RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXXXXXX	CASE:  PD-2014-03993
BRANCH OF SERVICE:  ARMY                                                                  SEPARATION DATE:  20071031

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E-4 (Infantryman) medically separated for bilateral sensorineural hearing loss.  The condition could not be adequately rehabilitated to meet the physical requirements of his Military Occupational Specialty (MOS). He was issued a permanent H3 profile and referred for a Medical Evaluation Board (MEB).  The “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 the bilateral hearing loss condition 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:  His hearing condition continues to worsen and negatively impact his daily activities.  He was not evaluated for a foot and back 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 20070724	VA* - (<1 Mos. Pre-Separation)  	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Sensorineural Hearing Loss	6100	0%	Bilateral Hearing Loss	6100	0%	20071002	
Other MEB/PEB Conditions x 0 (Not In Scope)	Other x 2 	
RATING:  0%	COMBINED RATING:  10%	
*Derived from VA Rating Decision (VARD) dated 20071106 (most proximate to date of separation (DOS)).  

ANALYSIS SUMMARY:  

Bilateral Hearing Loss (HL) Condition.  The narrative summary (NARSUM) noted that on a routine periodic hearing evaluation, the CI was found to have HL due to noise exposure.  Magnetic resonance imaging to rule out a central nervous system cause was normal and the CI was given an H3 profile, fitted with hearing aids, and referred for an MEB.

At the MEB exam 20 April 2007, 6 months before separation, the CI reported HL and occasional ringing in his ears.  The MEB physical exam noted a normal exam of both ears.  Audiometry on 25 January 2007 showed mild to moderate HL bilaterally, greater on the left than right.  Speech discrimination was normal.  Audiometry results in decibels (dB) at frequencies in Hertz (Hz) for the right ear were 0 at 1000, 10 at 2000, 50 at 3000, and 45 at 4000; for the left ear were 0 at 1000, 45 at 2000, 50 at 3000, and 50 at 4000.  Additional results of the audiogram are summarized in the chart below.

At the VA Compensation and Pension (C&P) exam performed 1 month before separation, the CI reported bilateral HL with difficulty following conversations and ringing in both ears.  Exam of the external ear was normal and audiometry showed bilateral HL.  Audiometry results in dB/Hz for the right ear were 0 at 1000, 10 at 2000, 50 at 3000, and 50 at 4000; for the left ear were 0 at 1000, 70 at 2000, 55 at 3000, and 65 at 4000.  

HEARING	EXAM	MEB  ~9 Mo. Pre-Sep	VA C&P ~1 Mo. Pre-Sep	
LEFT EAR	Average Hearing Loss	36.25 dB	48 dB	
	Speech Discrimination	84%	96%	
	Table VI / VIa	II 		
RIGHT EAR	Average Hearing  Loss	26.25 dB	28 dB	
	Speech Discrimination 	92%	100%	
	Table VI / VIa	I 	I	
§4.85 RATING	Table VII	0%	%	
(Average hearing loss 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 PEB and VA both rated the bilateral HL 0%, coded 6100.  The Board reviewed the 6100 rating criteria for HL of one or both ears.  At the MEB exam, based on Table VI “Numeric Designation of Hearing Impairment Based on Puretone Threshold Average and Speech Discrimination”, the Roman numeral designation for the hearing impairment of the right ear is I and for the left ear is II.  Next, according to Table VII “Percentage Evaluation for Hearing Impairment” this results in a 0% impairment rating for the bilateral HL.  At the C&P exam the corresponding hearing impairment Roman numeral designation for the right ear was also I.  However, for the left ear, the VARSD specifies that if “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 VIa [Numeric Designation of Hearing Impairment Based only on Puretone Threshold Average], whichever results in the higher numeral.  That numeral will then be elevated to the next higher level.”  Following this process, the Roman numeral designation for the left ear is III, and according to Table VII, this also results in a 0% rating for the bilateral HL condition.  There was no evidence in record that occasional tinnitus of both ears resulted in impairment which could be considered as separately unfitting conditions and there was no other ratable impairment of the right or left ear documented in record.  The Board thus determined that the bilateral HL could be rated 0% and no higher.  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 bilateral HL 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 bilateral HL condition and IAW VASRD §4.85, 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 20140907, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

MEMORANDUM FOR Commander, US Army Physical Disability Agency (AHRC-00), 2900 Crystal Drive, Suite 300, Arlington, VA   22202-3557

SUBJECT:  Department of Defense Physical Disability Board of Review Recommendation for XXXXXXXXXXXXXXXXXXXXXXX AR20160004442  (PD201403993)

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