Citation Nr: 21010501 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 14-31 026 DATE: February 25, 2021 ORDER Entitlement to service connection for bilateral upper extremity peripheral neuropathy is denied. Entitlement to service connection for bilateral lower extremity peripheral neuropathy is denied. Entitlement to an initial rating in excess of 70 percent for posttraumatic stress disorder (PTSD) is denied. Entitlement to an initial compensable rating for hearing loss prior to April 8, 2013, is denied. Entitlement to a rating in excess of 10 percent for hearing loss beginning April 8, 2013, is denied. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of upper extremity peripheral neuropathy. 2. The preponderance of the evidence of record is against finding that the Veteran has, or has had at any time during the appeal, a current diagnosis of lower extremity peripheral neuropathy. 3. Throughout the period on appeal, the impairment associated with the Veteran’s PTSD has been productive of occupational and social impairment with deficiencies in most areas; but not total occupational and social impairment. 4. Prior to April 8, 2013, the Veteran’s hearing impairment was no worse than Level II in the right ear and no worse than Level I in the left ear. 5. For The period on appeal beginning April 8, 2013, the Veteran’s hearing impairment is no worse than Level V in the right ear and no worse than Level II in the left ear. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral upper extremity peripheral neuropathy have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309, 3.310. 2. The criteria for service connection for bilateral lower extremity peripheral neuropathy have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309, 3.310. 3. The criteria for an initial rating in excess of 70 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1—4.14, 4.130, Diagnostic Code 9411. 4. The criteria for an initial compensable rating for hearing loss prior to April 8, 2013, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1—4.14, 4.85, Diagnostic Code 6100. 5. The criteria for a rating in excess of 10 percent for hearing loss beginning April 8, 2013, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.102, 4.1—4.14, 4.85, Diagnostic Code 6100. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from February 1969 to September 1970, to include service in the Republic of Vietnam. He is in receipt of the Combat Infantryman Badge, amongst other decorations. This case comes before the Board of Veterans’ Appeals (Board) on appeal from multiple rating decisions issued by the Department of Veterans Affairs (VA) Regional Office (RO). This case was previously before the Board in April 2019, at which time the issues currently on appeal were remanded for additional development. The case has now been returned to the Board for further appellate action. In an August 2020 rating decision, the agency of original jurisdiction (AOJ) granted, in pertinent part, entitlement to a total disability rating based on individual unemployability (TDIU), effective September 24, 2012; and entitlement to service connection for a bilateral eye condition. These grants represent full grants of the matters previously on appeal. Accordingly, these matters are no longer before the Board. In the August 2020 rating decision, the AOJ also granted an increased rating for PTSD from 50 percent to 70 percent, effective September 24, 2012. That grant does not constitute a complete grant of the benefit sought on appeal. As the Veteran is presumed to seek the maximum available benefits, the issue remains on appeal. See AB v. Brown, 6 Vet. App. 35, 38 (1993). In an October 2020 submission, the Veteran’s attorney requested the full 90 days from docketing of this case at the Board to submit additional evidence and argument in support of the appeals. The submission indicated that the Veteran’s attorney will consider this request to have been granted unless written notification to the contrary was received. The Board granted this Motion for Extension of Time in October 2020. The requested extension period has expired and the Board may proceed with adjudication. Service Connection Generally, to establish service connection, a claimant must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called “nexus” requirement. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). VA has established certain rules and presumptions for chronic diseases, such as organic diseases of the nervous system. See 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a); Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). With chronic diseases shown as such in service so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless attributable to intercurrent causes. 38 C.F.R. § 3.303(b). If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. § 3.303(b). In addition, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, chronic diseases are presumed to have been incurred in service if they manifested to a compensable degree within one year of separation from service. 