable and "there were other possible and plausible addresses available to VA" at the time. Id. at 72. In this case, the Veteran claims that he never received the January 24, 2000 notification of a rating decision on the same date. See December 2020 IHP. Specifically, he cites to two incorrectly addressed November 1999 VA letters as sufficient to rebut the presumption of regularity. However, although the Board acknowledges the Veteran indeed received two pieces of incorrectly addressed correspondence in 1999, he also received two pieces of correctly addressed correspondence in December 1999 and a January 3, 2000 letter from the VA stating his claims were still pending. Furthermore, the evidence of record indicates the January 24, 2000 rating decision that denied the Veteran’s claim, was properly mailed to the Veteran on that date with a notification letter. Additionally, the electronic claims file does not contain any information that any mailed notices were returned to VA as undeliverable or that there were any other irregularities in the mailing process. As such, considering the evidence of record, the Veteran has not rebutted the presumption of regularity. Second, the Veteran seeks an earlier effective date prior to October 7, 2011 for his left upper extremity neuropathy. Specifically, he alleges the effective date should be the initial claim of entitlement for his left wrist disability. In that regard, the Board reiterates the March 2018 Board remand’s finding of the following: Also, it appears that the granted issue regarding neuropathy of the left upper extremity was raised sua sponte by the RO as part and parcel of the Veteran’s appeal for an increased initial evaluation for a service-connected left wrist disability. As such, while the Veteran did not separately express disagreement with the assigned initial evaluation or effective date for this disability, those issues are in appellate jurisdiction as part and parcel of the issues regarding an increased initial evaluation and earlier effective date for his service-connected left wrist disability. As such, the Veteran’s claim for an effective date prior to October 7, 2011 is properly before the Board. As to the regulations associated with his effective date claims, generally, the effective date of a compensation award based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim, or the date entitlement arose, whichever is later. 38 U.S.C. § 5110; 38 C.F.R. § 3.400. The effective date for an award of direct service connection may be established on the day following separation from service or the date entitlement arose, if the claim is received within one year of separation from service; otherwise, the general rule applies. 38 U.S.C. § 5110(b)(1); 38 C.F.R. § 3.400(b)(2)(i). The Board notes that on March 24, 2015, VA amended its adjudication regulations to require that all claims governed by VA's adjudication regulations be filed on standard forms prescribed by the Secretary, regardless of the type of claim or posture in which the claim arises. See 79 Fed. Reg. 57660 (Sept. 25, 2014). The amendments are only effective for claims and appeals filed on or after March 24, 2015. As the claim in this case was filed prior to that date, the amendments are not applicable in this instance. As such, the Board will apply the regulations prior to March 24, 2015. The date of receipt of a claim is the date on which a claim, information, or evidence is received by VA. 38 C.F.R. § 3.1(r). A claim is a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a benefit. 38 C.F.R. §§ 3.1(p); 3.155. Any communication indicating an intent to apply for a benefit under the laws administered by VA may be considered an informal claim provided it identifies, but not necessarily with specificity, the benefit sought. See 38 C.F.R. § 3.155(a). To determine when a claim was received, the Board must review all communications in the claims file which may be construed as an application or claim. See Quarles v. Derwinski, 3 Vet. App. 129, 134 (1992). In this case, it is undisputed that the January 24, 2000 rating decision, which initially denied service connection to a left wrist disability, left wrist scars, hearing loss, and tinnitus, is final. The Veteran did not initiate a timely appeal by filing a Notice of Disagreement or otherwise disagree with this decision. See 38 U.S.C. § 7105; 38 C.F.R. §§ 20.302, 20.1103. He also did not submit any relevant evidence or argument within 1 year of the January 24, 2000 rating decision which would render it non-final for VA adjudication purposes. See Buie, 24 Vet. App. at 251-52. After the January 24, 2000 rating decision, the only evidence of a new claim of entitlement to service connection or a new claim to reopen entitlement to service connection is his October 7, 2011 VA Form 21-4138 informal claim for compensation and an October 7, 2011 VA Form-525 Application for Compensation. After his October 7, 2011 forms were processed a June 2013 rating decision granted the Veteran service connection for a left wrist disability, two left wrist scars, and hearing loss. The Board also notes: (1) the Veteran would later be granted service connection for tinnitus in a June 2014 rating decision with an October 7, 2011 effective date after a clear and unmistakable error was identified in the June 2013 rating decision denying his claim. (2) The Veteran would later be granted service connection for left upper extremity neuropathy in a July 2020 supplemental statement of the case with an October 7, 2011 effective date. Nonetheless, in September 2013 the Veteran filed a NOD to the June 2013 rating decision seeking increased ratings for his left wrist disability, his left wrist scars, and his hearing loss. Additionally, in the column identified as “Percentage sought if known” the Veteran also wrote the date “12-15-1999.” In the March 2018 Board remand, the Board determined his effective date claims were in regard to downstream issues and were timely and effective and thus placed in at issue in the Board’s appellate jurisdiction. However, the Board finds that the claim of entitlement to an earlier effective date than October 7, 