BVA9503750 DOCKET NO. 93-12 293 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Louisville, Kentucky THE ISSUE Entitlement to an increased (compensable) evaluation for bilateral hearing loss with status post bilateral stapedectomies for otosclerosis. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States ATTORNEY FOR THE BOARD Ronald R. Bosch, Counsel INTRODUCTION The veteran served on active duty from November 1964 to December 1968 and from April 1976 to May 1992. This appeal arose from an October 1992 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Louisville, Kentucky. The RO, in relevant part, granted entitlement to service connection for bilateral hearing loss with status post stapedectomies for otosclerosis. The case has been forwarded to the Board of Veterans' Appeals (Board) for appellate review. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that his bilateral hearing loss is more disabling than currently evaluated. He argues that VA audiology examinations are not conducted properly as they do not take into account the daily noise environment to which everyone is exposed. He states he has been advised by his attending physician not to make any sudden rapid movements, and that changes in direction may result in vertigo. The appellant states that he has considerable difficulty trying to hear properly on a daily basis. This has necessitated that he turn up the volume on radios and television. He states that his temporary job is threatened because of his hearing loss. He worries constantly about making any mistakes in his job due to safety concerns. He advises that he is being tested every 60 days at a community clinic and requests that such examination reports be obtained in support of his claim. 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 a grant of an increased (compensable) evaluation for bilateral hearing loss with status post stapedectomies for otosclerosis. FINDINGS OF FACT 1. A July 1992 VA audiology examination disclosed that right pure tone thresholds were 25, 30, 45, and 65 decibels with an average of 41 decibels at 1000, 2000, 3000, and 4000 hertz with a speech recognition of 96 percent. 2. A July 1992 VA audiology examination disclosed that left pure tone thresholds were 20, 30, 55, and 70 decibels with an average of 44 decibels at 1000, 2000, 3000, and 4000 hertz with a speech recognition of 100 percent. 3. Audiology studies conducted at a military medical facility on October 9, 1992, disclosed left pure tone thresholds of 20, 25, 55, and 70 decibels with an average of 42.5 decibels at 1000, 2000, 3000, and 4000 hertz; and right pure tone thresholds of 25, 40, 60, and 75 decibels with an average of 50 decibels at 1000, 2000, 3000, and 4000 hertz. 4. Audiology studies at a military medical facility on October 13, 1992, disclosed left pure tone thresholds of 20, 25, 55, and 70 decibels with an average of 42.5 decibels at 1000, 2000, 3000, and 4000 hertz; and right pure tone thresholds of 20, 20, 45, and 60 decibels with an average of 36.2 decibels at 1000, 2000, 3000, and 4000 hertz. CONCLUSION OF LAW The criteria for an increased (compensable) evaluation for bilateral hearing loss with status post stapedectomies for otosclerosis have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 3.321(b)(1), 4.7, 4.85, Diagnostic Code 6100 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION Initially the Board finds that the veteran's claim is well grounded within the meaning of 38 U.S.C.A. § 5107(a), in that he has presented a claim which is plausible. The Board is satisfied that all relevant facts have been properly developed, and that no further assistance to the veteran is required in order to comply with 38 U.S.C.A. § 5107(a). In accordance with 38 C.F.R. §§ 4.1 and 4.2, and Schafrath v. Derwinski, 1 Vet.App. 589 (1991), the Board has reviewed the service medical records and all other evidence of record pertaining to the history of the veteran's bilateral hearing loss with status post stapedectomies for otosclerosis. The Board has found nothing in the historical record which would lead to a conclusion that the current evidence of record is inadequate for rating purposes. A review of the service medical records discloses that bilateral defective hearing was demonstrated as early as 1979. The veteran underwent a tympanotomy and stapedectomy in 1980. Bilateral otosclerosis was reported in 1981, and a history of a right stapedectomy is 1967 was noted. A July 1992 VA audiology examination report shows right pure tone thresholds were 25, 30, 45 and 65 decibels with an average of 41 decibels at 1000, 2000, 3000, and 4000 hertz, with a speech recognition of 96 percent. Left pure tone thresholds were 20, 30, 55, and 70 decibels with an average of 44 decibels at 1000, 2000, 3000, and 4000 hertz, with a speech recognition of 100 percent. A July 1992 VA ear, nose, and throat examination report shows the veteran reported prior ear surgery in 1967 and 1980, which he described as stapedectomies. It was assumed that