Citation Nr: A25106295 Decision Date: 12/10/25 Archive Date: 12/10/25 DOCKET NO. 250821-578389 DATE: December 10, 2025 ORDER Entitlement to an initial compensable evaluation for service-connected bilateral hearing loss is denied. REMANDED Entitlement to an evaluation in excess of 50 percent for service-connected posttraumatic stress disorder (PTSD) is remanded. Entitlement to an evaluation in excess of 10 percent for service-connected right wrist sprain, status post surgery residuals, is remanded. FINDING OF FACT The Veteran's bilateral hearing loss has been manifested by hearing acuity of no worse than Level II in his right ear and Level III in his left ear. CONCLUSION OF LAW The criteria for a compensable rating for bilateral hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1969 to February 1973. These matters come before the Board of Veterans' Appeals (Board) on appeal from an August 2024 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). By way of background, the Veteran filed a VA Form 21-526EZ in March 2022 and sought entitlement to service connection for a right wrist disability. The RO granted service connection for a right wrist disability and associated scars in a July 2022 rating decision. The RO awarded a 10 percent rating for the Veteran's wrist disability and a noncompensable evolution for the Veteran's associated scar. The Veteran filed a VA Form 21-526EZ in May 2023 and requested service connection for PTSD. In an October 2023 rating decision, the RO granted entitlement to service connection for PTSD and assigned an initial 50 percent evaluation. The RO assigned an effective date of December 5, 2022, the date of the Veteran's Intent to File. In an April 2024 VA Form 21-526EZ, the Veteran sought entitlement to service connection for hearing loss and increased evaluations for his service-connected PTSD and right wrist disability. In the August 2024 rating decision on appeal, the RO denied the Veteran's claims for increased evaluations because it found he did not show for scheduled VA examinations. The RO granted entitlement to service connection for hearing loss and assigned a noncompensable evaluation. In the August 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the August 2024 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. However, because the Board is remanding the claims of entitlement to an increased evaluation for PTSD and a right wrist disability, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii). 1. Entitlement to an initial compensable evaluation for service-connection for hearing loss. The Veteran contends entitlement to an initial compensable evaluation for his service-connected hearing loss. See August 2025 VA Form 10182. The Veteran does not offer an explanation for why he believes he is entitled to an increased rating. Increased ratings Disability evaluations are determined by the application of the facts presented to VA's Schedule for Rating Disabilities (Rating Schedule) in 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.321(a), 4.1. Where there is a question as to which of two evaluations shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. In evaluating the severity of a particular disability, it is essential to consider its history. 38 C.F.R. § 4.1; Peyton v. Derwinski, 1 Vet. App. 282 (1991). In cases where the original rating assigned is appealed, consideration must be given to whether a higher rating is warranted at any point during the pendency of the claim. Fenderson v. West, 12 Vet. App. 119 (1999). Nevertheless, the Board acknowledges that a claimant may experience multiple distinct degrees of disability that might result in different levels of compensation from the time the increased rating claim was filed until a final decision is made. Hart v. Mansfield, 21 Vet. App. 505 (2007). The analysis in the following decision is therefore undertaken with consideration of the possibility that different ratings may be warranted for different time periods. If the evidence for and against a claim is approximately balanced, the claim will be granted. 38 C.F.R. § 4.3. A claim will be denied only if the record persuasively weighs against the claim. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). Any reasonable doubt regarding the degree of disability should be resolved in favor of the claimant. 38 C.F.R. § 4.3. The Veteran's right ear hearing loss is rated under Diagnostic Code 6100. VA evaluates hearing impairment under the General Rating Formula for Impairment of Auditory Acuity in 38 C.F.R. §§ 4.85, 4.86, Diagnostic Code 6100. Evaluations for defective hearing range from noncompensable (zero percent) to 100 percent based on organic impairment of hearing acuity, as measured by the results of speech discrimination tests, together with the average hearing threshold levels as measured by puretone audiometry tests in the frequencies of 1000, 2000, 3000, and 4000 cycles per second (Hertz) (Hz)). To evaluate the degree of disability for a hearing loss disability, the Rating Schedule establishes eleven auditory acuity levels designated from Level I, for essentially normal acuity, through Level XI, for profound deafness. 38 C.F.R. § 4.85. Examinations are conducted without the use of hearing aids. 38 C.F.R. § 4.85 (a). Regulations also provide that in cases of exceptional hearing loss, i.e., when the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more, the ratings specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VI(A), whichever results in the higher numeral. Each ear will be evaluated separately. 38 C.F.R. § 4.86 (a). The provisions of 38 C.F.R. § 4.86 (b) further provide that when the puretone threshold is 30 decibels or less at 1000 Hertz, and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VI(A), whichever results in the higher numeral. That numeral will then be evaluated to the next higher Roman numeral. Each service-connected ear will be evaluated separately. An examination for hearing impairment for VA purposes must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test (Maryland CNC Test) and a puretone auditory test. 38 C.F.R. § 4.85. Factual background The Veteran underwent a VA examination in August 2024 and was diagnosed with bilateral sensorineural hearing loss. The Veteran reported that his hearing loss did not impact his daily life. Accordingly, the VA examiner found no functional loss. On the authorized audiological evaluation, pure tone thresholds, in decibels, were as follows: Hertz 500 1000 2000 3000 4000 Right 35 35 50 50 55 Left 35 35 45 55 60 The average puretone threshold was 47.50 in the right ear and 48.75 in the left ear. Speech audiometry revealed speech recognition ability of 100 percent in the right ear and 100 percent in the left ear. The examiner stated the puretone test results are valid for rating purposes, and the use of word recognition score (Maryland CNC word list) was appropriate. The August 2024 VA examination results reflect an exceptional pattern of hearing impairment. Under Table VI, Numeric Designation of Hearing Impairment Based on Puretone Threshold Average and Speech Discrimination (Table VI), the August 2024 examination results yield numeric hearing impairment designation of Level I in the right ear and a Level I designation in the left ear. See 38 C.F.R. § 4.85. Intersection of the two levels is consistent with a noncompensable (zero percent) rating. 