2011, for a grant of service connection for left upper extremity neuropathy, a left wrist disability, two left wrist scars, hearing loss, and tinnitus must be dismissed as a matter of law. In Rudd v. Nicholson, 20 Vet. App. 296 (2006), the Court held that Appellants are prohibited from collaterally attacking a prior final rating decision by filing a freestanding earlier effective date claim. The Court specifically held that, once a rating decision has become final, as is the case here with the January 24, 2000 rating decision which denied service connection, a claimant may not properly file, and VA has no authority to adjudicate, a freestanding earlier effective date claim in an attempt to overcome the finality of an AOJ decision. The Court reasoned in Rudd that to allow such claims would vitiate the rule of finality. See Rudd, 20 Vet. App. at 299. Although there are numerous exceptions to the rule of finality and application of res judicata within the VA adjudication system, a new and distinct claim for an earlier effective date is not one of them. See Rudd, 20 Vet. App. at 300; see also DiCarlo v. Nicholson, 20 Vet. App. 52, 56-57 (2006) (discussing the types of collateral attack authorized to challenge a final decision by the Secretary). In DiCarlo, the Federal Circuit specifically held that, “Except as provided by law, when a case or issue has been decided and an appeal has not been taken within the time prescribed by law, the case is closed, the matter is ended, and no further review is afforded.” Id., at pp. 55-56 (citations omitted). As such, the Veteran's earliest effective date of service connection under the applicable laws and regulations is October 7, 2011. See 38 C.F.R. § 3.400; see Rudd, 20 Vet. App. at 299-300. The Board notes, that if the Veteran wishes to continue to pursue an earlier effective date than October 7, 2011 for service connection of his left upper extremity neuropathy, a left wrist disability, two left wrist scars, hearing loss, and tinnitus, he must file an entirely separate appeal that specifically alleges the January 24, 2000 rating decision was made in clear and unmistakable error. As stated above, a clear and unmistakable error claim must be made in a direct claim against the allegedly incorrect rating decision; i.e., "The January 24, 2000 rating decision was made in clear and unmistakable error." Then, his claim of clear and unmistakable error will then be analyzed under pertinent VA laws and regulations applicable at the time of his January 24, 2000 rating decision. In sum, the Board finds it cannot adjudicate his earlier effective date claims to the extent that they attempt to reopen a prior final rating decision without violating the Court's express prohibition against freestanding earlier effective date claims found in Rudd. See Rudd, 20 Vet. App. at 296. In light of these findings, the Board concludes that the earlier effective date sought on appeal is not permissible. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53-56. Therefore, there is no legal entitlement to an effective date earlier than October 7, 2011, for the grant of service connection for left upper extremity neuropathy, a left wrist disability, two left wrist scars, hearing loss, and tinnitus, and his claims must be dismissed. See also Sabonis v. Brown, 6 Vet. App. 426 (1994). INCREASED RATING Disability ratings are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities. See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two ratings are potentially applicable, the higher rating will be assigned if the disability more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. See 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the veteran. See 38 C.F.R. § 4.3. A disability rating may require re-evaluation in accordance with changes in a veteran's condition. Thus, it is essential that the disability be considered in the context of the entire recorded history when determining the level of current impairment. See 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Nevertheless, where a veteran is appealing the rating for an already established service-connected condition, his present level of disability is of primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). However, when an appeal is based on the assignment of an initial rating for a disability, following an initial award of service connection for this disability, the rule articulated in Francisco does not apply. Fenderson v. West, 12 Vet. App. 119 (1999). Instead, the evaluation must be based on the overall recorded history of a disability, giving equal weight to past and present medical reports. Id. Staged ratings are appropriate for an increased-rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007). Under 38 C.F.R. § 4.124a, diseases of the peripheral nerves are rated based on the degree of paralysis, neuritis, or neuralgia. The term "incomplete paralysis" indicates a degree of impaired function substantially less than the type of picture for "complete paralysis" given for each nerve, whether due to varied level of the nerve lesion or to partial regeneration. 38 C.F.R. § 4.124a, Diseases of the Peripheral Nerves, Note. When the involvement is wholly sensory, the rating for incomplete paralysis should be for the mild, or, at most, the moderate degree. Id. The terms "slight," "moderate," and "severe" are not defined in the rating schedule. Rather than applying a mechanical formula, the Board must evaluate all of the evidence to arrive at a just and equitable decision. 38 C.F.R. § 4.6. The use of such terminology by VA examiners and others, although an element to be considered by the Board, is not dispositive of an issue. All evidence must be evaluated in arriving at a decision regarding an increased rating. 