38 C.F.R. §§ 3.307(a)(3), 3.309(a). Pertinent to a claim for service connection, such a determination requires a finding of a current disability that is related to an injury or disease in service. Watson v. Brown, 4 Vet. App. 309 (1993); see also Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). Under applicable regulation, the term “disability” means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. § 4.1; see also Hunt v. Derwinski, 1 Vet. App. 292, 296 (1991); Allen v. Brown, 7 Vet. App. 439 (1995); Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (the term “disability” as used in 38 U.S.C. § 1110 “refers to the functional impairment of earning capacity, not the underlying cause of said disability,” and held that “pain alone can serve as a functional impairment and therefore qualify as a disability”). The existence of a current disability is the cornerstone of a claim for VA disability compensation. See Degmetich v. Brown, 104 F.3d 1328, 1332 (1997) (holding that §§ 1110 and 1131’s requirement of the existence of a present disability for VA compensation purposes cannot be considered arbitrary); see also McClain v. Nicholson, 21 Vet. App. 319, 323 (2007) (holding that the requirement of a current disability is met when a claimant has a disability at the time a claim for VA compensation is filed or during the pendency of that claim). Consequently, the evidence of record must show that the Veteran currently has the disability for which benefits are being claimed. Further, the Veteran was presumed to have been exposed to herbicide agents while serving in the Republic of Vietnam. VA laws and regulations provide that if a Veteran was exposed to Agent Orange during service, certain listed diseases are presumptively service connected. 38 U.S.C. § 1116(a)(1); 38 C.F.R. § 3.309(e). 38 C.F.R. § 3.309(e) lists the diseases covered by the regulation. The list of diseases that are deemed associated with herbicide exposure includes early-onset peripheral neuropathy. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Right and Left Upper and Lower Extremity Neuropathy The Veteran generally asserts that he has right and left upper and lower extremity peripheral neuropathy that is related to his period of active service. Specific argument in support of this appeal has not been submitted. At the outset, the Board acknowledges that in the August 2020 rating decision, the AOJ granted, in pertinent part, entitlement to service connection for right upper extremity hemiparesis and numbness residuals of a cerebral artery aneurysm to include cerebrovascular accident; right lower extremity sciatic nerve disability; right lower extremity anterior crural nerve disability; right lower extremity external cutaneous nerve of the thigh disability; right lower extremity ilio-inguinal nerve disability; and a right lower extremity obturator nerve disability, each with an effective date of September 24, 2012. These disabilities, and their assigned ratings, are not currently before the Board on appeal. Therefore, these ratings will not be discussed in this decision. The Board concludes that the Veteran does not have a diagnosis of a right or left upper extremity peripheral neuropathy, or a right or left lower extremity peripheral neuropathy, and has not had one at any time during the pendency of the claim or recent to the filing of the claim. In his September 2012 VA Form 21-526EZ (Application for VA disability benefits), the Veteran indicated that he was applying for VA benefits related to peripheral neuropathy. The application did not contain any additional detail with regard to his claimed peripheral neuropathy. The Veteran’s service treatment records are unremarkable for any complaints of, treatment for, or diagnosis of neuropathy during active service. In his September 1970 separation examination report, clinical evaluation revealed no neurological abnormalities, as well as no abnormalities of the upper extremities, lower extremities. Moreover, post-service medical records are absent complaints, findings and diagnoses of neuropathy. In March 2020, the Veteran was afforded a VA examination with regard to the etiology of any currently present neuropathy. Several abnormal findings were noted during the examination. Following examination, the examiner reported that the Veteran did not have a diagnosis of peripheral neuropathy and that the Veteran did not experience functional impairment related to peripheral neuropathy. The examiner commented that all abnormal findings noted on examination were related the Veteran’s aneurysm with a cerebrovascular accident and resulting right side hemiparesis. As the record does not reflect a current diagnosis of bilateral upper and bilateral lower extremity peripheral neuropathy, the cornerstone element of service connection has not been met, and service connection is not warranted. In the absence of proof of a present disability (and, if so, of a nexus between that disability and service), there can be no valid claim for service connection. See Boyer v. West, supra; Brammer v. Derwinski, supra. The Board has considered the evidence in light of the case of Saunders v. Wilkie in which the United States Court of Appeals for the Federal Circuit addressed “the legal issue [of] whether pain without an accompanying pathology can constitute a “disability” under [38 U.S.C.] § 1110.” 