BVA9504843 DOCKET NO. 91-54 748 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Lincoln, Nebraska THE ISSUES 1. Entitlement to service connection for a left knee disorder. 2. Entitlement to service connection for a bilateral wrist disorder. 3. Entitlement to service connection for a bilateral ankle disorder. 4. Entitlement to service connection for a right hip disorder. 5. Entitlement to service connection for a left hip disorder. 6. Entitlement to service connection for bilateral defective hearing. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Carolyn Wiggins, Associate Counsel INTRODUCTION The veteran served on active duty from October 1959 until July 1989. This appeal arises from January and April 1990 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in Lincoln, Nebraska which denied service connection for a left knee disorder, a bilateral wrist disorder, a bilateral ankle disorder, a bilateral hip disorder and bilateral defective hearing. This case was remanded by the Board in May 1991 and February 1993 for further development. The requested development has now been accomplished. However, during the course of development at the RO the original claims folder was misplaced and a rebuilt claims folder was created. The rebuilt folder was then sent to the Board for review. In the fall of 1994 the original claims folder was found and forwarded to the Board. The Board now has before it both the original and rebuilt claims folders. In February 1993 the Board noted that the issue of entitlement to service connection for left foot and toe disorders had previously been certified for appellate review. However, the RO subsequently granted service connection for left tarsal tunnel syndrome and osteophyte cyst formation of the left metatarsal head. As such, the issue of entitlement to service connection for a left foot and toe disorder was considered to be moot. The veteran's current service connected disabilities consist of heart disease classified as hypertension with myocardial infarction evaluated as 30 percent disabling, osteoarthritis of the lumbar spine rated under Diagnostic Code 5010 as 10 percent disabling, osteoarthritis of the cervical spine evaluated under Diagnostic Code 5010 as 10 percent disabling, tinnitus evaluated as 10 percent disabling, left tarsal tunnel syndrome evaluated as 10 percent disabling, hemorrhoids evaluated as noncompensably disabling, bilateral pes planus evaluated as noncompensably disabling, hallux valgus deformity of the right foot evaluated as noncompensably disabling, and hallux valgus deformity of the left foot with x-ray evidence of cyst formation, sclerosis and osteophyte formation evaluated as noncompensably disabling. In June 1994 the veteran filed a claim for an increased rating for heart disease. This claim has not been developed or certified for appellate consideration and is referred to the RO for appropriate consideration. CONTENTIONS OF APPELLANT ON APPEAL The appellant contends that service connection should be established for a left knee disorder, a bilateral wrist disorder, a bilateral ankle disorder, a bilateral hip disorder and bilateral defective hearing, in that such disabilities had their origins during his period of active service. 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 evidence supports the grant of service connection for a right hip disorder. It is also the decision of the Board that the preponderance of the evidence is against the claims for service connection for a bilateral wrist disorder, a bilateral ankle disorder, a left knee disorder, and a left hip disorder. It is further the decision of the Board that the veteran has failed to present a well grounded claim for service connection for bilateral defective hearing. FINDINGS OF FACT 1. A chronic left knee disorder was not manifest in active military service and is not shown to be present at the current time. 2. A chronic bilateral wrist disorder was not manifest in active military service and is not shown to be present at the current time. 3. A chronic bilateral ankle disorder was not manifest in active military service and is not shown to be present at the current time. 4. Osteoarthritis of the cervical spine, unrelated to trauma, developed during service, has been granted service connection and has now progressed to involve the right hip. . 5. A chronic left hip disorder was not manifest in active military service and is not shown to be present at the current time. 6. The claim seeking service connection for bilateral defective hearing is not plausible. CONCLUSIONS OF LAW 1. A chronic left knee disorder was not incurred in or aggravated in active military service. 38 U.S.C.A. § 1110, 1131 (West 1991); 38 C.F.R. § 3.303(b) (1994). 2. A chronic bilateral wrist disorder was not incurred or aggravated in active military service. 38 U.S.C.A. § 1110, 1131 (West 1991); 38 C.F.R. § 3.303(b) (1994). 3. A chronic bilateral ankle disorder was not incurred or aggravated in active military service. 38 U.S.C.A. § 1110, 1131 (West 1991); 38 C.F.R. § 3.303(b) (1994). 4. Osteoarthritis initially involving the cervical spine and currently involving both the cervical spine and right hip, was incurred in wartime service. 38 U.S.C.A. §§ 1110, (West 1991). 