RECORD OF PROCEEDINGS
PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXXXXXXXXXXX 	CASE:  PD-2017-04363
BRANCH OF SERVICE:  Army 	SEPARATION DATE:  20060522

SUMMARY OF CASE:  Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Food Service Operator, medically separated for “moderate to severe hearing loss [HL] bilaterally” with a disability rating of 20%.   

CI CONTENTION:  His condition returned 2 years after separation and required additional surgery.  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 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 - 20060418	VARD - 20060530	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Moderate to Severe Bilateral HL 	6100	20%	Bilateral HL Status Post Tympanomastoidectomy with Excision of Extension Granulation Tissue Throughout the Middle Left Ear	6201-6100	0%	20060428	
COMBINED RATING:  20%	COMBINED RATING OF ALL VA CONDITIONS:  20%	

ANALYSIS SUMMARY:  

Moderate to Severe Bilateral HL.  According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI underwent a left tympanomastoidectomy (repair of the tympanic membrane and removal of infected bone behind the ear [mastoid]) on 2 February 2004.  The post-operative diagnosis was tympanic membrane perforation with chronic otorrhea [drainage] and connective [conductive] HL.  The CI also had a history of HL in the right ear and was diagnosed with mixed conductive and sensorineural HL in both ears.  The CI was fitted for hearing aids in both ears and reported benefit.  He was evaluated in October 2005 by an ENT (ear, nose, and throat) specialist and the assessment was mixed HL, worse on the left, with eustachian tube dysfunction (tube between ear and nasopharynx that ventilates the middle ear) and chronic rhinitis.  A SPRINT (speech reception in noise test) test on 28 February 2006 recommended separation from the military.  
During the 2 March 2006 MEB examination (recorded on DD Forms 2807-1 and 2808), 2 months prior to separation, the CI reported HL in both ears, worse on the left, and using hearing aids in both ears.  Audiometry showed hearing levels in the right ear of 55 decibels (dB) at 1000 hertz (1K), 50 dB at 2K, 3K and 4K (average decibel loss of 51.25) and in the left ear of 70 dB at 1K, 75 dB at 2K and 3K, and 90 dB at 4k (average decibel loss of 77.5).  The same-day MEB NARSUM physical examination noted complaints of bilateral HL and cited the MEB audiogram.

At the 12 April 2006 audiology examination, one month prior to separation, the CI reported no recent ear infections.  Physical examination showed the ear canals were clear.  Audiometry showed hearing levels in the right ear were 30 dB at 1K, 2K and 4K with 35 dB at 3K(average decibel loss of 31.25); word recognition score was 100%.  In the left ear, earing levels were 40 dB at 1K, 45 dB at 2K, 50 dB at 3K, and 65 dB at 4K (average threshold of 50) and word recognition score of 84%.  The 28 April 2006 VA Compensation and Pension (C&P) physical examination, one month before separation showed a retracted right tympanic membrane and a distorted left tympanic membrane that was dull and with chronic redness.  The 12 April 2006 audiogram above was cited.  

The panel directed attention to its rating recommendation based on the above evidence.  The PEB rated the HL condition 20%, coded 6100 (hearing impairment), citing moderate to severe HL bilaterally.  The VA rated the bilateral HL condition 0%, analogously coded 6201-6100 (chronic non-suppurative otitis media with effusion-hearing impairment), based on the C&P examination, citing Table VII of CFR §4.85.

According to VASRD §4.85 (evaluation of hearing impairment), the numeric designation of hearing impairment based on Puretone threshold average is determined by intersecting the percent of speech discrimination row with the Puretone threshold average column in Table VI.  Using the 12 April 2006 audiogram (most proximate to separation), which included speech discrimination scores, the right ear was I and the left ear was II.  Referring to Table VII (percentage evaluation for hearing impairment), the intersection of these two numeric designations of I provides a 0% rating for hearing impairment.  The panel concluded there was no evidence to support a higher rating at separation than that adjudicated by the PEB.  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 HL condition.  

BOARD FINDINGS:  In the matter of the bilateral hearing loss condition and IAW VASRD §4.85, 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:

AR20200002315 

Dear XXXXXXXXXXXXX:

	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.