886 F.3d 1356, 1363-64 (Fed. Cir. 2018). The Federal Circuit held that the Veterans Court erred “as a matter of law in holding that pain alone, without an accompanying diagnosis or identifiable condition, cannot constitute a ‘disability’ under [38 U.S.C.] § 1131, because pain in the absence of a presently-diagnosed condition can cause functional impairment.” The Federal Circuit “conclude[d] that pain is an impairment because it diminishes the body’s ability to function, and that pain need not be diagnosed as connected to a current underlying condition to function as an impairment.” Further, the Federal Circuit held that “[w]e do not hold that a veteran could demonstrate service connection simply by asserting subjective pain to establish a disability, the veteran’s pain must amount to a functional impairment. To establish the presence of a disability, a veteran will need to show that pain reaches the level of a functional impairment of earning capacity.” In this case, there is no credible persuasive evidence or allegation that the Veteran suffers from a right or left upper or lower extremity peripheral neuropathy disability that is productive of functional impairment. To that end, the record contains no evidence that the Veteran experiences functional impairment associated with neuropathy. Moreover, the March 2020 VA examiner found that the Veteran did not experience functional impairment related to peripheral neuropathy. See Saunders v. Wilkie, supra. The Board acknowledges that the Veteran experienced sensory and reflex defects throughout the period on appeal; however, the March 2020 examiner reported that such symptoms are related to disabilities that are already service connected. In addition, the record does not reflect, and the Veteran has not alleged, that he suffers from impairment of earning capacity due to his claimed peripheral neuropathy that is of similar severity, frequency, and duration as those VA has determined by regulation would cause impaired earning capacity in an average person. Wait v. Wilkie, 33 Vet. App. 8 (2020). To the extent that the Veteran believes that he has a current right or left upper or lower extremity peripheral neuropathy disability, he is not competent to provide a diagnosis in this case. Jandreau v. Nicholson, supra. Rather, a diagnosis of a neuropathy disability requires expertise that the Veteran has not established. Therefore, the Board gives more probative weight to the competent medical evidence. In the absence of competent evidence that a current right and left upper extremity neuropathy and right and left lower extremity neuropathy disability exists which was caused by the Veteran’s military service, the criteria for establishing service connection for such have not been established. Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to service connection for right and left upper and lower extremity peripheral neuropathy is not warranted. 38 U.S.C. § 5107: 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. Increased Rating Claims 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 (Rating Schedule). 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. Separate ratings can be assigned for separate periods of time based on the facts found - a practice known as “staged” ratings. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Staged ratings are appropriate whenever the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Id. PTSD The Veteran generally asserts that he should have a higher rating for his PTSD as it is worse than contemplated by the currently assigned rating. During the period on appeal, the Veteran’s PTSD was rated 70 percent under Diagnostic Code 9411, which assigns ratings based upon the General Rating Formula for Mental Disorders. 38 C.F.R. § 4.130. A 70 percent rating is warranted when there is occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to suicidal ideation; obsessional rituals which interfere with routine activities, speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately, or effectively; impaired impulse control, such as unprovoked irritability with periods of violence; spatial disorientation, neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances, including work or a work-like setting; and the inability to establish and maintain effective relationships. Id. A maximum 100 percent rating is warranted when there is total occupational and social impairment, due to such symptoms as: gross impairment in thought processes or communication; persistent delusions or hallucinations; grossly inappropriate behavior; persistent danger of hurting self or others; intermittent inability to perform activities of daily living, including maintenance of minimal personal hygiene; disorientation to time and place; memory loss for names of close relatives, own occupation, or own name. Id. The symptoms listed in the General Rating Formula for Mental Disorders are not intended to constitute an exhaustive list. Rather, the symptoms serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. See Mauerhan v. Principi, 16 Vet. App. 436 (2002). At a December 2012 VA examination, the Veteran reported that he was divorced, and that had a good relationship with his two children and a few friends. He indicated that he retired from his job as a manager at Sears in 2002 following an aneurysm and stroke. On