5. A chronic left hip disorder was not incurred or aggravated in active military service. 38 U.S.C.A. § 1110, 1131 (West 1991); 38 C.F.R. § 3.303(b) (1994). 6. The claim seeking service connection for bilateral defective hearing is not well grounded. 38 U.S.C.A. § 5107 (a)(West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The veteran's claims, other than the one for service connection for bilateral defective hearing, are "well grounded" within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). He has presented claims which are plausible. The Board is satisfied that all relevant facts have been properly developed. No further assistance to the veteran is required in order to comply with the duty to assist him mandated by 38 U.S.C.A. § 5107(a) (West 1991). To establish service connection for a claimed disability, the facts as shown by evidence must demonstrate that a particular disease or injury resulting in current disability was incurred during active service or, if preexisting active service, was aggravated therein. 38 U.S.C.A. §§ 1110, 1131(West 1991). Service connection may also be granted on a presumptive basis for certain chronic diseases, including osteoarthritis unrelated to trauma and organic diseases of the nervous system including sensorineural hearing loss, when they are manifested to a compensable degree within the initial post service year. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137 (West 1991); 38 C.F.R. §§ 3.307, 3.309 (1994). For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "chronic." Continuity of symptomatology is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b)(1994). The veteran's representative has requested that the doctrine of reasonable doubt be applied in this case. 38 C.F.R. § 3.102 (1994) provides that it is the defined and consistently applied policy of the VA to administer the law under a broad interpretation , consistent, however, with the facts shown in every case. When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin such doubt will be resolved in favor of the claimant. By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence, which does not satisfactorily prove or disprove the claim. We have considered the doctrine of reasonable doubt with regard to each issue on appeal. As to those disorders for which service connection is denied, the evidence is found not to be in equipoise. As to the disorder for which service connection is granted, we were able to allow without resort to the doctrine of reasonable doubt. As to the disorder for which a well grounded claim has not been received, we never reached the merits of the case. Although not specifically addressed in our discussion of each individual issue, we have considered the veteran's testimony in June 1990. Some of the testimony related to claims for service connection which the RO has granted. Included in this is tinnitus, tarsal tunnel syndrome of the left foot and arthritic changes in the left foot associated with hallux valgus. Virtually all of the testimony was considered credible and for the most part supported by service medical records. However, the testimony was not probative as to the issues for which the Board has denied service connection or dismissed the claim for service connection, because it was not supported by clinical findings on VA examinations following service I. LEFT KNEE DISORDER On service entrance examination in October 1959, no abnormalities of the veteran's left knee were noted. Service medical records in January 1980 reveal that the veteran complained of left knee pain. He said he had had pain for two or three weeks. No trauma to the knee was reported. Examination of the knee was negative. Left knee pain with varus derotational osteotomy was noted. In May 1985 popping behind the left knee was recorded. The left knee was described as "popping" at around 30 degrees of flexion. He denied any pain or stiffness. There was no history of trauma, locking or buckling. There was full range of motion. No tenderness or effusion was demonstrated. Lochman's and McMurray's signs were negative. The examiner noted knee bursitis with a question mark. In June 1985 there is another notation of knee "popin". On a periodic service medical examination in January 1986 mild left knee tenderness in the medial hamstrings was noted. The summary of defects includes "left knee tendonitis, on treatment". On a follow up examination of the left knee in January 1986 it was reported that there was continued popping and that the knee was becoming sore, but the popping seemed to be resolving. There was no swelling, buckling or catch. The pain was located in the post medial area. The examiner's objective findings were mild tenderness of "senitendinosis" tendon without effusion or instability, and full range of motion of the knee. A VA examination in September 1989, revealed no crepitation, effusion, medial or lateral laxity of the left knee. The drawer sign and McMurray's were negative. The diagnosis by the physician's assistant was left knee injury with residual painless popping. An X-ray of the left knee was normal. In July 1990 a VA examination noted a history of left knee popping since 1985. The pain had persisted and was aggravated by