RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-02768
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090722

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

CI CONTENTION:  No specific contention made.  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 Medical Evaluation Board (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 - 20090430	VARD - 20090324	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Bilateral Hearing Loss	6100	0%	Bilateral Hearing Loss	6100	0%	20090604	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  10%	

ANALYSIS SUMMARY:  

Bilateral Hearing Loss.  According to the service treatment record and MEB narrative summary (NARSUM), the CI’s bilateral hearing loss began while deployed in 2002 with prolonged exposure to gunfire.  An audiogram in November 2002 showed an average loss of 11.25 dB on the left and 22.5 dB on the right with a 60 dB loss at 6000 Hz bilaterally.  Post deployment, a hearing test showed that he had some hearing impairment, which over time had gotten worse.  

In February 2006, the average hearing loss on the left was 22.5 dB and 23.75 dB on the right; in July 2006, the loss was 21.25 dB on the left and 16.25 dB on the right; and in November 2006 it was 25 dB on the left and 22.5 dB on the right.  
At a hearing conservation visit on 19 June 2007 the CI reported worse hearing loss in the left ear.  Physical examination revealed normal outer ears and external auditory canals.  An audiogram showed a 21.25 dB loss on the left and a 25 dB loss on the right, which was interpreted as mild to moderate sensorineural hearing loss bilaterally.  Speech threshold with discrimination was excellent bilaterally.  There was good SRT/PT (speech reception threshold/pure-tone) agreement and tympanic membrane mobility was normal.  Acoustic testing evoked optoacoustic emissions consistent with pure tone findings and cochlear sites of the lesions.  

The 13 August 2008 audiogram revealed an average hearing loss of 26.25 dB on the left and 31.25 dB on the right.  At a hearing conservation visit on 3 September 2008 an H3 profile was issued for moderate to moderately-severe/severe high frequency sensorineural hearing loss bilaterally, which was based on an average 33.75 dB loss on the left and a 32.5 dB loss on the right.  Speech recognition was 100% on the right and 88% on the left.  Binaural amplification (hearing aids) was recommended and hearing aid information was given.  On 20 November 2008 SPRINT (speech recognition in noise test) testing revealed a filtered speech test with a score at the 48 percentile.  The CI was recommended to be reassigned to a non-noise hazardous MOS.  On 21 January 2009, the CI reported wearing his hearing aids 10 hours every day, although he did not wear them when working outside because of the wind noise.  He was advised to continue the use of the hearing aids on a full time basis.  

During the 23 March 2009 MEB examination (recorded on DD Forms 2807-1 and 2808), 4 months prior to separation, the CI reported bilateral moderate to moderately-severe high frequency sensorineural hearing loss.  Audiometry revealed an average hearing loss of 26.25 dB on the left and 33.75 dB on the right.  The 17 April 2009 MEB NARSUM examination, 3 months prior to separation, showed adequate hearing with the hearing aids inserted, but without the hearing aids he could not hear any of the loudest noises.  On testing with a tuning fork, he could not hear, but felt the vibrations. 

At the 4 June 2009 VA Compensation and Pension (C&P) examination, 1 month before separation, the CI reported bilateral hearing loss with difficulty hearing in groups.  Physical examination showed the right and left auricles were within normal limits as were the external ear examinations.  Pure audiometry results on the right averaged 36.25 dB loss and on the left 36.25 dB.  Speech recognition with the Maryland CNC word list was 80% in each ear when the level of presentation was 70 dB HL.  On 28 November 2008 the CI was fitted for new hearing aids, which were programmed at level two.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral hearing loss 0%, coded 6100 (hearing Impairment), citing “speech discrimination is 100% in right ear and 88% in left ear.  Pure tone threshold average is 32.5 in right ear and 33.75 in left ear.”  The VA also rated the bilateral hearing loss condition 0%, coded 6100, based on the C&P examination, citing hearing loss on objective testing.  The panel was in accord with the PEB, which rated the bilateral hearing loss condition 0% based on VASRD tables VI and VII, albeit the examination was 10 months prior to separation whereas the VA examination was 4 months after separation; however, it also rated the bilateral hearing loss condition 0%.  After due deliberation, considering all of the evidence and mindful of VASRD §4.3 (reasonable doubt), the panel concluded there was insufficient cause to recommend a change in the PEB adjudication for the bilateral hearing loss.  

BOARD FINDINGS:  In the matter of the bilateral hearing loss and IAW VASRD §4.85 and §4.86, the panel recommends no change in the PEB adjudication.  There are no other conditions within the panel’s scope of review for consideration.  Therefore, the panel recommends 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 20170424, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record

AR20180008679, XXXXXXXXXXXXXXXXXX

XXXXXXXXXXXXXXXXXX

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,					      
Enclosure