Citation Nr: 0007220 Decision Date: 03/16/00 Archive Date: 03/23/00 DOCKET NO. 95-37 167 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to an initial disability evaluation in excess of 20 percent for service-connected bilateral hearing loss. 2. Entitlement to an initial disability evaluation in excess of 10 percent for service-connected tinnitus. 3. Entitlement to an effective date earlier than February 6, 1995, for service-connected bilateral hearing loss. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD W. Yates, Associate Counsel INTRODUCTION The appellant served on active duty from February 1952 to February 1954. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 1995 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. That rating decision, in pertinent part, granted service connection for bilateral hearing loss and for tinnitus. The decision also assigned noncompensable (0 percent) initial disability ratings for both of these conditions, effective February 6, 1995. In March 1997, the Board remanded this matter for examination of the appellant and medical opinions. Following completion of the requested development, the RO issued a rating decision, dated in September 1997, that increased the evaluation of the appellant's service-connected bilateral hearing loss to 20 percent, effective February 6, 1995. During the pendency of this appeal, the appellant raised a claim for an earlier effective date for his service-connected bilateral hearing loss. In March 1998, the RO issued a rating decision which denied this claim. Thereafter, the appellant filed a timely notice of disagreement and substantive appeal of this issue. In August 1999, the RO issued a rating decision that assigned the appellant's service-connected tinnitus an increased disability evaluation of 10 percent, effective February 6, 1995. On a claim for an original or an increased rating, the claimant is generally presumed to be seeking the maximum benefit allowed by law and regulation, and such a claim remains in appellate status where a subsequent rating decision awarded a higher rating, but less than the maximum available benefit. AB v. Brown, 6 Vet. App. 35, 38 (1993). Accordingly, the Board now proceeds with its review of the appeal. FINDINGS OF FACT 1. All evidence necessary for an equitable adjudication of the veteran's claims has been developed. 2. A VA audiological examination of the veteran's bilateral hearing loss, performed in June 1995, revealed average puretone thresholds, at 1000, 2000, 3000, and 4000 hertz levels, of 62 decibels in the right ear and 61 decibels in the left ear. The report also noted speech recognition ability of 88 percent in both ears. Based on this examination, the veteran has Level III hearing in the right ear and Level III hearing in the left ear. 3. A VA audiological examination of the veteran's bilateral hearing loss, performed in July 1997, revealed average puretone thresholds, at 1000, 2000, 3000, and 4000 hertz levels, of 65 decibels in the right ear and 62 decibels in the left ear. The report also noted speech recognition ability of 64 percent in the right ear and 72 percent in the left ear. Based on this examination, the veteran has Level VI hearing in the right ear and Level V hearing in the left ear. 4. The veteran's service-connected tinnitus is manifested by a constant bilateral ringing in the ears and is not shown to render the regular schedular criteria inapplicable. 5. The veteran's original claim for service connection for bilateral hearing loss was received at the Department of Veterans Affairs Regional Office in Montgomery, Alabama, on February 6, 1995. 6. A search for evidence of an earlier application has failed to establish that the appellant filed a claim with VA seeking service-connected compensation benefits for bilateral hearing loss prior to February 6, 1995. CONCLUSIONS OF LAW 1. The schedular criteria for an initial disability rating in excess of 20 percent for service-connected bilateral hearing loss have not been met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. Part 4, §§ 4.85, 4.86, 4.87, Tables VI and VII, Diagnostic Codes 6100-6110 (1998 & 1999); 64 Fed. Reg. 25202-25210 (May 11, 1999). 2. The schedular criteria for an initial disability rating in excess of 10 percent for service-connected tinnitus are not met. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 U.S.C.A. §§ 3.321, Part 4, Diagnostic Code 6260 (1999). 