weight bearing. There was no swelling or locking. On examination there was no crepitus, laxity of the medial collateral ligament or lateral collateral ligament. The drawer sign was negative. There was no effusion. Range of flexion of the left knee was demonstrated to be to 140 degrees. Mild medial joint line tenderness was noted. An X-ray report noted no abnormalities of the left knee. An examination of the left knee by the VA in March 1992 noted no pain on motion. There was no heat erythema or effusion. No crepitus was heard on flexion or extension. McMurray's sign was negative. Collateral ligaments were intact and without pain or stress. The anterior and posterior cruciate were intact and without pain or stress. Range of motion of the left knee was recorded as from 0 to 135 degrees on flexion and extension. The clinical impression regarding the left knee was a history of intermittent arthralgia. Examination of his knees by the VA in March 1993 showed both knees to have full range of motion , from 0 to 130 degrees of flexion. He was slightly tender to palpation at the medial joint line bilaterally. The knees were stable to varus-valgus stress as well as Lachman and anterior drawer maneuvers. There was no crepitus and no pain with patellar compression. The impression on the radiographic report was normal knees. Under the heading diagnosis the examiner wrote the following: "This appears to be of the medial aspect of both knees, however, does not appear to be degenerative in nature or meniscal in origin. He has really minimal swelling and denies any locking or catching episodes in the knees. This may be a strain at the medial collateral ligament or possible could be early, medial compartment, degenerative disease." A September 1993 X-ray of the left knee recorded an impression of normal left knee. An October 1993 VA examination reports subjective complaints of left knee pain. He denied any pain at rest or any at night. The pain was intermittent. He had not noted any swelling. Examination of the left knee showed no swelling or effusion. The knees were in mild genu varum. Range of motion was from 0 to 135 degrees. There was minimal crepitus with patellofemoral motion. There was no evidence of ligamentous instability. McMurray's and shrug test were negative. X-rays of the knees were normal. Multiple joint pain was diagnosed. For reasons which will become apparent in our discussion of the claim for service connection for a right hip disorder, if the veteran at a later time develops degenerative arthritis of the left knee, such pathology should be recognized as part and parcel of the multiple joint arthritis for which service connection is already in effect. However, at the current time we find no acceptable evidence of the current existence of intrinsic left knee pathology The left knee complaints in service were on various occasions referred to as questionable bursitis and tendonitis, but there was never any definitive evidence of joint pathology. The symptoms consisted of subjective complaints of left knee pain and minimal crepitus. The post service clinical findings referable to the left knee consist of a full range of motion , no evidence of instability, and no evidence of arthritis or other joint pathology on x-ray. Symptoms of subjective intermittent knee pain and minimal crepitus are considered too non-specific to warrant service connection, in the absence of a diagnosis or any objective evidence of organic knee pathology. Chronic identifiable left knee pathology is not shown to have been present in service and is not shown to be present at the current time. Service connection for a left knee disorder at the current time is not warranted II. A BILATERAL WRIST DISORDER On the veteran's service entrance examination in October 1959 his upper extremities were reported to be normal. In July 1987 the veteran sought treatment for pain in his left hand after playing golf. There was tenderness noted over the dorsum of the hand. There is no specific mention of any wrist injury. An assessment was made of soft tissue injury of the left hand. A service physical in November 1988 reported normal upper extremities, as did the service retirement examination. A VA examination of the wrists in September 1989, found no tenderness, or swelling of the metacarpal phalangeal joint. There was no crepitation or pain demonstrated during range of motion studies. Range of motion demonstrated on dorsiflexion was from 0 to 60 degrees, palmar flexion was 0 to 80 degrees, radial deviation was from 0 to 20 degrees and ulnar deviation was from 0 to 45 degrees, for the right and left wrists. X-rays of the wrists were normal. The diagnosis was history of arthralgia of the wrists. On VA examination in March 1992, evaluation of the wrists revealed no erythema, effusion or crepitation. There was full range of motion without any pain. The veteran had full use of the metacarpal phalangeal joints, the proximal interphalangeal joints and the distal interphalangeal joints of both hands. Range of motion demonstrated on dorsiflexion was from 0 to 70 degrees, palmar flexion was 0 to 80 degrees, radial deviation was from 0 to 20 degrees and ulnar deviation was from 0 to 45 degrees. A March 1993 VA examination