RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2015-01978
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20090615

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

CI CONTENTION:  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 on 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 - 20090303	VARD – N/A	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Hearing Impairment	6100	0%	No VA examination in evidence	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  N/A	

ANALYSIS SUMMARY:  

Hearing Impairment.  According to service treatment records (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s hearing impairment condition was noted at enlistment.  The CI enlisted with an H2 hearing profile.  There was no history of injury to his ears or unusual noise exposure.  The MEB forwarded “bilateral high frequency sensorineural hearing loss, moderate right ear, severe left ear” for PEB adjudication.  The baseline reference audiogram performed in November 2006 (CPF 113), established prior to initial duty in hazardous noise areas, pure tone threshold averages showed mild (15dB - 30dB) right ear (22.5dB) hearing loss and mild (15dB - 35dB) left ear (26dB) hearing loss.  At a hearing clinic evaluation on 18 March 2008 the CI reported a high level of environmental noise exposure from small arms (right-handed shooter) and endorsed firing with hearing protection most of the time.  The comprehensive audiometry documented moderate to severe sensorineural hearing loss.  Based on his level of hearing loss he was rated with the Speech Recognition in Noise Test (SPRINT) with a 49th percentile score and the Category E (Separation from service) designation.  At the MEB examination (recorded on DD Forms 2807 and 2808) dated January 2009, 5 months prior to separation, the CI reported no specific ear or hearing problems.  Physical examination showed normal ear exam except ear wax.  The MEB NARSUM examination on 26 January 2009, 5 months prior to separation, noted that he couldn’t hear very well.  Physical examination showed normal ear exam.  The NARSUM examiner recounted the findings of the audiology consultation.  The puretone threshold averages are listed in the chart below.  An audiology evaluation in February 2009 noted a speech recognition threshold (SRT) of 80dB for the right ear and 65dB for the left ear.  The CI’s right ear could not be tested due to a high speech reception threshold of 8OdB HL.  Speech word discrimination testing is typically performed at 40dB above the SRT.  Speech recognition for the left ear was noted at 64 % at 65dB and 61% at 80 dB (poor word recognition at suprathreshold levels).  There was no VA examination in evidence.  The audio examinations in evidence which the Board weighed in arriving at its rating recommendation, with documentation of additional ratable criteria, are summarized in the chart below.  

HEARING	EXAM	MEPS- 20060901	Audiology-20080318	MEB - 20090106	
LEFT EAR	Average Hearing Loss	26 dB	55 dB	 53 dB	
	Speech Discrimination		64%		
	Table VI / VIa	I	VI	  III	
RIGHT EAR	Average Hearing Loss	23 dB	38 dB	 38 dB	
	Speech Discrimination 		Not Calculated		
	Table VI / VIa	I	I	 I	
§4.85 RATING	Table VII	0%	0%	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 rated the hearing impairment condition 0%, coded 6100 (Hearing Loss), citing severe loss left ear and moderate loss right ear with hearing aids recommended.  The VASRD uses two tables to determine a numeric designation of hearing impairment for each ear.  Table VI is based on pure tone threshold average (PTA) and speech discrimination when both are available and Table VIa based only on PTA.  IAW VASRD §4.85 (c) [Evaluation of hearing impairment] the CI’s hearing loss was rated via Table VIa because the CI speech discrimination could not be measured for the right ear.  The PTA of 38dB on the right and 55 dB on the left met criteria for a 0% 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 impairment condition.  

BOARD FINDINGS:  In the matter of the hearing impairment 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.  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 20150604, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170004068, XXXXXXXXXXXXXXXXXX.

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Dear XXXXXXXXXXXXXXXXXX:

The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found your separation disability rating and your separation from the Army for disability with severance pay to be accurate.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed), and I accept its recommendation.  I regret to inform you that your application to the DoD PDBR is denied.

This decision is final.  Recourse within the Department of Defense or the Department of the Army is exhausted; however, you have the option to seek relief by filing suit in a court of appropriate jurisdiction.

Sincerely,