38 C.F.R. §§ 4.2, 4.6. Left upper extremity neuropathy from October 7, 2011 to December 10, 2019 The Veteran seeks a disability rating in excess of 20 percent for left upper extremity neuropathy from October 7, 2011 to December 10, 2019. In a December 2014 rating decision, the RO assigned the Veteran’s left upper extremity neuropathy a 20 percent disability rating under the provisions of 38 C.F.R. § 4.124a, Diagnostic Code 8714 (Rated under Diagnostic Code 8514) for incomplete paralysis of the radial nerve. The rating decision does not specify whether the rating is for mild or moderate incomplete paralysis. A 20 percent rating is also warranted for moderate incomplete paralysis of the radial nerve and a 40 percent rating is warranted for severe incomplete paralysis of the radial nerve. Turning to the evidence of record, a May 2013 VA scar and disfigurement examination report included a review of the claims file, a recitation of complaints and medical history and physical examination results. The report determined he experienced an “electrical sensation” on his service-connected left wrist scar that would involve but would not be limited to the radial nerve. In August 2014, the Veteran underwent a VA peripheral nerves examination report which included a review of the claims file, a recitation of complaints and medical history and physical examination results. The report determined he had other symptoms of a peripheral nerve condition; specifically, “with pressure applied to left radial nerve at base of thumb, Veteran experiences "an electric sensation" radiating proximally on forearm (left).” The report also determined he had mild paresthesias and/or dysesthesias and mild incomplete paralysis of the left upper extremity. A November 2014 VA treatment record indicates he subjectively reported complaints of, “pain down his left arm to his ulnar distrib. of his hand.” On July 28, 2016, the Veteran underwent a VA peripheral nerves examination report which included a review of the claims file, a recitation of complaints and medical history, and physical examination results. The Veteran subjectively reported the following symptoms: He reports dropping items from his left hand. Unable to hold a coffee cup in his left hand. He endorses difficulty with buttoning his shirt, putting on jewelry, or using a tool in the left hand. The abnormal sensation at the scar-affects the local nerve interruption of nerve innervation superficial but the cutaneous nerve branch would be the radial nerve branch… The Veteran endorses radial pain is constant aching and rated at 8/10. Flares occur 3-4 times per week. The pain changes to a sharp pain and rated as a 10+/10. Treatment includes Ibuprofen, brace, rest, heat with pain level returning to baseline in 1 hr. The report determined he experienced moderate constant pain of the left upper extremity and mild paresthesias and/or dysesthesias of the left upper extremity. The report also noted other symptoms such as the “electrical sensation” that occurs at the base of the thumb. The report noted he was negative for muscular atrophy and that he had decreased sensitivity in his hand/fingers (C6-8). Lastly, the report noted he had moderate incomplete paralysis of the radial nerve. After a review of the claims file in conjunction with the applicable laws and regulations, the Board finds that although the Veteran’s left upper extremity neuropathy worsened from mild to moderate, a disability rating in excess of 20 percent from October 7, 2011 to December 10, 2019, is denied. A 40 percent rating is warranted for severe incomplete paralysis of the radial nerve of the minor (non-dominant) extremity. As previously stated, the December 2014 rating decision did not state whether the Veteran’s left upper extremity neuropathy was rated under mild or moderate incomplete paralysis. However, both mild and moderate incomplete paralysis are rated as 20 percent disabling under Diagnostic Code 8714. Here, the evidence of record indicates the Veteran’s left upper extremity neuropathy worsened from mild to moderate during this period. Specifically, the August 2014 VA examination characterized his neuropathy as mild incomplete paralysis with mild paresthesias and/or dysesthesias. However, the July 2016 VA examination determined he now experienced mild numbness, decreased sensitivity in his hand/fingers (C6-8), and was diagnosed with moderate incomplete paralysis of the radial nerve. As such, although the evidence indicates his left upper extremity neuropathy has progressed from mild to moderate during this time period, both levels of severity are rated at 20 percent. Furthermore, the evidence of record does not contain any competent or credible medical evidence that would indicate his left upper extremity neuropathy manifested at a severe rating. Thus, the evidence of record is devoid of any indication his left upper extremity neuropathy warrants a disability rating in excess of 20 percent from October 7, 2011 to December 10, 2019. Also, the Board has considered all potentially applicable diagnostic codes, but finds there are no alternative or separate ratings that can be applied for the period beginning October 7, 2011 to December 10, 2019. In sum, the evidence of record indicates the Veteran’s left upper extremity neuropathy increased in severity from mild to moderate. However, as both levels of severity are rated at the same 20 percent rating, the preponderance of the evidence is against finding the Veteran’s left upper extremity neuropathy warrants a disability rating in excess of 20 percent for the period beginning October 7, 2011 to December 10, 2019. To the extent that a higher disability rating is sought, the preponderance of the evidence is against the claim. Hence the benefit of the doubt rule does not apply. Gilbert, 1 Vet. App. 49; 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7. Accordingly, the Veteran’s claim for a disability rating in excess of 20 percent for left upper extremity neuropathy under Diagnostic Code 8714, for the period beginning October 7, 2011 to December 10, 2019, is denied. Left upper extremity neuropathy from December 10, 2019 During this time period, for reasons explained below, in a July 2020 SSOC the RO changed the rating code assigned to the Veteran’s left upper extremity neuropathy. Prior to December 10, 2019, he was rated under Diagnostic Code 8714 for incomplete paralysis of the radial nerve. 