RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX	CASE:  PD-2016-00743
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20040701

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects that this covered individual (CI) was an Reserve E4, Automated Logistical Specialist, medically separated for “bilateral hearing loss” with a disability rating of 0%.

CI CONTENTION:  “Review all conditions.”  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 - 20040414	VARD - 2005630	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Hearing Loss	6100	0%	Hearing Loss	6100	NSC	20041217	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  NSC	

ANALYSIS SUMMARY:

Bilateral Hearing Loss.  According to the service treatment record (STR) and the Medical Evaluation Board (MEB) narrative summary (NARSUM), the CI reported that her hearing loss began in March 2003 after exposure to the weapons training range.  Review of the records showed that she actually had a mild hearing loss at accession and also a documented shift recorded in February 2003, one month prior to the reported loss from the firing range.  The panel noted that a cardiology evaluation dated 29 August 2002 for an unrelated medical problem documented that the CI worked as a machine operator in a factory.  The CI was evaluated in otolaryngology on 2 September 2003.  She was noted to have nearly symmetric hearing loss with a normal tympanogram (response of the ear drum to testing) and normal appearing ear drums.  There was no exposure to trauma or toxic medication.  She was thought to have otosclerosis (an abnormal growth of the middle ear bone which can lead to hearing loss).  The CI was subsequently issued hearing aids.  At the 16 December 2003 MEB NARSUM, 7 months prior to separation, the CI reported progressive hearing loss since noise exposure on the firing range in March 2003.  As noted above, her loss actually preceded this.  Also, the progressive loss was typical for this condition rather than from a single episode of acoustic trauma.  The examination of the ears was normal.  

At 17 December 2004 VA Compensation and Pension (C&P) audiology evaluation, 6 months after separation, the CI reported the use of hearing aids.  She denied tinnitus.  The physical examination of the ears was normal.  The audiometric values that the panel considered are charted below.  

Right		Frequency in Hertz
Date	1000 	2000	3000 	4000 	Average	Speech Discrimination	%/Table	
19950713	25	15	20	5	16.25		0/VIA	
20030213	60	45	45	35	46.25		0/VIA	
20030626	70	60	60	45	58.75		10/VIA	
20031216	80	80	75	60	73.75		10/VIA	
20041217	65	55	60	45	56.25	86%	0/VI	

Left 		Frequency in Hertz
Date	1000 	2000 	3000 	4000 	Average	Speech Discrimination	%/Table	
19950713	25	15	10	0	12.5		0/VIA	
20030213	55	40	40	30	41.25		0/VIA	
20030626	60	50	55	35	50		10/VIA	
20031216	70	55	55	60	60		10/VIA	
20041217	60	55	50	40	51.25	86%	0/VI	

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral hearing loss condition 0%, coded 6100 (hearing impairment).  The VA did not initially service-connect the hearing loss condition, also coded 6100, based on the C&P examination 6 months after separation, citing medical evidence failed to show the hearing loss was caused by military service or was service aggravated.  However, a subsequent de novo review by a DRO [Decision Review Officer] found this to be a “clear and unmistakable error” and rated the hearing loss at 0% IAW Tables VI and VII of the VASRD.  The rating for hearing loss is based on both the average loss in each ear at 1000, 2000, 3000, and 4000 Hertz (cycles per second) and the speech discrimination for Tables VI and VIA.  The VA examination contained all of the necessary ratable criteria and was also the closest examination to separation.  However, the two pre-separation PEB examinations were also proximate to separation and supported a 10% rating.  A 10% rating is therefore recommended IAW VASRD §4.7 (higher of two examinations).  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the bilateral hearing loss condition, coded 6100. 

BOARD FINDINGS:  In the matter of the bilateral hearing loss condition, the panel unanimously recommends a disability rating of 10%, coded 6100 IAW VASRD §4.85.  

The panel 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	
Bilateral Hearing Loss	6100	10%	

The following documentary evidence was considered:

Exhibit A.  DD Form 294, dated 20160912, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Treatment Record

AR20170017476, XXXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXXX

Dear XXXXXXXXXXXXXXXXXXX:

	The Department of Defense Physical Disability Board of Review (DoD PDBR) reviewed your application and found that your disability rating should be modified but not to the degree that would justify changing your separation for disability with severance pay to a permanent retirement with disability.  I have reviewed the Board’s recommendation and record of proceedings (copy enclosed) and I accept its recommendation.  This will not result in any change to your separation document or the amount of severance pay.  A copy of this decision will be filed with your Physical Evaluation Board records.  I regret that the facts of the case did not provide you with the outcome you may have desired.
  
	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. 

	A copy of this decision has also been provided to the Department of Veterans Affairs and to the counsel you listed on your application, XXXXXXXXXXXXXXXXXXX.

Sincerely,	
Enclosure