3. An effective date earlier than February 6, 1995, for service-connected bilateral hearing loss is not warranted in this case. 38 U.S.C.A. § 5110(a) (West 1991); 38 C.F.R. § 3.400 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION I. Factual Background The veteran's claims are "well grounded" within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). When a claimant is awarded service connection for a disability and subsequently appeals the RO's initial assignment of a rating for that disability the claim continues to be well grounded as long as the rating schedule provides for a higher rating and the claim remains open. Shipwash v. Brown, 8 Vet. App. 218, 224 (1995). All relevant facts have been properly developed and no further assistance to the veteran is required to comply with the duty to assist mandated by 38 U.S.C.A. § 5107(a). In Fenderson v. West, 12 Vet. App. 119 (1999), the United States Court of Appeals for Veterans Claims (Court) noted, in pertinent part, that there is a "distinction between an original rating and a claim for an increased rating" and that this distinction "may be important . . . in terms of determining the evidence that can be used to decide whether the original rating on appeal was erroneous . . . ." Fenderson, 12 Vet. App. at 126. In Fenderson, the Court held that the rule articulated in Francisco v. Brown did not apply to the assignment of an initial rating for a disability following an initial award of service connection for that disability. Fenderson, 12 Vet. App. at 126; Francisco v. Brown, 7 Vet. App. 55, 58 (1994). The Court held in Francisco that, although VA regulations require review of the entire recorded history of a disability by the adjudicator to ensure a more accurate evaluation, the regulations do not give past medical reports precedence over current medical findings and that, where an increase in the disability rating is at issue, the present level of the veteran's disability is the primary concern. Instead, in Fenderson, the Court held that, where a veteran appealed the initial rating assigned for a disability, "staged" ratings could be assigned for separate periods of time based on facts found. Fenderson, 12 Vet. App. at 126. As in Fenderson, the RO in this case identified the issues on appeal as entitlement to increased disability evaluations for the appellant's service-connected hearing loss and service- connected tinnitus, rather than as a disagreement with the original rating award. However, the RO's September 1995 SOC, November 1995 SSOC, September 1997 SSOC and August 1999 SSOC, provided the appellant with the appropriate applicable law and regulations and an adequate discussion of the basis for the RO's assignment of initial disability evaluations in this matter. In addition, the appellant's pleadings herein clearly indicate that he is aware that his appeal involves the RO's assignment of initial disability evaluations. Furthermore, the assignment of disability ratings for hearing impairment is derived by a mechanical application of the rating schedule to the numeric designations assigned after audiometric evaluations are rendered. See Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). Thus, there is very little judgment involved in determining the rating for service-connected bilateral hearing loss. Consequently, the Board sees no prejudice to the appellant in recharacterizing the issues on appeal to properly reflect the appellant's disagreement with the initial disability evaluations assigned to his service-connected bilateral hearing loss and his service-connected tinnitus. See Bernard v. Brown, 4 Vet. App. 384 (1993). The veteran's complete service medical records are not available for review. These records are believed to have been destroyed in a fire at the National Personnel Records Center (NPRC). Consequently, in reaching this decision, the Board fully acknowledges and accepts its heightened obligation to provide an explanation of the reasons or bases for its findings and to consider the benefit of the doubt rule under 38 U.S.C.A. § 5107(b). See O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991). II. Factual Background A review of the veteran's report of separation, Form DD 214, revealed that he served on active duty in the United States Army from February 1952 through February 1954. In February 1954, the veteran's discharge examination was conducted. An audiological evaluation performed at that time noted pure tone thresholds, in decibels, as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 20 15 5 -- 40 LEFT 25 15 10 -- 50 The report noted a diagnosis of deafness, due to machine gun blast while in basic training. In January 1972, the veteran filed an application for compensation or pension, VA Form 21-526. Although the form requested that the veteran list the "nature of sicknesses, diseases or injuries" for which the claim is made, no reference to either hearing loss or tinnitus was indicated. Medical treatment reports submitted in support of this claim, dated November 1971 through January 1972, revealed treatment for and a diagnosis of bursitis of the shoulder, bilaterally. No other conditions were indicated. In January 1972, the RO issued a rating decision which found that the veteran's disabilities were not sufficient to permanently prevent him from engaging in substantially gainful employment. On February 6, 1995, the veteran filed his present application for compensation or pension, VA Form 21-526, seeking service connection for hearing loss. In June 1995, a VA audiological evaluation of the veteran was conducted. The report of this evaluation noted pure tone thresholds, in decibels, as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 35 40 50 70 90 LEFT 35 40 55 70 80 The average pure tone threshold at 1000, 2000, 3000 and 