38 C.F.R. § 4.124a. However, after December 10, 2019, his left upper extremity neuropathy is rated at 30 percent under Diagnostic Code 8613 for moderate incomplete paralysis of the entire left radicular group (Rated under Diagnostic Code 8513). A 60 percent disability rating is warranted for severe incomplete paralysis of all (minor) radicular groups. Turning to the evidence of record, on December 10, 2019 he underwent a VA peripheral nerves examination report which included a review of the claims file, a recitation of complaints and medical history, and physical examination results. He reported the following subjective symptoms: persistent pain from the dorsal aspect proximal hand just distal to the elbow, a burning sensation in his entire distribution and numbness in his hands. As to his hands, he specifically reported: I can be sitting at breakfast holding a piece of toast and it just locks up and I drop my toast. I have no confidence in it whatsoever. It will just seize up and drop whatever I'm holding…Is able to button and unbutton his shirt with his right hand. Lifts glasses, cups of coffee, etc. with his right hand and not his left. Lifts his grandchildren with his right hand/arm. Notes when his grandchildren ask him to help with something if the pieces are small, he is not able to do so. Wears shoes he can slip on. The report determined he had moderate left upper extremity constant pain, paresthesias and/or dysesthesias, and numbness. The report also noted he had muscular atrophy of the left wrist and a sensory examination noted decreased sensation in his hand/fingers (C6-8) and the inner/outer forearm (C6/T1). The report also determined he had mild incomplete paralysis of the musculospiral, median, and ulnar nerves. After a review of the claims file in conjunction with the applicable laws and regulations, the Board finds the preponderance of the evidence is against finding the Veteran’s left upper extremity neuropathy warrants a disability rating in excess of 30 percent, under Diagnostic Code 8613, from December 10, 2019. A 60 percent rating is warranted for severe incomplete paralysis of all radicular groups. 38 C.F.R. § 4.124a, Diagnostic Code 8613. Here, the December 2019 VA examination diagnosed him with mild incomplete paralysis of the musculospiral, median, and ulnar nerves with moderate constant pain, paresthesias and/or dysesthesias, and numbness. Moreover, the evidence of record does not contain any medical evidence indicating his neuropathy manifested at a severe rating. Additionally, the Board acknowledges his lay statements within the December 2019 VA examination relating to difficulty using his left hand; however, his symptoms are contemplated by his current 30 percent rating. Also, the Board has considered all potentially applicable diagnostic codes, but finds there are no alternative or separate ratings that can be applied for the period from December 10, 2019. Accordingly, the Board finds the preponderance of the evidence is against finding the Veteran’s left upper extremity neuropathy warrants a disability rating in excess of 30 percent under Diagnostic Code 8613, from December 10, 2019. Hence the benefit of the doubt rule does not apply. Gilbert, 1 Vet. App. 49; 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7. As such, the Veteran’s claim for a disability rating in excess of 30 percent for left upper extremity neuropathy, from December 10, 2019, is denied. The Board also acknowledges the October 2020 IHP claim for an extraschedular rating for the Veteran’s left upper extremity neuropathy to include analysis of the Veteran’s complete disability picture under Johnson v. McDonald, 762 F.3d 1362 (Fed. Cir. 2014). However, during the pendency of the appeal, the VA amended its regulation to abrogate the effect of extraschedular evaluation based on collective impact of multiple service-connected disabilities under the holding of Johnson v. McDonald. 762 F.3d 1362. The new regulation makes it clear that an extra-schedular evaluation under 38 C.F.R. § 3.321(b)(1) only applies to an individual service-connected disability when the disability is so exceptional or unusual that it renders the regular rating schedule impractical, and that such extra-schedular evaluation may not be based on the combined effect of more than one service-connected disability. See 82 Fed. Reg. 57830, 57835 (Dec. 8, 2017). The new regulation applies to all applications for benefits that are received by VA on or after January 8, 2018 or that are pending before VA, the United States Court of Appeals for Veterans Claims, or the United States Court of Appeals for the Federal Circuit (Federal Circuit) on January 8, 2018. See 82 Fed. Reg. 57830, 57835 (Dec. 8, 2017). The Court has found that this new amendment applied retroactively as it did not have an impermissible retroactive effect. Thurlow v. Wilkie, 30 Vet. App. 231 (2018). As such, the Board will apply the new regulation to this case and consideration under Johnson is not applicable. As to an extraschedular rating, ratings shall be based, as far as practicable, upon the average impairments of earning capacity with the additional proviso that the Secretary shall from time to time readjust this schedule of ratings in accordance with experience. 38 C.F.R. § 4.1. To accord justice to the exceptional case where the schedular evaluation is inadequate to rate a single service-connected disability, the Director of Compensation Service or his or her delegate is authorized to approve on the basis of the criteria set forth in this paragraph (b), an extra-schedular 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). There is a three-step inquiry for determining whether a veteran is entitled to an extraschedular rating. Thun v. Peake, 22 Vet. App. 111, 115 (2008). Initially, the Board must determine whether the evidence presents such an exceptional disability picture that the available schedular ratings for the service-connected disability are inadequate. Yancy v. McDonald, 27 Vet. App. 484 (2016); Doucette v. Shulkin, 28 Vet. App. 366 (2017) (holding that either the veteran must assert that a schedular rating is inadequate or the evidence must present exceptional or unusual circumstances); Sowers v. McDonald, 27 Vet. App. 472, 478 (2016) ("[t]he rating schedule must be deemed inadequate before extraschedular consideration is warranted"). Second, if the schedular rating does not contemplate the veteran's level of disability and symptomatology and is found inadequate, the Board must determine whether the veteran's disability picture exhibits other related factors such as marked interference with employment and frequent periods of hospitalization. Thun, 22 Vet. App. at 116. Third, if the first two Thun elements have been satisfied, then the case must be referred to the Under Secretary for Benefits or the Director of the Compensation and Pension Service to determine whether, to accord justice, the veteran's disability picture requires the assignment of an extraschedular rating. Id. In other words, the first element of Thun compares a veteran's symptoms to the rating criteria, while the second element considers the resulting effects of those symptoms; if either prong is not met, then referral for extraschedular consideration is not appropriate. Yancy, 27 Vet. App. at 495. The Board or the RO must determine whether the schedular rating criteria reasonably describe a veteran's disability level and symptomatology. If the schedular rating criteria do reasonably describe the Veteran's disability level and symptomatology, the assigned schedular evaluation is adequate, referral for extraschedular consideration is not required, and the analysis stops. Here, referral for extraschedular consideration is not warranted as the first prong of a Thun analysis is not fulfilled. Thun, 22 Vet. App. at 116. A comparison of the Veteran's disability and the applicable rating criteria does not show that his symptoms are not contemplated by the rating schedule. 38 C.F.R. § 4.124a. Moreover, the Veteran does not report any symptoms associated with his left upper extremity that are not included in the rating criteria or have otherwise been left uncompensated or unaccounted for by his assigned schedular ratings. See 38 C.F.R. § 4.124a, DC 8510 to 8519; see also Thun, 22 Vet. App. at 115. Although the Veteran reports he often chooses not to use his left hand and reports difficulty using his left hand, these symptoms are specifically contemplated by the rating criteria of Diagnostic Code 8613. Moreover, the evidence of record simply does not support his contentions that these symptoms are of such an exceptional nature as to require extraschedular consideration. Additionally, Diagnostic Code 8613 provides disability ratings on the basis of complete paralysis. However, as previously noted, at no point has the Veteran’s left upper extremity manifested as complete paralysis to meet the schedular criteria contemplated by an 80 percent rating under Diagnostic Code 8613. In short, there is nothing exceptional or unusual about the Veteran's disability because the rating criteria reasonably describe his disability level and symptomatology and referral for extraschedular consideration is not warranted. Thun, 22 Vet. App. at 115. Left wrist disability in excess of 10 percent The Veteran seeks entitlement to a disability rating in excess of 10 percent for his left wrist disability. The Veteran's right wrist is currently rated at 10 percent under 38 C.F.R. § 4.71a, Diagnostic Code 5215, for wrist limitation of motion and dorsiflexion less than 15 degrees or palmar flexion limited in line with the forearm. In addition to the previously mentioned regulations for increased ratings, when evaluating joint disabilities rated on the basis of limitation of motion, the VA must consider granting a higher rating in cases in which functional loss due to pain, weakness, excess fatigability, or incoordination is demonstrated, and those factors are not contemplated in the relevant rating criteria. 38 C.F.R. §§ 4.40, 4.45, 4.59; DeLuca v. Brown, 8 Vet. App. 202 (1995). Although pain may be a cause or manifestation of functional loss, limitation of motion due to pain is not necessarily rated at the same level as functional loss where motion is impeded. Mitchell v. Shinseki, 25 Vet. App. 32 (2011). Instead, Mitchell explained that pursuant to 38 C.F.R. §§ 4.40 and 4.45, the possible manifestations of functional loss include decreased or abnormal excursion, strength, speed, coordination, or endurance (38 C.F.R. § 4.40), as well as less or more movement than is normal, weakened movement, excess fatigability, and pain on movement (as well as swelling, deformity, and atrophy) that affects stability, standing, and weight-bearing (38 C.F.R. § 4.45). Thus, functional loss caused by pain must be rated at the same level as if the functional loss were caused by any of the other factors cited above. In evaluating the severity of a joint disability, the VA must determine the overall functional impairment due to these factors. Other applicable ratings for the wrist are as follows: Under 38 C.F.R. § 4.71a, Diagnostic Code 5214, for ankylosis of the wrist, a 20 percent rating warranted for favorable ankylosis of the wrist with a 20- or 30-degree dorsiflexion; a 30 percent rating is for wrist ankylosis in any other position, except favorable; and a 40 percent rating is for wrist unfavorable ankylosis in any degree of palmar flexion, or with ulnar or radial deviation. Turning to the evidence of record, in May 2013, he underwent a VA wrist conditions examination report which included a review of the claims file, a recitation of complaints and medical history, and physical examination results. His palmar flexion was 70 degrees with pain and his dorsiflexion was 60 degrees with pain. He was able to perform repetitive use testing and his palmar flexion was 70 degrees and his dorsiflexion was 60 degrees. The report determined he experienced less movement and weakened movement than normal and pain on movement. The report also determined he was negative for ankylosis. The remarks section includes the following: “In terms of Mitchell criteria, with increased repetition over time, it is expected that there would be no increased loss in functionality or ROM during flare-up or when joint is used over period of time. No incapacitation no change in ROM after 3 repetitions and no pain and no