includes the veteran's statement's that his wrist pain comes and goes. He experiences pain in the wrist, especially when he is gripping something. He denied any injury to his wrists. Examination of his wrists showed 75 degrees of dorsiflexion and 80 degrees of palmar flexion. He had full supination and pronation. He was minimally tender to palpation at the volar aspect of the proximal wrist just proximal to the wrist crease. There was no Tinel's and no Phalen's. His neurovascular status was intact. He had a strong grip bilaterally. The diagnosis reads: "Bilateral (blank space), this is volar pain and may be very early carpal tunnel syndrome bilaterally. He tends to describe this as being worse with working and gripping maneuvers. His X-rays were unremarkable." On VA examination in October 1993 motor testing of the upper extremities revealed 5/5 strength in all muscle groups. Sensation was grossly intact. Examination of the hands showed no Phalen's nor Tinel's at the wrist. Grip strength was "okay" and there was no thenar atrophy. The diagnosis was multiple joint pain. The examiner included the following discussion: The patient has had considerable workup in previous compensation and pension examinations for these joint complaints. Clinical examination and radiographic examination showed no evidence of degenerative changes in the joint and clinical examination is inconsistent with soft tissue causes such as carpal tunnel in wrist. The patient may benefit from rheumatologic workup looking for systemic cause for his multiple joint complaints. In December 1993 another VA orthopedic examination was conducted. The directions for the examination were to look for a systemic cause for multiple joint pain. The veteran reported having wrist pain since the 1980's. Activity caused increased pain. There was no real morning stiffness. He reported no joint swelling. There was full range of motion of the wrists. X-rays were normal. The diagnosis was normal joint exam. The clinical picture presented with regard to the wrists is one of complaints of joint pain from shortly after service, up to the current time. There were no clinically documented complaints or findings of a disorder of either wrist during service. Regarding post service clinical records, we have no specific diagnosis of a disorder of either wrist, no clinical evidence of pathology of either wrist and no x-ray evidence of pathology of either wrist. Service connection for a bilateral wrist disorder is not warranted in this case. III. A BILATERAL ANKLE DISORDER On service entrance examination in October 1959 the veteran's feet and lower extremities were reported to be normal. The service medical records reveal no clinically documented complaints of findings of pathology specifically referable to the ankles, as distinguished from the feet. It is significant to note at this point that the veteran has already been granted service connection for bilateral pes planus, left tarsal tunnel syndrome and hallux valgus of both feet with osteophyte formation on the left. A September 1989 VA examination revealed no clinical documentation of ankle pathology. X-rays of the ankles were normal and there was no diagnosis of a disorder of either ankle. As regards the feet, as distinguished from the ankles, bilateral calcaneal spurs were noted on x-ray. A March 1992 VA examination reported a history of intermittent pain in the ankles with activity or prolonged standing. Range of motion of the ankles was measured as 0 to 10 degrees on dorsiflexion, and 0 to 45 degrees on plantar flexion, bilaterally. There was full range of motion without pain. No swelling, erythema or effusion was noted. X-rays of the ankles revealed no fractures or osseous abnormalities. The examiners impression was a history of intermittent arthralgia of the ankles. During a March 1993 VA examination the veteran complained of bilateral ankle pain. He said it was worse in the morning when he gets out of bed. He described it as diffuse pain in his ankles which he cannot pinpoint. He said his ankles are "okay" if he stays off his feet and does not walk a lot. He said he had flat feet and he felt that may be contributing to his ankle pain. Examination of his ankles showed no tenderness to palpation. The examiner noted that he had flat feet and the left arch reconstituted more than the right when he stood on his toes. X- rays of both ankles showed os trigonum bilaterally but no evidence of degeneration or previous fractures. The diagnosis was bilateral ankle pain. "The patient states that this is really very episodic and depends on how much he has been on his feet. He certainly has flat feet bilaterally, the right being somewhat more rigid than the left. He may be experiencing some discomfort from his flatfoot deformity which is difficult to differentiate and by his description may be causing pain in his ankles." VA x-rays of the ankles in September 1993 were normal. There was a questionable bone density at the left of the talonavicular articulation on the right. It was thought to be an artifact, with previous trauma noted as another consideration. On VA examination in December 1993, x-rays of the ankles were described as normal. Reference was made to a bone fragment on the