38 C.F.R. § 4.85, Table VII Percentage Evaluation for Hearing Impairment (Diagnostic Code 6100) (Table VII). The provisions of 38 C.F.R. § 4.86 (a) are applicable to the above bilateral ear audiometry. Of note, the Board acknowledges the Veteran's average puretone threshold at his August 2024 VA examination was 48.75 in his left ear. As Table VIA provides for puretone threshold averages from 42 - 48 and 49 - 55, the Board will afford the Veteran the benefit of the doubt and round up his puretone threshold average to 49 for purposes of rating under Table VIA. The provisions of 38 C.F.R. § 4.86 (a) permit a Level II designation for the right ear pursuant to Table VIA, and Level III designation for his left ear after the elevation required by 38 C.F.R. § 4.86 (a) and the rounded 49 puretone threshold average. These higher levels permit a noncompensable rating under 38 C.F.R. § 4.85, Table VII. The Board finds that an initial compensable evaluation is not warranted for the Veteran's hearing loss. VA regulations prescribe a mechanical application of a formula to determine its evaluations. The Veteran does not contend his hearing loss impacts his daily life, nor offer an explanation as to why he believes he is entitled to a compensable evaluation. Rossy v. Shulkin, 29 Vet. App. 142, 145 (2017). In sum, his hearing loss is not severe enough to warrant a higher rating. For these reasons, an initial compensable evaluation for the Veteran's service-connected hearing loss is not warranted. REASONS FOR REMAND 1. Entitlement to increased evaluations for PTSD and a right wrist disability. In June 2024, the RO requested a VA examination to determine the severity of the Veteran's service-connected PTSD and right wrist disability. The examinations were cancelled on June 18, 2024, because the Veteran called to report that one examination was scheduled on a holiday and that the other examination was scheduled when the Veteran had a previously-scheduled doctor's appointment. See Report of General Information (receipt date Junen 18, 2024). In July 2024, the RO requested another VA examination for the Veteran's claims. The file reflects that the Veteran did not attend the examinations for his claims of increased evaluations for his service-connected PTSD and right wrist disability. However, it is unclear whether the Veteran was provided adequate notice of the examinations. Although there is a copy of a July 11, 2024, appointment notice in the claims file, the Board notes that the examination was scheduled for July 13, 2024. The notice only has the Veteran's mailing address and does not indicate other attempts to contact the Veteran regarding his scheduled examination. Additionally, the Veteran had an examination scheduled on July 26, 2024, and it is unclear whether the notice was mailed to the Veteran. There are no additional copies of the examination notices sent to the Veteran or any other attempts of record to contact the Veteran regarding his scheduled examinations. Simply put, the Board finds that adequate steps were not taken to provide a VA examination prior to the August 2024 rating decision on appeal. The Board finds that a remand is warranted to correct this pre-decisional error. See 38 C.F.R. §§ 3.159(c), 20.802(a). Notably, the Veteran attended the VA examination for his hearing loss claim and his claims file contains the same date of notice as his other examination requests. The Board reminds the Veteran the duty to assist is not always a one-way street, and he has an obligation to actively participate, including attending scheduled examinations. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). The Veteran is advised he is expected to cooperate in the efforts to adjudicate the claims, and his failure to do so may result in denial of his claims. See 38 C.F.R. § 3.655. The matters are REMANDED for the following action: 1. Schedule the Veteran for an appropriate VA examination to determine the current severity and manifestation of his service-connected PTSD. The Veteran must be provided notice of the time and place to report for these examinations, and all attempts to contact him about these matters must be commemorated in the Veteran's file. All symptomatology associated with the disability, including any functional effects, should be reported. 2. Schedule the Veteran for an examination to determine the Veteran's level of functioning without the use of medication regarding his right wrist disability. The Veteran must be provided notice of the time and place to report for these examinations, and all attempts to contact him about these matters must be commemorated in the Veteran's file. All symptomatology associated with the disability, including any functional effects, should be reported. The examiner must specifically provide the following: (a.) Document all medications the Veteran is taking for his right wrist disability; including, but not limited to, oral medications, topical medications, and injections. (b.) Complete all range of motion testing required by the Wrist Conditions examination under the following parameters: (i) Range of motion measurements while the Veteran is taking medications. (ii) Range of motion measurements, or at a minimum, range of motion estimates, representing the Veteran's functional limitation if he were not taking medications. If this is not feasible, the clinician MUST provide a detailed explanation and rationale for why this could not be accomplished. Specifically, if the clinician cannot provide range of motion measurements without resorting to mere speculation, the clinician should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). CHRISTOPHER A. WENDELL Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Houman, Kelsey J. 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.