examination, the examiner reported that the Veteran’s PTSD was productive of difficulty falling and staying asleep, difficulty concentrating, exaggerated startle response, feeling of detachment, avoidant behavior, depressed mood, anxiety, mild memory loss, difficulty in understanding complex commands, impaired abstract thinking, disturbances in motivation and mood, difficulty in adapting to stressful circumstances, and difficulty in establishing and maintaining effective work and social relationships. The examiner opined that the Veteran’s PTSD was most productive of occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although generally functioning satisfactory, with normal routine behavior, self-care and conversation. At a September 2014 VA examination, the Veteran reported that he was socially isolated and had few friends. The examiner reported that the Veteran’s PTSD was productive of anxiety, depressed mood, irritability, hypervigilance, problems with concentration, sleep disturbance, panic attacks that occur weekly or less often, disturbances in motivation and mood, exaggerated startle response, feeling of detachment, avoidant behavior, mild memory loss, difficulty in understanding complex commands, impaired abstract thinking, disturbances in motivation and mood, difficulty in adapting to stressful circumstances, and difficulty in establishing and maintaining effective work and social relationships. The examiner opined that the Veteran’s PTSD was most productive of occupational and social impairment with deficiencies in most areas. At a February 2020 VA examination, the Veteran reported that he had not received treatment for his PTSD. On examination, the Veteran’s thought process was organized, with slow speech. The Veteran reported that he had difficulty with memory since he had an aneurysm approximately 26 years prior. The Veteran denied experiencing suicidal or homicidal ideation or intent, as well as hallucinations or delusions. The examiner reported that the Veteran’s PTSD was productive of anxiety, depressed mood, irritability, hypervigilance, problems with concentration, sleep disturbance, disturbances in motivation and mood, suspiciousness, exaggerated startle response, feeling of detachment, avoidant behavior, mild memory loss, flattened affect, chronic sleep impairment, disturbances in motivation and mood, difficulty in adapting to stressful circumstances, and difficulty in establishing and maintaining effective work and social relationships. The examiner opined that the Veteran’s PTSD was most productive of occupational and social impairment with deficiencies in most areas. A review of the record shows that the Veteran receives treatment at the VA Medical Center for various disabilities. However, there is no indication from the record that his PTSD symptoms are manifestly different than those reported at above-mentioned examinations. Of note, throughout the appeal period, the Veteran has denied experiencing suicidal ideations. Indeed, as much was noted in the VA treatment records as well as the VA examination reports of record. Based on the evidence of record, lay and medical, the Board finds that the Veteran is not entitled to a rating in excess of 70 percent. In this regard, the Veteran’s overall disability picture more closely approximates the criteria for a 70 percent rating, which contemplates occupational and social impairment with deficiencies in most areas. The Board considered the lay statements of record describing symptoms, and considers them to be probative, but finds that they are representative of symptomatology that most closely approximates a rating of 70 percent. In this regard, the Veteran reported, among other symptoms, anxiety, depressed mood, irritability, hypervigilance, problems with concentration, sleep disturbance, panic attacks that occur weekly or less often, disturbances in motivation and mood, exaggerated startle response, feeling of detachment, avoidant behavior, mild memory loss, difficulty in understanding complex commands, impaired abstract thinking, disturbances in motivation and mood, difficulty in adapting to stressful circumstances, and difficult in establishing and maintaining effective work and social relationships. 38 C.F.R. § 4.130, Diagnostic Code 9411. As shown above, the record reflects that the Veteran’s symptoms have not been consistent with total occupational and social impairment such that a 100 percent disability rating is warranted at any point during the pendency of the appeal. In that regard, the Veteran has not displayed gross impairment in thought processes or communication, nor has the record shown that he is a persistent danger of hurting himself or others or grossly inappropriate behavior. Moreover, there is no evidence that the Veteran has experienced hallucinations or delusions, or obsessive rituals. Further, the Veteran has not displayed disorientation to time or place, or memory loss for names of close relatives, his prior occupations, or his own name. Additionally, there is no evidence or allegation that he was unable to maintain minimal personal hygiene. The Veteran reported that he had a good relationship with his children and that he had a few friends, which demonstrates that the Veteran was not totally socially impaired. This is not a disability picture indicating total occupational and social impairment. The Board acknowledges the Veteran’s lay testimony and statements regarding the severity of his symptoms. Laypersons are competent to attest to physical symptoms that are experienced or observed. Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). However, the Board finds that the lay evidence describing the symptoms in this case does not establish a greater degree of functional impairment than the rating assigned herein. The Veteran’s belief that he is entitled to higher ratings for his disability is outweighed by the objective medical findings of record. That is, the Board assigns greater probative value to the pertinent objective findings on the VA examination reports and treatment records that were recorded following physical examinations of the Veteran, than to the Veteran’s general belief that he is entitled to a higher rating. Consideration has been given to assigning staged ratings. However, at no time during the period in question has the disability warranted a higher schedular rating than that assigned. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Neither the Veteran nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). In this case, the preponderance of the evidence is against a rating in excess of 70 percent and the claim must, accordingly, be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. Hearing Loss The Veteran asserts that he should have higher ratings for his bilateral hearing loss because his disability is worse than contemplated by the currently assigned ratings. The Veteran is currently in receipt of an initial noncompensable rating effective January 2, 2013 to April 8, 2013; and a 10 percent rating on and after April 8, 2013. Ratings of hearing loss range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of speech discrimination tests combined with the average hearing threshold levels as measured by pure tone audiometry tests in the frequencies 1000, 2000, 3000, and 4000 cycles per second. To rate the degree of disability for service-connected hearing loss, the Rating Schedule has 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(h), Table VI. In order to establish entitlement to a compensable rating for hearing loss, it must be shown that certain minimum levels of the combination of the percentage of speech discrimination loss and average pure tone decibel loss are met. The assignment of disability ratings for hearing impairment is derived by a mechanical application of the Rating Schedule to the numeric designations assigned after audiometric evaluations are rendered. Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). The criteria for rating hearing impairment use controlled speech discrimination tests (Maryland CNC) together with the results of pure tone audiometry tests. These results are then charted on Table VI, or Table VIA in exceptional cases as described in 38 C.F.R. § 4.86, and Table VII, as set out in the Rating Schedule. 38 C.F.R. § 4.85. An exceptional pattern of hearing loss occurs when the pure tone threshold at 1000, 2000, 3000, and 4000 Hertz is 55 decibels or more, or when the pure tone threshold is 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. 38 C.F.R. § 4.86. A January 2013 VA audiological evaluation was conducted. At that time, the examiner noted that the Veteran did not experience any functional impact due to hearing loss on his daily life. Audiological testing results at that time were as follows: Hertz 1000 2000 3000 4000 Average Right Ear 25 45 50 60 45 Left Ear 20 40 55 60 44 Speech recognition ability was 88 percent in the right ear and 94 percent in the left ear. The examiner diagnosed bilateral hearing loss. Applying those values to the rating criteria results in a numeric designation of Level II in the right ear and Level I in the left ear. 38 C.F.R. § 4.85, Table VI. Application of the levels of hearing impairment in each ear to Table VII at 38 C.F.R. § 4.85 produces a noncompensable rating. An exceptional pattern of hearing loss was not shown. 38 C.F.R. § 4.86. An August 2014 VA audiology consultation note shows that the Veteran reported significant difficulty understanding speech with background noise, as well as at a distance and without visual cues. Audiological testing results at that time were as follows: Hertz 1000 2000 3000 4000 Average Right Ear 25 45 55 60 46 Left Ear 20 40 50 55 41 Speech recognition ability was 64 percent in the right ear and 90 percent in the left ear. The examiner diagnosed bilateral hearing loss. Applying those values to the rating criteria results in a numeric designation of Level V in the right ear and Level II in the left ear. 38 C.F.R. § 4.85, Table VI. Application of the levels of hearing impairment in each ear to Table VII at 38 C.F.R. § 4.85 produces a 10 percent rating. An exceptional pattern of hearing loss was not shown. 