flare-up during today’s examination.” In September 2020 the Veteran underwent a VA wrist conditions examination report which included a review of the claims file, a recitation of complaints and medical history, and physical examination results. He reported flare-ups and described them as follows: [occurring] intermittently depending on weather, use, dexterity and position. The left wrist flare-ups are moderate to severe. The left wrist flare-ups last spasms 10-30 minutes; pain 3-4 hours. The left wrist flare-ups are precipitated by prolonged activities requiring dexterity, positional. He also reported functional loss, describing it as that he cannot button a shirt, put on jewelry, hold small items, or grip a coffee cup. His palmar flexion was 50 degrees with pain, his dorsiflexion was 50 degrees with pain, his ulnar deviation was 20 degrees with pain, and his radial deviation was 20 degrees. The report determined pain resulted in functional loss and there was pain upon palpitation. He was able to perform repetitive use testing and no additional functional loss was noted. He was examined after repetitive use over time, the results were consistent with the Veteran’s statements, and pain contributed to functional loss. His palmar flexion was 30 degrees, his dorsiflexion was 20 degrees, and his ulnar and radial deviations were 10 degrees each. The examination was conducted during a flare-up, the results were medically consistent with the Veteran’s statements, and pain contributed to functional loss. His palmar flexion and dorsiflexion were 0 degrees and his ulnar and radial deviations were 0 degrees. The report determined he experienced less movement than normal and weakened movement. The report also determined he did not experience muscular atrophy, ankylosis, or any other pertinent physical findings. After a review of the claims file in conjunction with the applicable laws and regulations, the Board finds the preponderance of the evidence is against finding the Veteran’s left wrist disability warrants a disability rating in excess of 10 percent. A 20 percent rating is for favorable ankylosis of the wrist in 20 to 30-degree dorsiflexion. 38 C.F.R. § 4.71a Diagnostic Code 5214. Here, the Board acknowledges the changes in terms of range of motion sustained between the May 2013 and September 2020 VA examinations. Specifically, the change in dorsiflexion from 65 degrees to 50 degrees and the Veteran’s September 2020 inability to move his wrist at all during a flare-up. However, as previously mentioned in the above sections, the Veteran’s left upper extremity neuropathy has continuously increased in severity since October 2011. Moreover, as previously addressed above, his limitation of range of motion was due to his continued worsening of his separate neurological disability and not his left wrist disability. Furthermore, if the Board were to grant a disability rating in excess of 10 percent based on his limitation of motion, the Board would be rating the same disability or its manifestation(s) under different Diagnostic Codes which would constitute prohibited pyramiding of compensation. See 38 C.F.R. § 4.14. As to the assignment of a disability rating, the September 2020 VA examination determined his initial range of motion dorsiflexion to be 50 degrees with pain. This indicates his left wrist disability improved in terms of range of motion. Moreover, the only evidence indicating his left wrist disability warrants a 20 percent rating is his inability to move his wrist during a flare-up, which he is compensated for with his separately rated left upper extremity neuropathy. As such, the September 2020 VA examination indicates his left wrist disability does not warrant a disability rating in excess of 10 percent. When evaluating disabilities based on range of motion, the Board must also consider whether a higher disability rating is warranted if his left wrist disability more closely resembles ankylosis as a result of additional functional loss due to pain, weakness, fatigability, incoordination, and other factors. DeLuca, 8 Vet. App. at 204-07. Here, as previously stated, although the Veteran was unable to move his wrist during a flare-up, the Veteran’s limitation was determined to be due to his left upper extremity neurological disability and not to his left wrist disability. As such, considering the Veteran’s left wrist dorsiflexion was 50 degrees with pain, and absence any competent or credible medical evidence to the contrary, the preponderance of the evidence is against finding the Veteran’s left wrist disability warrants an increased rating under DeLuca. Additionally, the Board is cognizant of the amputation rule which provides that the combined rating for disabilities of an extremity shall not exceed the rating for the amputation at the elective level, were amputation to be performed. See 38 C.F.R. § 4.68. However, as the Veteran’s left upper extremity’s combined disability rating has not exceeded 80 percent, this provision is not applicable. In conclusion, the preponderance of the evidence is against finding the Veteran’s left wrist disability warrants a disability rating in excess of 10 percent for limitation of motion. To the extent that a higher rating is sought, the preponderance of the evidence is against the claim. Hence, the benefit of the doubt rule does not apply. Gilbert, 1 Vet. App. 49; 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7. Accordingly, the Veteran's claim of entitlement to a disability rating in excess of 10 percent for a left wrist disability is denied. Left wrist scars in excess of 0 percent The Veteran seeks a compensable disability rating for two scars on his left wrist, which are currently assigned a zero percent evaluation under 38 C.F.R. § 4.118, Diagnostic Code 7804. The Veteran’s left wrist is rated as noncompensable under 38 C.F.R. § 4.118, Diagnostic Code 7804 for painful or unstable scars. A 10 percent disability rating is warranted for one or two scars that are unstable or painful. Diagnostic Code 7804 also contains the following notes: (1) An unstable scar is one where, for any reason, there is frequent loss of covering of