right. On examination there was a mild valgus deformity of the right ankle. In summary we have no pathology of either ankle described in service medical records. We have no clinical or x-ray evidence of any left ankle pathology at the current time. As regards the right ankle, a valgus deformity was described in 1993, and a bone density of questionable etiology was described on x-rays of the right ankle in 1993. We concur with the examiners comments on the March 1993 VA examination. The veteran may well be having ankle pain at the current time due to bilateral pes planus. We should add that he may also be having some ankle pain due to his other service connected foot pathology. However, if this is the case it relates to the appropriate ratings to be assigned for the bilateral foot pathology, rather than to the grant of service connection for a bilateral ankle disorder, which has not been adequately documented at the current time. A proper basis is not afforded for granting service connection for a bilateral ankle disorder. IV. RIGHT AND LEFT HIP DISORDERS On service entrance examination in October 1959 the musculoskeletal system and lower extremities were reported as normal. Service medical records in August 1973 contain a radiographic report of an anterior posterior frog view of the right hip which revealed normal radiographic findings. A January 1978 medical examination noted a 5.0 centimeter traumatic scar of the left lower hip "WHHS". This is shown by the other service medical records to be a burn scar of the left thigh. X-rays of the hips were interpreted by the radiologist as normal. However, the examining physician noted mild sclerosis of the superior aspect of the right acetabulum. In 1983 a radiographic report noted normal hips. An annual physical examination in November 1988 reported a normal spine and lower extremities as did the service retirement examination. VA X-rays in March 1992 reported no fracture or osseous abnormality of the pelvis. A small exostosis projecting laterally off the inferior pubis ramus was noted. On examination of the hips range of motion on forward flexion was from 0 to 125 degrees, interior rotation was from 0 to 40 degrees and exterior rotation was from 0 to 60 degrees. No pain was demonstrated on range of motion studies. The consultation report says, "No actual hip pain or problem--by hip pain talks about upper buttock pain assoc" with arthritis of the low back. The examiner's impression was that there was no disease or pathology of the right or left hip. The "hip pain " refers to buttock pain associated with his service connected low back condition. In March 1993 a VA examination contains a complaint of right hip pain after activities. The veteran said it was hard to lie on his right hip after activity. He said it is difficult to lie on his right side because of pain in his hip. He denied any injuries. His left hip was normal. Range of motion of his right hip on flexion was up to 120 degrees. There was some mild pain with extreme flexion. He could abduct to 40 degrees. External rotation was to 40 degrees. Internal rotation was 10 degrees. There was some mild pain with full internal rotation. He tended to lie on the examining table with the right hip further externally rotated than the left. He said that was the most comfortable position for his right hip. X-rays of the pelvis and hips showed some mild changes at the right acetabulum, but were otherwise unremarkable. The diagnosis was right hip pain. The examiner said, "The patient does have some limitation in his internal rotation and has shown some very early mild degenerative changes on the acetabular side of his right hip. This most likely is early degenerative joint disease." In October 1993 a VA examination of the right hip showed flexion of approximately 95 degrees with extension to 10 degrees. Internal rotation was limited to approximately 5 degrees with external rotation being 60 degrees. These compared to values of 45 degrees of internal and external rotation on left side. His abduction was approximately 45 degrees and adduction of 20 degrees. Some of the difference of his internal and external rotation values from left and right side seemed to be related to some mild right, femoral retroversion. This was also manifest by the mild external rotation deformity of the right lower extremity while lying at rest supine on the table. The radiologist interpreted x-rays of both hips to be normal. The orthopedic examiner interpreted the x-rays to show mild sclerosis of the superior aspect of the right acetabulum. A. A RIGHT HIP DISORDER The Board is of the opinion that there is evidence of degenerative (osteoarthritis) in the right hip at the current time. It is therefore appropriate that we consider the nature of the arthritis that the RO has already granted service connection for. The service medical records reveal that the arthritis in the lumbar spine was preceded by clinical documentation of a lumbosacral strain. We concur with the RO that as such, the arthritis in the lumbar spine is properly classified as traumatic arthritis or arthritis due to strain. 