38 C.F.R. § 4.86. A September 2014 VA audiological evaluation was conducted. At that time, the examiner noted that the Veteran’s hearing loss included difficulty hearing conversations. Audiological testing results at that time were as follows: Hertz 1000 2000 3000 4000 Average Right Ear 25 45 55 60 46 Left Ear 20 40 50 55 41 Speech recognition ability was 64 percent in the right ear and 90 percent in the left ear. The examiner diagnosed bilateral hearing loss. Applying those values to the rating criteria results in a numeric designation of Level V in the right ear and Level II in the left ear. 38 C.F.R. § 4.85, Table VI. Application of the levels of hearing impairment in each ear to Table VII at 38 C.F.R. § 4.85 produces a 10 percent rating. An exceptional pattern of hearing loss was not shown. 38 C.F.R. § 4.86. A February 2020 VA audiological evaluation was conducted. At that time, the examiner noted that the Veteran’s hearing loss included difficulty understanding speech. Audiological testing results at that time were as follows: Hertz 1000 2000 3000 4000 Average Right Ear 30 55 65 70 55 Left Ear 30 45 60 60 49 Speech recognition ability was 68 percent in the right ear and 88 percent in the left ear. The examiner diagnosed bilateral hearing loss. Applying those values to the rating criteria results in a numeric designation of Level V in the right ear and Level II in the left ear. 38 C.F.R. § 4.85, Table VI. Application of the levels of hearing impairment in each ear to Table VII at 38 C.F.R. § 4.85 produces a 10 percent rating. An exceptional pattern of hearing loss was not shown. 38 C.F.R. § 4.86. In addition to dictating objective test results, a VA audiologist must fully describe the functional effects caused by a hearing disability in the final report. Martinak v. Nicholson, 21 Vet. App. 447 (2007). The January 2013, September 2014 and February 2020 VA examiners adequately reported the effects of the Veteran’s bilateral hearing loss on ordinary conditions of daily life. Therefore, the Board finds that the audiology evaluation reports are in compliance with the requirements of Martinak. For the period on appeal prior to April 8, 2013, the Board finds that the Veteran is not entitled to a compensable rating for his bilateral hearing loss. In this regard, there is no indication from the record that the Veteran’s hearing impairment was worse than Level II in the right ear or Level I in the left ear. 38 C.F.R. § 4.86. The result of the Veteran’s VA examination falls within the schedular criteria for, at worst, a noncompensable rating. Therefore, the criteria for an initial compensable rating prior to April 8, 2013, have not been met. 38 C.F.R. § 4.85, Diagnostic Code 6100. Next, for the period on appeal beginning April 8, 2013, the Board finds that the Veteran is not entitled to a rating in excess of 10 percent for his bilateral hearing loss. In this regard, there is no indication from the record that the Veteran’s hearing impairment was worse than Level V in the right ear or Level II in the left ear. 38 C.F.R. § 4.86. The result of the Veteran’s VA examinations fall within the schedular criteria for, at worst, a 10 percent rating. Therefore, the criteria for an a ratin in excess of 10 percent beginning April 8, 2013, have not been met. 38 C.F.R. § 4.85, Diagnostic Code 6100. To the extent that the Veteran and contends that his hearing loss is more severe than currently evaluated during any period on appeal, the Board observes that the Veteran, while competent to report symptoms, is not competent to report that his hearing acuity is of sufficient severity to warrant higher evaluations under VA’s tables for rating hearing loss disabilities because such an opinion requires medical expertise (training in evaluating hearing impairment), which he has not been shown to possess. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006); Charles v. Principi, 16 Vet. App. 370 (2002); Woehlaert v. Nicholson, 21 Vet. App. 456 (2007) (although the claimant is competent in certain situations to provide a diagnosis of a simple condition such as a broken leg or varicose veins, the claimant is not competent to provide evidence as to more complex medical questions). Consideration has been given to assigning further staged ratings. However, at no time during the period in question has the disability warranted a higher schedular rating than that assigned. Fenderson v. West, supra; Hart v. Mansfield, supra. In Doucette v. Shulkin, 28 Vet. App. 366 (2017), the Court held that the rating criteria for hearing loss contemplate the functional effects of decreased hearing and difficulty understanding speech in an everyday environment as these are the effects that VA’s audiometric tests are designed to measure. The Veteran has not otherwise described functional effects that are considered exceptional or, that are not otherwise contemplated by the assigned rating. Id. Thus, his complete disability picture is compensated under the rating schedule. Further, neither he nor his representative has raised any other issues, nor have any other issues been reasonably raised by the record. Id. Accordingly, the Board finds that the preponderance of the evidence is against the claims of entitlement to an initial compensable rating for hearing loss prior to April 8, 2013, and entitlement to a rating in excess of 10 percent beginning April 8, 2013. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, supra. KRISTY L. ZADORA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Christopher O'Donnell, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.