RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXX                                                                            	 CASE:  PD-2014-00235		
BRANCH OF SERVICE:  Army                                   	Separation Date:  20070417

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-5 (Infantryman) medically separated for bilateral hearing loss.  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty.  He was issued a permanent H3 profile and referred for a Medical Evaluation Board (MEB).  The “bilateral high frequency sensorineural hearing loss” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  No other condition was submitted by the MEB.  The Informal PEB adjudicated his hearing loss as unfitting, rated 0%, citing application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The CI made no appeals and was medically separated. 

CI CONTENTION:  He was not evaluated for a right ankle condition.  His complete submission is at Exhibit A.

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44, Enclosure 3, paragraph 5.e. (2).  It is limited to those conditions determined by the PEB to be unfitting for continued military service and when specifically requested by the CI, those conditions identified by the PEB, but determined to be not unfitting.  Any conditions outside the Board’s defined scope of review and any contention not requested in this application may remain eligible for future consideration by the Board for Correction of Military/Naval Records.  Furthermore, the Board’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The Board’s assessment of the PEB rating determinations is confined to review of medical records and all available evidence for application of the VASRD standards to the unfitting medical condition at the time of separation.  The Board has neither the role nor the authority to compensate for post-separation progression or complications of service-connected conditions.  That role and authority is granted by Congress to the Department of Veterans Affairs, operating under a different set of laws.  The Board gives consideration to VA evidence, particularly within 12 months of separation, but only to the extent that it reasonably reflects the severity of the disability at the time of separation.  

RATING COMPARISON:  

IPEB – Dated 20070329	VA* - (~2 Mos. Post-Separation)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral High Frequency Sensorineural Hearing Loss	6100	0%	Bilateral Hearing Loss	6100	0%	20070611	
Other x 0 (Not In Scope)	Other x 6 	
RATING: 0%	RATING:  10%	
*Derived from VA Rating Decision (VARD) dated 20070629 (most proximate to date of separation [DOS]).  

ANALYSIS SUMMARY:  

Bilateral High Frequency Sensorineural Hearing Loss Condition.  The CI developed moderate to severe bilateral hearing loss that was treated with use of hearing aids.  The MEB and DD Form 2808, Report of Medical Examination, approximately 4 months prior to separation documented an average 40 decibel (dB) hearing loss in this right ear and 45 dB in his left ear.  On the Filtered Speech Test (SPRINT) in October 2006, the CI demonstrated a raw score of 136/200 (difficult understanding words) which placed him in the 11th percentile (SPRINT Category E; separation from Service).  The CI’s permanent H3 profile had additional restrictions of no exposure to noise in excess of 85dB or weapon firing without use of properly fitted hearing protection.  The audiogram results are summarized in the chart below.  The MEB Narrative Summary exam approximately 2 months prior to separation documented that the CI wore bilateral hearing aids and was doing well.  There was no history of significant acoustic nerve (hearing) trauma and the bilateral ear exam was otherwise normal.  

The VA Compensation and Pension (C&P) exam approximately 2 months after separation documented that the CI reported a rare bilateral ringing of moderate loudness which was described as a faint bell that occurred about once weekly and lasted for 15 to 20 seconds each time.  The examiner opined that these rare episodes of head noises were consistent with auditory function and were not typical of an etiology of noise exposure and that there was no evidence of tinnitus.  There were audiogram evaluations in evidence, with documentation of additional ratable criteria, which the Board weighed in arriving at its rating recommendation; as summarized in the chart below.  

Audiometric Threshold (Hz) →	500	1000	2000	3000	4000	6000	Comments	§4.85/6 Rating	
MEB ~ 4 Mo Pre-Sep		PEB 0%	
Right	5	10	30	55	65	90	40 dB Right ear
45dB Left ear
SPRINT 11th Percentile (Category E)		
Left	10	10	60	55	55	70			
VA C&P ~2 Mo. Post-Sep		VA 0%	
Right	15	10	65	55	60	70	48 dB Right ear; 84% Word recognition
46 dB Left ear; 88% Word Recognition		
Left	15	10	40	65	70	90			

The Board directed attention to its rating recommendation based on the above evidence.  The PEB and VA both coded the hearing loss condition as 6100 (hearing loss) and rated at 0%.  Both audiograms proximate to separation were independently rated at 0% using VASRD rating criteria, including potential use of Table VI and Table VII IAW VASRD §4.86a and §4.85.  The Board also considered Table VIa (exceptional hearing pattern) for the Service exam as the SPRINT test for word recognition was different than the VASRD required (CNC) test.  The CI had no history of phonophobia, vertigo, tinnitus or other evidence to support Meniere’s syndrome (endolymphatic hydrops) which could support a higher rating.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board concluded that there was insufficient cause to recommend a change in the PEB adjudication for the hearing loss condition.  

BOARD FINDINGS:  IAW DoDI 6040.44, provisions of DoD or Military Department regulations or guidelines relied upon by the PEB will not be considered by the Board to the extent they were inconsistent with the VASRD in effect at the time of the adjudication.  The Board did not surmise from the record or PEB ruling in this case that any prerogatives outside the VASRD were exercised.  In the matter of the hearing loss condition and IAW VASRD §4.85a and §4.86a, the Board unanimously recommends no change in the PEB adjudication.  There were no other conditions within the Board’s scope of review for consideration.  

RECOMMENDATION:  The Board, therefore, recommends that there be no re-characterization of the CI’s disability and separation determination.  

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20140101 w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB						

MEMORANDUM FOR Commander, US Army Physical Disability Agency 
(AHRC-DO), 2900 Crystal Drive, Suite 300, Arlington, VA  22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXXXX, AR20160000425 (PD201400235)

I have reviewed the enclosed Department of Defense Physical Disability Board of Review (DoD PDBR) recommendation and record of proceedings pertaining to the subject individual.  Under the authority of Title 10, United States Code, section 1554a,   I accept the Board’s recommendation and hereby deny the individual’s application.  
This decision is final.  The individual concerned, counsel (if any), and any Members of Congress who have shown interest in this application have been notified of this decision by mail.

 BY ORDER OF THE SECRETARY OF THE ARMY:

Enclosure

CF: 
(  ) DoD PDBR
(  ) DVA