RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-00784
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20050604

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an active duty E4, Petroleum Supply Specialist, medically separated for hearing loss with a disability rating of 0%.  

CI CONTENTION:  “Severe loss of hearing in both ears…”   The CI made no specific contention.  The CI’s complete submission is at Exhibit A.  

SCOPE OF REVIEW:  The Board’s scope of review is defined in DoDI 6040.44.  It is limited to those conditions determined by the Physical Evaluation Board (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 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 based upon a review of medical records and all available evidence for application of the Veterans Affairs Schedule for Rating Disabilities (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:  

SERVICE PEB - 20050331	VARD - 20140920	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Sensorineural Hearing Loss	6100	0%	Hearing Loss Sensorineural	6100	0%	20140722	
			Tinnitus	6260	10		
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Hearing Loss.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s hearing condition existed prior to service (EPTS) and he was granted a waiver for service entry (1996).  The CI had noted gradually worsening hearing and increased difficulty understanding speech and was referred with a hearing threshold shift in 2003.  The MEB forwarded “bilateral sensorineural hearing loss” for PEB adjudication.  The MEB NARSUM examination on 15 December 2004, 6 months prior to separation, noted complaints of gradually worsening hearing and increased difficulty understanding speech. Diagnostic imaging was negative for evidence of central nervous system lesions or tumors. Physical exam showed a normal ear, nose, and throat exam.  Audiograms showed profound sensorineural hearing loss worse in the left ear.  The average loss of the right ear (1000-4000Hz) was 62.5 dB with speech discrimination of 96%; the average on the left was 92.5 dB with speech discrimination of 84%.  There was no VA Compensation and Pension (C&P) evaluation, performed proximate to separation (first C&P exam 22 July 2014, 9 years after separation).  

The Board directed attention to its rating recommendation based on the above evidence.  The PEB rated the hearing condition 0%, coded 6100 (impairment of auditory acuity based on table VII), citing EPTS and not permanent service aggravation, but compensable IAW 10 USC 1207a (the ‘eight year rule’).  The VA rated the hearing condition 0% coded 6100, based on the VA C&P examination 9 years after separation, citing left ear with 68 percent speech discrimination.  The VA additionally rated the tinnitus condition 10% coded 6260 (tinnitus) citing recurrent tinnitus.  The Service exam had the highest probative value for rating at separation due to its proximity to separation.  Use of Table VI and VII would warrant a 0% rating; however, the audiogram proximate to separation documented an exceptional hearing pattern for the left ear IAW VASRD §4.86 (puretone threshold at each of the four specified frequencies [1000, 2000, 3000, and 4000 Hertz] was 55 decibels or more), and therefore Table VIa was applicable for the left ear.  Use of Table VIa for the left ear and Table VI for the right ear indicated a 10% rating under Table VII was warranted.  The CI had no history of phonophobia, vertigo, 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 recommends a disability rating of 10% for the hearing loss condition, coded 6101.  

BOARD FINDINGS:  In the matter of the hearing loss condition, the Board unanimously recommends a disability rating of 10%, coded 6101 IAW VASRD §4.85, §4.86, and §4.87.  There were no other conditions within the Board’s scope of review for consideration.  

The Board recommends that the CI’s prior determination be modified as follows, effective as of the date of the prior medical separation:  

CONDITION	VASRD CODE	PERMANENT RATING	
Sensorineural Hearing Loss	6101	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20150601, 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 
XXXXXXXXXXXXXXXXXX, AR20170000742 (PD201500784)

1.  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, accept the Board’s recommendation to modify the individual’s disability rating to 10% without re-characterization of the individual’s separation.  This decision is final.  

2.  I direct that all the Department of the Army records of the individual concerned be corrected accordingly no later than 120 days from the date of this memorandum.   

3.  I request that a copy of the corrections and any related correspondence be provided to the individual concerned, counsel (if any), any Members of Congress who have shown interest, and to the Army Review Boards Agency with a copy of this memorandum without enclosures.

 BY ORDER OF THE SECRETARY OF THE ARMY:

CF: 
(  ) DoD PDBR
(  ) DVA