skin over the scar. (2) If one or more scars are both unstable and painful, add 10 percent to the evaluation that is based on the total number of unstable or painful scars. (3) Scars evaluated under diagnostic codes 7800, 7801, 7802, or 7805 may also receive an evaluation under this diagnostic code, when applicable. Turning to the evidence of record, a May 2013 VA examination report included a review of the claims file and an in-person evaluation and determined he had one linear 6cm painful scar at the base of his left thumb and one linear 4cm scar also at the base of the thumb. The report also determined there was an “electrical sensation” if his lateral scar was touched. An August 2014 VA examination report included a review of the claims file and an in-person evaluation. The report determined he still had a linear 6cm left wrist dorsal surface scar and a 4cm a left wrist lateral aspect, radial, scar. The report also determined neither scar was painful or unstable and noted continued “electrical sensation” on his lateral scar. In July 2016, the Veteran underwent a VA examination report which included a review of the claims file and an in-person evaluation. He subjectively reported his left lateral wrist scar symptoms as “constant burning sensation, electrical sensation or the feeling of bugs under my skin” and rates it as a “7/10.” He also reported the burning decreases from “3-4/10” with scratching. As to his horizontal wrist scar, the report determined it was non-tender to palpitation and he denied pain to the scar. Lastly, the report determined the Veteran did not have both painful and unstable scars and noted continued “electrical sensation” on his lateral scar. After careful consideration of the claims file in conjunction with the applicable laws and regulations, the Board finds the preponderance of the evidence is against finding the Veteran's service-connected two left wrist scars warrant a compensable disability rating. A 10 percent disability rating is warranted for one or two scars that are unstable or painful. 38 C.F.R. § 4.118, Diagnostic Code 7804. Here, the Board acknowledges the Veteran’s continued reports and VA examinations of record indicating he has one painful scar. However, as previously noted and the VA examinations have determined, the pain from his scar is an “electrical sensation” that has previously been determined to be a symptom of his left upper extremity neuropathy and not the scar itself. Moreover, the only evidence indicating his left wrist scars warrant a compensable disability rating is the pain described as an “electrical sensation,” which he is compensated for with his separately rated left upper extremity neuropathy. Furthermore, if the Board were to grant a disability rating in excess of 10 percent based on the pain associated with the electrical sensation, the Board would be rating the same disability or its manifestation(s) under different Diagnostic Codes which would constitute prohibited pyramiding of compensation. See 38 C.F.R. § 4.14. In conclusion, the preponderance of the evidence is against finding the Veteran’s two left wrist scars warrant higher than a compensable disability rating. Hence the benefit of the doubt rule does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53-56. Accordingly, the Veteran’s claim for a compensable disability rating for his two left wrist scars is denied. Loss of use of the left hand The Veteran has argued that he has loss of use of his left hand. SMC is payable at a specified rate if a veteran, as the result of service-connected disability, has suffered the loss of use of a hand. See 38 U.S.C. § 1114(k); 38 C.F.R. §§ 3.350(a), 4.63, 4.71a, Diagnostic Code 5125 (which equates to a 60 percent rating for a non-dominant (minor) extremity), note 1. Loss of use of a hand, for SMC purposes, is defined as the condition where no effective function remains other than that which would be equally well served by an amputation stump at the site of election below the elbow with use of a suitable prosthetic appliance. The determination will be made on the basis of actual remaining function of the hand, whether the acts of grasping, manipulation, etc. could be accomplished equally well by an amputation stump with prosthesis. See 38 C.F.R. § 4.63. The Court has stated that “[t]he relevant inquiry concerning an SMC award is not whether amputation is warranted but whether the appellant has had effective function remaining other than that which would be equally well served by an amputation with use of a suitable prosthetic appliance.” Tucker v. West, 11 Vet. App. 369, 373 (1998) (citing 38 C.F.R. §§ 3.350(a)(2), 4.63). After a review of the claims file in conjunction with the applicable laws and regulations, the Board finds the preponderance of the evidence is against finding the Veteran has effectively lost the use of his left hand. As previously stated, since December 10, 2019 the Veteran is in receipt of a 30 percent disability rating for his left upper extremity under Diagnostic Code 8613, which is consistent with moderate incomplete paralysis; as well as 10 percent for the service-connected orthopedic wrist disability under Diagnostic Code 5215. While the combined effect of these disabilities on the hand – which equates to a 40 percent rating under the combined rating table in 38 C.F.R. § 4.25 – are certainly significant, the evidence of records does not demonstrate that his symptoms manifest loss of use of the hand. Here, although during the November 2019 VA examination the Veteran subjectively reported that he has “no confidence” in his left hand and is unable to lift glasses and cups of coffee with his left hand; it was determined his pinch and grip in his left hand rated as “4/5.” Additionally, the December 2020 VA wrist examination determined he still maintained left wrist range of motion and did not experience any muscular atrophy. Although the Veteran contends that he has loss of use, clinical evaluation consistently reveals the ability to pinch and grip and some, albeit limited, dexterity. Moreover, the November 2019 and December 2020 VA examiners both determined he would not be equally