RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00507
BRANCH OF SERVICE:  Air Force	SEPARATION DATE:  20020722

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

CI CONTENTION:  The evidence supports a higher rating.  Additional unfitting conditions were not considered.  The complete submission is at Exhibit A.

SCOPE OF REVIEW:  The panel’s scope of review is defined in DoDI 6040.44.  It is limited to review of disability ratings assigned 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 or non-compensable.  Any conditions outside the panel’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 panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections, where appropriate.  The panel’s assessment of the PEB rating determination 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(s) at the time of separation.  The panel 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 panel 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 - 20020531	VARD 20070827	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Cholesteatoma of Left Ear with Hearing Loss Status Post Mastoid Surgery	6260-6299-6100	0%	Left Ear Hearing Loss	6100	0%	20070803	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:

Cholesteatoma of Left Ear with Hearing Loss.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI’s underwent a left ear mastoidectomy (removal of the mastoid air cell) and tympanoplasty (reconstruction of the tympanic membrane) on 18 April 2001 due to cholesteatoma (an expanding growth in the middle ear and mastoid process) and chronic ear infections.  Removal of the cholesteatoma necessitated resection of parts of the bones required for hearing.

The 5 February 2002 MEB NARSUM examination, 5 months prior to separation, noted minimal hearing in the left ear.  Physical examination showed the tympanic membranes were clear bilaterally, however, there were “some very subtle changes related to the surgery in his left ear” visualized.  The examiner opined “left cholesteatoma status post-surgical removal, now with permanent hearing loss.”  A 06 March 2002 audiogram demonstrated speech reception threshold at 90 decibels (dB) on the left, 10 dB on the right and speech discrimination scores of 100% at 40 dB on the right and 92% at 100dB on the left.  Puretone audiometry tests were not noted.  
There was no VA examination in evidence proximate to separation.

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the left ear condition 0%, analogously coded 6260-6299-6100 (tinnitus recurrent-hearing loss), citing status post mastoid surgery.  The VA also rated the left ear condition 0%, coded 6100, based on the VA examination performed in 2007.  The evidence did not support a rating higher than 0% under the hearing loss rating system.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded that there was insufficient cause to recommend a change in the PEB adjudication for the hearing loss status post mastoid surgery condition.

BOARD FINDINGS:  In the matter of the hearing loss status post mastoid surgery condition and IAW VASRD §4.87, the panel unanimously recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  The panel, therefore, recommends that there be no modification or re-characterization of the CI’s disability and separation determination.

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160705, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

SAF/MRB
1500 West Perimeter Road, Suite 3700
Joint Base Andrews, MD  20762

XXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXX

Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2016-00507.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

Sincerely,

Attachment:
Record of Proceedings