RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2014-02984
BRANCH OF SERVICE:  Army	BOARD DATE:  20150619
SEPARATION DATE:  20050610

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-3 (Construction Equipment Operator) medically separated for hearing loss.  The condition did not improve adequately 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 sensorineural hearing loss” was forwarded to the Physical Evaluation Board (PEB) IAW AR 40-501.  The MEB also forwarded one other condition (“possible Meniere’s disease”) for PEB adjudication.  The Informal PEB adjudicated “bilateral sensorineural hearing loss” as unfitting, rated 0%, with likely application of the Veterans Affairs Schedule for Rating Disabilities (VASRD).  The remaining condition was found to be not unfitting.  The CI made no appeals and was medically separated.

CI CONTENTION:  “Please consider all conditions.”

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 20050404	VA* -  based on Service Treatment Records (STR)	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Hearing Loss	6100	0%	Bilateral Hearing Loss	6100	NSC	STR	
Possible Meniere’s Disease	Not Unfitting					
Other MEB/PEB Conditions x 0 (Not in Scope)	Other x 4 	
RATING:  0%	RATING:  NSC	
*Derived from VA Rating Decision (VARD) dated 20061025 (most proximate to date of separation [DOS]).

ANALYSIS SUMMARY:

Sensorineural hearing loss (SNHL).  As a young child, this CI had surgery on his left ear.  When he entered the Army in December 2002, his physical profile was H-2.  During his 2 years of active duty, he was exposed to noise from small arms fire, heavy machinery, and power tools.  In December 2004, he reported right-sided hearing loss.  He also was having occasional episodes of vertigo, tinnitus (ringing in the ears), and headache.  The CI was diagnosed with bilateral SNHL.  He had a SPRINT (speech recognition in noise test) performed, and he was Category E.  Based on the results of the SPRINT, an MEB was initiated.  The MEB physical examination (PE) was on 11 January 2005.  On PE of his ears, the tympanic membranes were intact.  There was no evidence of masses, or middle ear fluid.  The results from two of his hearing tests are shown in the chart below.

Audiometric Threshold (Hz) →	500	1000	2000	3000	4000		Comments		
Audiogram done at Military Entrance Processing Station (MEPS)	10 December 2002		
- Right ear	15	20	00	05	10				
- Left ear	30	30	25	10	00				
Audiogram done 5 months Pre-Separation (MEB exam)	5 January 2005		
- Right ear	40	45	50	55	40				
- Left ear	45	40	35	35	35				

As noted above, the CI was found unfit due to bilateral SNHL.  He was medically separated with a 0% disability rating.  After separation, he was scheduled for a VA Compensation and Pension exam on 5 September 2006.  However, he failed to appear for that evaluation.  He did have a VA examination on 27 December 2006 (18 months after separation). Based on the results of that exam, the VA denied service-connection for his SNHL condition.

The Board carefully reviewed all available evidence.  The January 2005 hearing test was performed just 5 months prior to separation, and therefore had significant probative value.  IAW VASRD §4.85 (Table VI), and based on the January 2005 exam, the right ear was Class I and the left ear was Class I.  The data from his January 2005 MEB exam and his December 2006 VA exam are summarized in the chart below.

Hearing		5 months Pre-Sep
(20050105)	18 months Post-Sep
(20061227)	
Right Ear	Average* 	47.5 dB	13.75 dB	
	Speech Discrimination	100%	(not recorded)	
	Table VI/VIa Numeral	Class I (from Table VI)	Class I (from Table VIa)	
 Left Ear	Average* 	36.25 dB	17.5 dB	
	Speech Discrimination 	100%	(not recorded)	
	Table VI/VIa Numeral	Class I (from Table VI)	Class I (from Table VIa)	
§4.85 Rating 	Table VII Percentage	0%	0%	
                 *Average is the sum of pure tone thresholds at 1000, 2000, 3000, and 4000 Hz; divided by four

The Board directed attention to its rating recommendation based on the above evidence.  The Board determined that, IAW VASRD §4.85, the SNHL condition was essentially non-compensable.  Therefore, a disability rating of 0% was warranted for the SNHL condition.  It was appropriately coded 6100 (Sensorineural Hearing Loss), and IAW VASRD §4.85, met criteria for the 0% rating level.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the Board found insufficient cause to recommend a change in the PEB adjudication of the bilateral hearing loss condition.

Other PEB Condition.  Due to the episodes of vertigo and tinnitus, the CI was diagnosed with “possible Meniere’s disease.”  This condition was adjudicated by the PEB as not unfitting.  The Board’s main charge with respect to this condition is to assess the appropriateness of the PEB’s fitness adjudication.  The Board’s threshold for countering fitness determinations is higher than the VASRD §4.3 (reasonable doubt) standard used for its rating recommendations, but remains adherent to the DoDI 6040.44 “fair and equitable” standard.  This condition was thoroughly reviewed by the action officer and considered by the Board.  The Board determined that the “possible Meniere’s disease” was not specifically profiled, nor was it implicated in the commander’s statement.  There was no performance-based evidence in the STR that this condition significantly interfered with satisfactory duty performance.  After due deliberation, and in consideration of the preponderance of the evidence, the Board found insufficient cause to recommend a change in the PEB fitness determination for the “possible Meniere’s disease.”  Therefore, no additional disability rating is recommended.

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 “Bilateral sensorineural hearing loss” and IAW VASRD §4.85, the Board unanimously recommends no change in the PEB adjudication.  In the matter of the “Possible Meniere’s disease” the Board unanimously recommends no change from the PEB determination as not unfitting.  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 20140612, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAMR-RB

SUBJECT:   Department  of Defense  Physical  Disability  Board of Review  Recommendation
for XXXXXXXXXX,  AR20160003298   (PD201402984)

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
( ) OVA
*