served by amputation or the use of a prosthetic. Although the Veteran is competent to report his symptoms, the Board finds the clinical findings are more probative. Thus, the evidence is against a finding that the Veteran would be equally well served with a prosthesis because the Veteran can still hold things, grasp albeit with difficulty and pain, and still has a range of motion of at least some digits. In assessing the function of the left hand, the Board has considered the competent lay assertions regarding symptoms experienced and observed. See, e.g., Layno v. Brown, 6 Vet. App. 465, 470 (1994) and Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). Specifically, the Board is sympathetic to the Veteran's assertions that his left hand has significant limitations. However, when viewed as a whole, the preponderance of the evidence is against a finding that the Veteran had no effective use of the left hand. For instance, the evidence of record, to include the Veteran's testimony indicate that he is able to grasp with his left hand albeit with difficulty, and that he can still grip objects for at least some period of time. The Board understands that the Veteran has been found to have a severe impairment of the left hand to include symptoms such as pain, weakness, decreased grip strength, and limitation of motion; however, it does not meet the criteria as to what constitutes a loss of use of the hand. The regulations defining loss of use of hand set a high standard as reflected in the examples provided in 38 C.F.R. §§ 3.350(a)(2)(i) and 4.63. While the Board is sympathetic to the impairment of his left hand, as the preponderance of the evidence is against the claim, the benefit of the doubt rule is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53-56. Accordingly, the Veteran’s claim for loss of use of the left hand is denied. Hearing Loss in excess of 0 percent The Veteran seeks entitlement to a compensable disability rating for his bilateral hearing loss. Disability ratings for hearing loss are derived from a mechanical application of the rating schedule to the numeric designations resulting from audiometric testing. See Lendenman v. Principi, 3 Vet. App. 345 (1992). The rating schedule establishes 11 auditory hearing acuity levels based on average pure tone thresholds and speech discrimination. See 38 C.F.R. §§ 4.85. When the pure tone threshold at each of the four specified frequencies (1,000, 2,000, 3,000 and 4,000 hertz) is 55 decibels or more, the rating specialist will determine the Roman Numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral. Each ear will be evaluated separately. When the pure tone threshold is 30 decibels or less at 1,000 hertz, and 70 decibels or more at 2,000 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 higher Roman numeral. Each ear will be evaluated separately. 38 C.F.R. § 4.86 (2018). An evaluation of the level of disability present must also include consideration of the functional impairment of the Veteran's ability to engage in ordinary activities, including employment. 38 C.F.R. § 4.10; see also Hensley v. Brown, 5 Vet. App. 155, 159-60 (1993), Martinak v. Nicholson, 21 Vet. App. 447, 455 (2007). Turning to the evidence of record, in September 2020, the Veteran underwent a VA audiological examination which revealed the following results: Hertz 1000 2000 3000 4000 Average Right 30 35 70 75 52.50 Left 30 40 75 95 60 A Maryland CNC speech recognition test revealed his right ear was 84 percent and his left ear was 76 percent. He subjectively reported the following functional impacts: “I cannot hear in crowds, church, my granddaughter or people behind me; masks made it difficult to understand conversations because I have hearing aids but I still need to read the lips and face whoever is talking to me.” After a review of the claims file in conjunction with the applicable laws and regulations, the Board finds that the criteria for a compensable disability rating for his service-connected bilateral hearing loss are not met. As noted above, application of the rating schedule for hearing loss is a mechanical process. In this case, the Veteran's level of hearing acuity does not warrant a compensable rating since his hearing loss is manifested by level II hearing acuity in the right ear and level IV hearing acuity in the left ear. Moreover, the Board acknowledges his September 2020 complaints of functional impact; however, per the Veteran’s own statements, his difficulty is in relation to individuals wearing face masks due to the current COVID-19 pandemic and not a worsening of his hearing loss condition. See 38 C.F.R. § 4.10; see also Hensley, 5 Vet. App. at 159-60, Martinak, 21 Vet. App. at 455. In sum, the preponderance of the evidence is against finding the Veteran’s hearing loss disability warrants a compensable rating. Hence, the benefit of the doubt rule does not apply. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53-56. As such, the Veteran’s claim for a compensable disability rating for his hearing loss is denied. REASONS FOR REMAND Entitlement to TDIU The Veteran alleges his service-connected disabilities prevent him from obtaining and pursuing a substantially gainful occupation. The Veteran’s claim was previously remanded in the March 2018 Board remand as part and parcel of a Manlincon remand. The remand directives ordered the RO to assist the Veteran develop his TDIU claim and then adjudicate his TDIU claim. However, while the RO adjudicated the other claims with the March 2018 Board remand, the RO never provided the Veteran with a SOC as to his claim of TDIU or at any point adjudicated his claim. As such, he is entitled to receive an SOC as to his claim for TDIU. Therefore, a remand is necessary to provide the Veteran with a SOC addressing his claim for TDIU. See 38 C.F.R. § 20.200; Manlincon v. West, 12 Vet. App. 238 (1999). The matter is remanded for the following action: Produce a statement of the case (SOC) regarding his claim for entitlement to TDIU. JONATHAN B. KRAMER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Law Clerk, Tyler R. Masters 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.