BVA9501172 DOCKET NO. 92-16 245 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Columbia, South Carolina THE ISSUE Entitlement to an increased (compensable) rating for bilateral hearing loss. (The issue of entitlement to payment or reimbursement by the Department of Veterans Affairs (VA) for unauthorized medical expenses incurred in connection with hospitalization at Cannon Memorial Hospital, Pickens, South Carolina, from April 23 to April 24, 1991, is addressed in a separate decision.) REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD J.P. Reep, Associate Counsel INTRODUCTION The veteran served on active duty from June to December 1950, from April 1951 to December 1953, and from June 1958 to October 1976. This matter came before the Board of Veterans' Appeals (the Board) on appeal from an April 1992 rating decision of the Columbia, South Carolina Regional Office (RO) of the Department of Veterans Affairs (VA), which assigned an increased rating of 10 percent to the veteran's service-connected hypertension, but continued a noncompensable evaluation for his service-connected bilateral hearing loss. In written argument, submitted to the Board by the American Legion in October 1992, the veteran's representative filed an informal claim for service connection for tinnitus and for paroxysmal atrial tachycardia. In this regard, attention is directed to the opinion of a Board Medical Adviser, Jack J. Rheingold, M.D., which was furnished on May 3, 1994. On the question of whether paroxysmal supraventricular tachycardia was related to or part and parcel of the veteran's service-connected hypertension, Dr. Rheingold opined that it was reasonable to consider a relationship between hypertension and arrhythmia. A copy of this medical opinion has been inserted into the claims folder. With respect to the issue of service connection for tinnitus, this issue is not inextricably intertwined with the issue of increased rating for hearing loss and, therefore, it will not be addressed herein. We refer it to the RO for appropriate action. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he is entitled to a compensable rating for his service-connected bilateral hearing loss, as his last VA examination indicates that the hearing in his left ear has deteriorated. He maintains that he had to quit his job as a high school teacher due to communication problems caused by his hearing loss. He also maintains that hearing loss causes problems in his personal life. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against the claim for an increased rating for bilateral hearing loss. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the appeal has been obtained. 2. The veteran's bilateral hearing loss is manifested by the averages of pure tone hearing thresholds, at 1000, 2000, 3000 and 4000 hertz (Hz), of 39 in the right ear and 80 in the left ear, and by speech discrimination scores of 92 in the right ear and 72 in the left ear; these results translate to numeric designations of Level I on the right and Level VI on the left. CONCLUSIONS OF LAW 1. The VA has no further duty to assist the veteran. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. §§ 3.103(a), 3.159 (1993). 2. An increased (compensable) evaluation for bilateral hearing loss is not warranted on either a schedular or extraschedular basis. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 3.321, 3.385, 4.85, Tables VI and VII, and Part 4, Code 6100 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Board finds that the veteran's claim is well grounded within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). That is, we find that he has presented a claim which is not implausible. We are also satisfied that all relevant facts have been properly developed. No further assistance to the veteran is required to comply with the duty to assist mandated by 38 U.S.C.A. § 5107(a) (West 1991) and 38 C.F.R. §§ 3.103(a) and 3.159 (1993). Service connection was initially granted for bilateral hearing loss by an April 1977 rating decision of the RO, wherein a noncompensable rating was assigned from November 1976. The noncompensable rating is currently in effect. There is no indication in the records currently before the Board that the veteran has received recent or ongoing treatment for hearing loss. At the time of VA medical examination in March 1992, he reported that he had not required a hearing aid. The veteran underwent a VA audiological examination in March 1992. According to the report the veteran related a history of progressive hearing loss in his left ear since 1967, with less hearing loss in his right ear. He also complained of tinnitus, which he reported did not bother him too much. Audiometric examination of the right ear revealed that pure tone thresholds at 1000, 2000, 3000 and 4000 Hz were 5, 20, 55, and 75 decibels, respectively, for an average decibel loss of 39. Corresponding frequencies in the left ear were 65, 70, 85 and 100, for an average decibel loss of 80. Speech recognition scores on the Maryland CNC Word list were 92 percent for the right ear and 72 percent for the left ear. The examiner indicated that the veteran's hearing in his right ear was within normal limits through 2000 Hz, with moderate sensorineural hearing loss at 3000 Hz and above. It was further indicated that the veteran had "severe sloping to profound mixed hearing loss" in his left ear. 38 U.S.C.A. § 1155 (West 1991) and 38 C.F.R. Part 4 (1993) provide that disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 C.F.R. Part 4 (1993) refers to the VA's Schedule for Rating Disabilities (Rating Schedule). Separate diagnostic codes of the Rating Schedule identify the various disabilities. Evaluations for hearing loss are determined by using the results of controlled speech discrimination tests and the results of the pure tone audiometry test, and applying them to a table (Table VI) of numeric designation of hearing impairment. 38 C.F.R. § 4.85 (1993). The resulting numeric designations, ranging from I to XI, are then applied to Table VII to determine the percentage evaluation to be assigned for hearing loss. According to the report of the veteran's most recent audiological examination, the average pure tone threshold in his right ear is 39; in his left, 80. Speech recognition scores on the Maryland CNC Word list were 92 percent for the right ear; 72 for the left. Applying these findings to Table VI, the numeric designation for his right ear is I; for his left, VI. Application of these numeric designations to Table VII indicates that the veteran's bilateral hearing loss does not warrant a compensable rating. 38 C.F.R. Part 4, Code 6100 (1993). The Board has also considered whether assignment of an extraschedular rating would be appropriate in view of the veteran's contentions relating to the effects his hearing loss has had on his daily life. In exceptional cases where the schedular evaluations are found to be inadequate, an extraschedular evaluation commensurate with the average earning capacity impairment due exclusively to the service-connected disability or disabilities may be approved provided the case presents such an exceptional or unusual disability picture with such related factors as marked interference with employment or frequent periods of hospitalization as to render impractical the application of the regular schedular standards. 38 C.F.R. § 3.321(b)(1). In this case, there is not shown to be an exceptional disability picture, warranting extraschedular consideration. It is noteworthy that on recent VA examination, he was reported not to be using a hearing aid. There is no clear evidence of interference with employment and the disability has not required frequent hospitalization. In the opinion of the Board, the preponderance of the evidence is clearly against the veteran's claim. As such, the record does not present an approximate balance of positive and negative evidence with respect to the merits of the veteran's claim. Accordingly, the benefit of the doubt is not for application in this case. 38 U.S.C.A. § 5107(b). ORDER An increased rating for bilateral hearing loss is denied. N. R. ROBIN The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.