he had otosclerosis. He had been wearing hearing aids for two years. He complained of occasional pruritus and drainage of the external auditory canals. The examiner noted that the audiogram revealed a bilateral mixed hearing loss with a 20-25 decibels bone gap on the right, and a 5-10 decibels bone gap on the left. The discrimination was excellent in both ears. The speech reception thresholds were approximately 25 in both ears. The tympanograms were type A. On examination the auricles were of normal contour. The external canals were without evidence of external otitis. There was bilateral anterior canal bulging. The tympanic membranes were normal with the exception of some minimal tympanosclerosis. There appeared to be no retraction and there was no tympanic membrane perforations. There was good mobility to tympanic membrane which indicated normal tympanum. The diagnostic impression was bilateral mixed hearing loss with a history of bilateral stapedectomies which suggested that the veteran had otosclerosis. The examiner noted that the veteran was well compensated with hearing aids and had no acute illnesses at the time. The claims file contains a report of audiology examinations conducted at a military medical facility on October 9, and October 13, 1992. The first of these examinations showed that left pure tone thresholds were 20, 25, 55, and 70 decibels with an average of 42.5 decibels at 1000, 2000, 3000, and 4000 hertz. Right pure tone thresholds were 25, 40, 60, and 75 decibels with an average of 50 decibels at 1000, 2000, 3000, and 4000 hertz. The second of these examinations revealed left pur tone thresholds of 20, 25, 55, and 70 decibels with an average of 42.5 decibels at 1000, 2000, 3000, and 4000 hertz. Right pure tone thresholds were 20, 20, 45, and 60 decibels with an average of 36.2 decibels at 1000, 2000, 3000, and 4000 hertz. The Board acknowledges the veteran's complaints of difficulties in his efforts to hear properly due to his bilateral hearing loss; however, the Board also acknowledges the VA examiners comment in July 1992 that the appellant was well compensated with his hearing aids. In response to additional contentions presented on appeal the Board observes that obtaining additional audiology examinations reported to be conducted every 60 days would serve no useful purpose as the July VA audiology examination and later dated audiology examinations conducted at a military medical facility are consistent in showing that the appellant's bilateral hearing loss is not so disabling as warrant a grant of an increased (compensable) evaluation. The VA audiology examinations are administered under uniform conditions and therefore block out background noises with use of earphones. Such exposure to background noises in the daily environment is taken into consideration in the conduction and evaluation of VA audiology examinations. The July 1992 VA audiology examination disclosed that right defective hearing was manifested by an average loss of 41 decibels with a speech reception of 96 percent and that left defective hearing was manifested by an average loss of 44 decibels with a speech recognition of 100 percent. These audiometric findings result in a numeric designation of I for each ear on Table VI of 38 C.F.R. § 4.85 of the VA Schedule for Rating Disabilities. The numeric designations of I for each ear equate to a noncompensable evaluation of 0 percent under diagnostic code 6100 on Table VII. A similar situation exists with respect to audiology studies reported at a military medical facility in October 1992. No question has been presented as to which of two or more evaluations would more properly classify the severity of bilateral hearing loss with status post stapedectomies for otosclerosis. 38 C.F.R. § 4.7. Bilateral hearing loss with status post stapedectomies for otosclerosis has not rendered the veteran's disability picture unusual or exceptional in nature, and has not markedly interfered with employment. It has not required frequent inpatient care as to render impractical the application of regular schedular standards, thereby precluding a grant of an increased (compensable) evaluation on an extraschedular basis. 38 C.F.R. § 3.321(b)(1). The audiology examinations conducted by VA and non-VA health care professionals have failed to substantiate the appellant's contention that his bilateral hearing loss with status post stapedectomies for otosclerosis has increased in severity as to warrant a grant of an increased (compensable) evaluation. For the foregoing reasons the Board finds no evidentiary basis upon which to predicate a grant of an increased (compensable) evaluation for bilateral hearing loss with status post stapedectomies for otosclerosis. 38 U.S.C.A. §§ 1155, 5107; 38 C.F.R. §§ 3.321(b)(1), 4.7, 4.85, Diagnostic Code 6100. ORDER Entitlement to an increased (compensable) evaluation for bilateral hearing loss with status post stapedectomies for otosclerosis is denied. 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.