RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXX	CASE:  PD-2017-03274
BRANCH OF SERVICE:  Army	SEPARATION DATE:  20090701

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E4, Infantryman, medically separated for “hearing impairment, bilateral” 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 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 - 20090416	VARD - 20090820	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Hearing Impairment, Bilateral	6100	0%	Bilateral Hearing Loss	6100	0%	20090714	
Tinnitus	Not Unfitting	Bilateral Tinnitus	6260	10%	20090717	
Anxiety Disorder	Not Unfitting	Generalized Anxiety Disorder	9400	70%	20090717	
Hyperlipidemia	Not Unfitting	No VA Placement	
COMBINED RATING:  0%	COMBINED RATING OF ALL VA CONDITIONS:  80%	

ANALYSIS SUMMARY:  

Hearing Impairment, Bilateral.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI was granted a waiver at MEPS for high frequency hearing loss in March of 2006.  He was exposed to loud noises while deployed, and when he returned his hearing had decreased, testing showed an H-3 profile, and audiology recommended separation. 

During the 5 September 2008 MEB examination (recorded on DD Forms 2807-1 and 2808), 10 months prior to separation, the CI reported more severe hearing loss and tinnitus.  Physical examination revealed an H-3 audiogram.  

The 19 February 2009 MEB NARSUM examination, 3 months prior to separation, noted complaints of hearing loss, use of bilateral hearing aids, and ringing in his ears.  Physical examination documented multiple audiograms and audiology evaluations.  The 18 August 2008 audiology values are charted below.  

At the 24 July 2009 VA Compensation and Pension (C&P) audio examination, 1 month after separation, the CI reported bilateral hearing loss, tinnitus, noise exposure to IED blasts, and being fit with hearing aids in 2008.  Physical examination showed hearing loss and decreased speech discrimination as charted below.  Orthoscopic examination was normal and testing confirmed mild sloping to severe sensorineural hearing loss in the right ear, and moderate to moderately severe loss in the left ear.  

HEARING	EXAM	MEB  ~10 Mo. Pre Sep	VA C&P ~1 Mo. After Sep	
LEFT EAR	Average Hearing Loss	48.75 dB	55 dB	
	Speech Discrimination	96%	84%	
	Table VI	I	II	
RIGHT EAR	Average Hearing Loss	47.5 dB	57.5 dB	
	Speech Discrimination 	100%	76%	
	Table VI	I	IV	
§4.85 RATING	Table VII	0%	0%	
(Average hearing loss is the sum of pure tone thresholds at 1000, 2000, 3000, and 4000 Hz divided by four)

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the bilateral hearing impairment condition 0%, coded 6100 (impairment of auditory acuity based on table VII), citing use of VASRD 4.85 and the charted hearing values above.  The VA also rated the bilateral hearing loss condition 0%, coded 6100, based on the C&P examination, citing rating derived from Table VII of 38 CFR 4.85 by intersecting row II, the better ear, with column IV, the poorer ear.  All examinations proximate to separation supported the 0% rating adjudicated by the PEB, and the CI had no history of phonophobia, vertigo, or other evidence to support Meniere’s syndrome (endolymphatic hydrops) which could support a higher rating.  After due deliberation, considering all 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 impairment condition.  

Contended PEB Conditions:  Anxiety Disorder, Hyperlipidemia, and Tinnitus.  The panel’s main charge is to assess the fairness of the PEB determination that the contended conditions were not unfitting.  None of the conditions were profiled, implicated in the commander’s statement, or judged to fail retention standards.  The panel noted the significant difference in mental health symptoms reported at the VA examination 2 months after separation, including panic attacks and homicidal and suicidal thoughts which were not manifested in service or in the STR. ·There was no performance-based evidence from the record that any of the conditions significantly interfered with satisfactory duty performance at separation.  After due deliberation, the panel concluded there was insufficient cause to recommend a change in the PEB fitness determination for any of the contended conditions, so no additional disability ratings are recommended.  

BOARD FINDINGS:  In the matter of the bilateral hearing impairment condition and IAW VASRD §4.87, the panel recommends no change in the PEB adjudication.  In the matter of the contended anxiety disorder, hyperlipidemia, and tinnitus conditions, the panel recommends no change from the PEB determinations as not unfitting.  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 20170407, w/atchs
Exhibit B.  Service Treatment Record
Exhibit C.  Department of Veterans Affairs Record 

AR20180012278, 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