RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX	CASE:  PD-2017-01951
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20051020

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Infantryman, medically separated for “neurosensory hearing loss” with a disability rating of 0%.  

CI CONTENTION:  The condition continues to negatively affect his daily life and stems from a condition not identified by the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB).  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 PEB to be unfitting for continued military service, and when specifically requested by the CI, those conditions identified by the MEB, but determined by the PEB 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.  The panel’s authority is limited to assessing the fairness and accuracy of PEB rating determinations and recommending corrections when appropriate.  The panel’s assessment of the PEB rating determination is based on review of medical records and all available evidence relevant to application of the Veterans Affairs Schedule for Rating Disabilities (VASRD) standards for 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, which operates 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 disability at the time of separation.  

RATING COMPARISON:  

SERVICE PEB - 20051003	VARD - 20060418	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Neurosensory Hearing Loss	6100	0%	Bilateral Hearing Loss	6100	0%	20060317	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  30%	

ANALYSIS SUMMARY:  

Hearing Loss.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI first noticed hearing loss in January 2003 after return from deployment and reported excessive noise exposure mainly due to artillery fire.  His MEPS hearing screen in September 2001 was normal, except at higher frequencies:  right ear required 45 dB at 4000Hz and 40 dB at 6000 Hz and left ear 40 dB at 4000Hz and 70 dB at 6000Hz.  He was not issued a hearing profile and required no waivers to enter the Army.  He deployed again in August 2003 and was exposed to an IED 2 months later.  He bled from both ears and had extreme ringing in his ears for about 4 days.  He complained of difficulty hearing for the remainder of his deployment.  He underwent a complete hearing evaluation in March 2005 and was determined to have severe bilateral hearing loss and was prescribed hearing aids.  Comprehensive audiometry testing on 4 April 2005, 7 months prior to separation, noted an average puretone threshold of 50 decibels in the right ear and 47.5 in the left ear with speech discrimination of 100% in each ear. 

During the 13 September 2005 MEB NARSUM examination, 1 month prior to separation, the CI reported he could not hear radio transmissions, even with hearing aids, and was limited in his weapons use due to his hearing deficit.  Other military activities, including physical fitness training, were not significantly affected.  The examiner noted the CI had severe bilateral high frequency hearing loss requiring hearing aids.  

At the 18 January 2006 VA Compensation and Pension (C&P) general examination, 3 months after separation, the CI reported wearing hearing aids but they were being repaired at the time.  He was unemployed but planned to return to school.  Physical examination was unremarkable.  The 17 March 2006 C&P audiology examination, 5 months post-separation, showed bilateral and sensorineural hearing loss, without tinnitus.  The loss was moderate and the examiner opined no follow-up was necessary.  The right ear showed an average decibel loss of 50 with speech discrimination of 80% and the left ear showed an average loss of 43.75 decibels with speech discrimination of 76%.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the hearing loss 0%, coded 6100 (hearing loss), citing hearing loss at 50 and 44 decibels respectively with hearing discrimination 100% bilaterally.  The VA also rated the hearing loss 0%, coded 6100, based on the C&P examination, citing average decibel loss of 44 in the left ear and 49 in the right ear.  The NARSUM examination noted the CI had severe bilateral high frequency hearing loss requiring hearing aids.  The panel considered the disparate hearing tests.  The April 2005 hearing test in the STR supported a numeric designation of Roman numeral I for the better ear and I for the poorer ear warranting a Table VII rating of 0% under code 6100.   Whereas the VA hearing test supported a numeric designation of III for the better ear and IV for the poorer ear warranting a Table VII rating of 10% under code 6100.  The panel considered the VA hearing examination was more proximal to separation and of more probative value.  Members agreed the C&P audiology findings met the VASRD criteria for a 10% rating.  After due deliberation, considering all the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel recommends a disability rating of 10% for the hearing loss, coded 6100.  

BOARD FINDINGS:  In the matter of the hearing loss, the panel recommends a disability rating of 10%, coded 6100 IAW VASRD §4.87.  There are no other conditions within the panel’s scope of review for consideration.  

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

CONDITION	VASRD CODE	PERMANENT RATING	
Neurosensory Hearing Loss	6100	10%	

[AR Number], XXXXXXXXXX

XXXXXXXXXX
XXXXXXXXXX
XXXXXXXXXX

Dear XXXXXXXXXX:

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.