SAF/MRB

Dear XXXXXXXXXX:

		Reference your application submitted under the provisions of DoDI 6040.44 (Section 1554, 10 USC), PDBR Case Number PD-2017-05241.

After careful consideration of your application and treatment records, the Physical Disability Board of Review determined that the rating assigned at the time of final disposition of your disability evaluation system processing was appropriate.  Accordingly, the Board recommended no re-characterization or modification of your separation.

I have carefully reviewed the evidence of record and the recommendation of the Board.  I concur with that finding and their conclusion that re-characterization of your separation is not warranted.  Accordingly, I accept their recommendation that your application be denied.

						

RECORD OF PROCEEDINGS PHYSICAL DISABILITY BOARD OF REVIEW

NAME:  XXXXXXXXXX		CASE: PD-2017-05241 BRANCH OF SERVICE: AIR FORCE	SEPARATION DATE: 20070312

SUMMARY OF CASE: Data extracted from the available evidence of record reflects this covered individual (CI) was an active duty E5, Security Forces Craftsman (Military Working Dog Handler), medically separated for “sensorineural hearing loss left ear with tinnitus” with a disability rating of 10%.

CI CONTENTION: In addition to the hearing loss and tinnitus, the CI requested review of a right foot bunion. 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 - 20070126	VARD - 20071105	
Condition	Code	Rating	Condition	Code	Rating	Exam	
Sensorineural Hearing Loss Left Ear with Tinnitus	6260	10%	Bilateral Hearing Loss	6100	NSC	20070820	
			Tinnitus	6260	10%	20070820	
COMBINED RATING: 10%	COMBINED RATING OF ALL VA CONDITIONS: 10%	

ANALYSIS SUMMARY:

Sensorineural Hearing Loss (SNHL) Left Ear with Tinnitus. According to the service treatment record (STR) and MEB narrative summary (NARSUM), the CI’s hearing loss and tinnitus gradually began in 2000 and specifically increased after becoming a Security Forces member. Audiogram at military entrance showed no evidence of tinnitus and normal hearing in the right ear, but there was hearing loss in the left ear of 35db at 3 khz, 40db at 4khz, 60db at 6khz. She reported exposure  to  loud  noises,  specifically  in  the  military  while  being  required  to  wear  hearing

protection. She also experienced noise exposure to dogs and reported no civilian exposure. An audiogram administered on 21 August 2006, 6 months prior to separation, showed normal hearing on the right and mild to moderate SNHL on the left. Word recognition was excellent on the right and good on the left. She reported tinnitus only in the left ear. An MRI of the internal auditory canals was normal. A repeat audiogram confirmed severe neuro-SNHL on the left with normal hearing on the right. The CI received a hearing aid on 8 November 2006, which was very beneficial, specifically with one-on-one conversations; however, room hearing was more muffled. The 13 November 2006 MEB NARSUM examination, 3 months prior to separation, noted  complaints  of  hearing  loss.    Physical  examination  was  unremarkable.     During  the   9 February 2007 MEB examination (recorded on DD Form 2697), 1 month prior to separation, the examiner diagnosed severe left SNHL.

At the 20 August 2007 VA Compensation and Pension (C&P) audio examination, 5 months after separation, the CI reported hearing loss and tinnitus bilaterally. Audiometry showed a left ear speech recognition score of 90 with mild to moderately severe hearing loss and excellent speech discrimination.

The panel directed attention to its rating recommendation based on the above evidence. The PEB rated the hearing loss with tinnitus 10%, coded 6260 (tinnitus). The VA rated the tinnitus 10%, coded 6260, based on the C&P examination, citing recurrent tinnitus. The VA rated the SNHL separately, coded 6100 (hearing loss) as not service connected, citing no established injury or corroborated acoustic trauma during service and mild to moderate left hearing loss on the entrance audiogram. Audiometry findings from both the August 2006 and VA C&P examinations were independently rated 0% using VASRD rating criteria and therefore would not warrant compensation. The panel concluded that the CI’s tinnitus was more likely than not caused by the same noise exposure that caused her hearing loss, more likely than not contributed to her hearing loss and played a part in her difficulty in safely understanding communication. The tinnitus is therefore appropriately considered to be part of the unfitting condition and warrants a rating of 10%. The panel therefore recommends analogous coding of the CI’s complete hearing disability as 6100-6260 at 10%. 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 hearing loss with tinnitus.

BOARD FINDINGS: In the matter of the hearing loss with tinnitus and IAW VASRD §4.87, 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.
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