38 C.F.R. § 4.58, Diagnostic Code 5010(1994). The arthritis which exists in the left foot may be traumatic or may be degenerative. To further analyze this would require that we obtain a medical opinion for the record. Colvin Derwinski, 1 Vet.App. 171 (1991). We are able to conclude that the arthritis in the cervical spine is completely unrelated to trauma. There was no clinical documentation of any trauma to the neck in service medical records. The veteran reported a neck injury in 1973 in his claim for compensation benefits in April 1989, and the rating action of January 1990 refers to a neck injury the veteran sustained while playing golf in 1973. However, the service medical records make no reference to such an injury. On several occasions during service there was specific reference to the onset of cervical spine symptoms with no history of injury. On this basis we conclude that the cervical arthritis which the RO has service connected is not traumatic arthritis. It is osteoarthritis, a disease entity capable of involving multiple joints. It now involves the right hip, and , as such service connection for osteoarthritis of the right hip is in order. B. LEFT HIP DISORDER There was no clinical documentation of left hip pathology in service and there is no clinical documentation of left hip pathology at the current time. As a matter of fact, at the time of the October 1993 VA examination the veteran was not even complaining of pain in the left hip. He noted that his hip pain was confined to the right hip. There is no basis for a grant of service connection for a left hip disorder. V. BILATERAL DEFECTIVE HEARING The threshold question to be answered regarding this issue is whether the veteran has presented a well a grounded claim; that is one which is plausible. If he has not presented a well grounded claim, this appeal must fail and there is no duty to assist him further in the development of his claim because such additional development would be futile. 38 U.S.C.A. § 5107 (a); Murphy v. Derwinski, 1 Vet.App. 78 (1990). Impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. Disability Due to Impaired Hearing, 59 Fed.Reg. 60,560 (1994) (to be codified at 38 C.F.R. § 3.385). On service entrance examination in October 1959 the veteran's hearing was recorded as 15/15 for the whispered voice. An audiological evaluation in service in December 1966 demonstrated, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 0 0 -5 -5 -5 LEFT 0 0 -5 -5 -5 On the service audiological evaluation in December 1969, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 0 0 0 0 0 LEFT 0 0 0 0 0 On the service audiological evaluation in December 1974, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 15 25 20 20 20 LEFT 20 20 15 15 20 The examiner wrote: "Note hearing loss since past exam." On the service audiological evaluation in January 1978, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 5 5 5 5 15 LEFT 10 5 5 10 20 On the service audiological evaluation in January 1986, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 10 10 25 15 15 LEFT 5 0 5 10 20 On the service audiological evaluation in November 1988, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 5 10 20 15 15 LEFT 0 0 10 15 20 On the service retirement examination in April 1989, the audiological evaluation revealed pure tone thresholds, in decibels, as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 10 10 20 10 20 LEFT 5 5 10 20 15 On the VA audiological evaluation in September 1989, pure tone thresholds, in decibels, were as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 5 10 15 5 10 LEFT 5 0 5 20 15 Speech audiometry revealed speech recognition ability of 98 percent in the right ear and of 94 percent in the left ear. The examiner remarked that hearing in the right and left ears was within normal limits from 250 hertz to 8000 hertz. The evidence does not demonstrate that the veteran has puretone thresholds above 40 decibels at any frequency or that he had at least three frequencies at or above 26 decibels or a speech recognition score of less than 94 percent at the current time. We do not consider the audiograms in service to be indicative of bilateral defective hearing. In any event, because he does not currently have recognizable bilateral defective hearing in terms of the controlling regulation, the claim is not well grounded. Although the Board has considered and denied the appeal for service connection for bilateral defective hearing on a ground different from that of the RO, that is, whether the appellant's claim was well grounded rather than whether he is entitled to prevail on the merits, the appellant has not been prejudiced by this action. In assuming that the claim was well grounded, the RO accorded the appellant greater consideration than his claim warranted under the circumstances. Bernard v. Brown, 4 Vet.App. 384, 392-394 (1993). ORDER Service connection for a left knee disorder is denied. Service connection for a bilateral wrist disorder is denied. Service connection for a bilateral ankle disorder is denied. Service connection for degenerative arthritis of the right hip is granted. Service connection for a left hip disorder is denied. Service connection for bilateral defective hearing is dismissed. BRUCE E. HYMAN Member, Board of Veterans' Appeals 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.