4000 hertz was 62 decibels in the right ear and 61 decibels in the left ear. Speech audiometry revealed speech recognition ability of 88 percent in both the right and left ear. The report also noted the veteran's complaints of intermittent tinnitus for the past twenty years. In July 1995, the veteran submitted a letter indicating that back in 1954 he was denied the right to file a claim for service connection for bilateral hearing loss. Specifically, he stated that he "was told I could not file until I was 65. Well as of July 2, 95 I am now 65." The veteran also noted in his letter that he "did not file a claim for VA in 72." In August 1995, the veteran was seen at the VA Medical Center in Birmingham, Alabama, with complaints of decreased hearing. The treatment record revealed that his hearing was tested showing a 10 to 30 decibel decrease in thresholds in both ears and a 20 to 30 percent decrease in discrimination in both ears since the VA audiological evaluation in June 1995. Multiple audiological evaluations conducted on the veteran in August 1995, September 1995, March 1996 and February 1997. However, a summary sheet was not provided with any of these examinations. In July 1997, a VA audiological evaluation of the veteran was conducted. The report of this evaluation noted pure tone thresholds, in decibels, as follows: HERTZ 500 1000 2000 3000 4000 RIGHT 45 45 60 75 80 LEFT 45 40 60 70 80 The average pure tone threshold at 1000, 2000, 3000 and 4000 hertz was 65 decibels in the right ear and 62 decibels in the left ear. Speech audiometry revealed speech recognition ability of 64 percent in the right ear and 72 percent in the left ear. The report also noted that the veteran's complaints of tinnitus had not changed since his June 1995 VA examination. In April 1998, a personal hearing was conducted before the RO. At the hearing, the veteran testified that his hearing loss is severe. He also testified that his tinnitus is manifested by a constant ringing or buzzing in both of his ears. Medical treatment reports, dated December 1998 to November 1999, were retrieved from the VA medical center in Birmingham, Alabama. A review of these records revealed treatment for a variety of conditions, including low back strain and shingles. In July 1999, a VA audiological evaluation was conducted. A summary sheet was not provided with this examination. The report, however, noted speech recognition ability of 76 percent in the right ear and 72 percent in the left ear. III. Analysis Review of the appellant's claims require the Board to provide a written statement of the reasons or bases for its findings and conclusions on material issues of fact and law. 38 U.S.C.A. § 7104(d)(1) (West 1991). The statement must be adequate to enable a claimant to understand the precise basis for the Board's decision, as well as to facilitate review by the Court. See Simon v. Derwinski, 2 Vet. App. 621, 622 (1992); Masors v. Derwinski, 2 Vet. App. 181, 188 (1992). To comply with this requirement, the Board must analyze the credibility and probative value of the evidence, account for evidence which it finds to be persuasive or unpersuasive, and provide reasons for rejecting any evidence favorable to the appellant. See Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F. 3d 604 (Fed. Cir. 1996) (table); Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994). The Board may not base a decision on its own unsubstantiated medical conclusions but, rather, may reach a medical conclusion only on the basis of independent medical evidence in the record or adequate quotation from recognized medical treatises. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). Moreover, the Board has the duty to assess the credibility and weight to be given to the evidence. See Madden v. Gober, 125 F.3d 1477 (Fed. Cir. 1997) and cases cited therein. Once the evidence is assembled, the Secretary is responsible for determining whether the preponderance of the evidence is against the claim. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). If so, the claim is denied; if the evidence is in support of the claim or is in equal balance, the claim is allowed. See also Alemany v. Brown, 9 Vet. App. 518, 519 (1996). A. Bilateral Hearing Loss When the issue involves a claim for an increased rating for hearing loss, the applicable rating will be determined by applying the numerical values listed in the audiological examination report to the applicable rating tables. Under these criteria, the severity of a hearing loss disability is determined by application of a rating schedule that establishes 11 auditory acuity levels, ranging from Level I (for essentially normal acuity) through Level XI (for profound deafness). 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4, §§ 4.85, 4.86, 4.87, Diagnostic Codes 6100 through 6110 (1999). It should be emphasized that "assignment of disability ratings for hearing impairment are derived by a mechanical application of the rating schedule to the numeric designations assigned after audiometric evaluations are rendered." Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992). The Board notes that certain regulations in the VA Schedule for Rating Disabilities pertaining to the evaluation of hearing impairment were revised during the pendency of this appeal and became effective on June 10, 1999. 64 Fed. Reg. 25202-25210 (May 11, 1999); see Karnas v. Derwinski, 1 Vet. App. 308, 312-13 (1991) (holding that, where a law or regulation changes after a claim has been filed or reopened, but before the administrative or judicial appeal process has been concluded, the version most favorable to appellant should and will apply unless Congress provides otherwise or permits the Secretary to do otherwise). However, the provisions in Tables VI, VIa, and VII did not change. Under the regulations governing the evaluation of hearing impairment prior to June 10, 1999, the findings on the veteran's July 1997 VA audiological examination resulted in a 20 percent disability rating. Specifically, an average puretone decibel loss of 65 in the right ear and 64 percent discrimination results in a "VI" under TABLE VI and an average puretone decibel loss of 62 in the left ear and 72 percent discrimination results in a "V" under TABLE VI. 38 C.F.R. § 4.85, TABLE VI (1998). A "VI" and a "V" results in a 20 percent disability rating under TABLE VII. 38 C.F.R. § 4.85, TABLE VII (1998). The report of the veteran's most recent VA audiological examination, performed in July 1999, contained incomplete findings for rating purposes. The Board notes, however, that the findings appear to be similar to those listed on the July 1997 examination. Specifically, the report noted speech recognition ability of 76 percent in the right ear and 72 percent in the left ear. The findings on the veteran's prior VA audiological examination, performed in June 1995, resulted in a noncompensable rating under the prior regulations. Specifically, an average puretone decibel loss of 62 in the right ear and an 88 percent discrimination resulted in a "III" under TABLE VI and an average puretone decibel loss of 61 in the left ear and 88 percent discrimination resulted in a "III" under TABLE VI. 38 C.F.R. § 4.85, TABLE VI (1998). A "III" and a "III" resulted in a noncompensable percent rating under TABLE VII. 38 C.F.R. § 4.85, TABLE VII (1998). Under the revisions to the regulations, either TABLE VI or TABLE VIa may be used to determine the Roman numeral designation "[w]hen the puretone threshold at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hertz) is 55 decibels or more" or "[w]hen the puretone threshold is 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz . . . ." 64 Fed. Reg. 25202-25210 (May 11, 1999), to be codified at 38 C.F.R. § 4.86(a), (b) (1999). In this case, neither of the VA audiological examinations conducted in June 1995 or July 1997 meets the standard set forth in 38 C.F.R. § 4.86 (a) (1999). Accordingly, the results of these examinations would be the same as under the prior regulations. Specifically, the July 1997 VA audiological examination warrants a disability rating of 20 percent. The June 1995 VA audiological examination warrants a noncompensable disability evaluation. See 38 C.F.R. § 4.85, TABLE VII (1999). Accordingly, the Board concludes that the veteran's service- connected bilateral hearing loss does not warrant an increased initial disability rating in excess of 20 percent. This conclusion is reached under both the old and new hearing loss regulations. See Karnas v. Derwinski, 1 Vet. App. at 308. The Board is sympathetic to the veteran's contentions regarding the severity of his service-connected bilateral hearing loss; however, as noted above, in Lendenmann, supra, the United States Court of Appeals for Veterans Claims held that the assignment of disability ratings for hearing impairment is derived by a mechanical application of the rating schedule to numeric designations assigned after audiometric evaluations are rendered. Based on the application of the rating criteria to the audiometric evidence in this case, an increased initial disability rating for the veteran's service-connected bilateral hearing loss may not be granted. In view of the foregoing, the preponderance of the evidence is against the veteran's claim for an increased initial disability evaluation for his service-connected bilateral hearing loss. B. Tinnitus The veteran's tinnitus is currently rated under Diagnostic Code 6260 for persistent tinnitus as 10 percent disabling. That level of disability contemplates persistent tinnitus as a symptom of head injury, concussion, or acoustic trauma. This is the highest level of disability allowable for tinnitus under Diagnostic Code 6260. To obtain a higher rating for his tinnitus, the veteran would have to be rated under other diagnostic codes which contemplate tinnitus as a symptom of other disability. The only other diagnostic codes which relate to the ears that provide for a higher rating are Diagnostic Codes 6204, 6205, and 6207. These code sections, however, require a diagnosis of labyrinthitis (6204), Meniere's syndrome (6205) or loss of auricle (6207), none of which have been shown or alleged. Therefore, an increased initial disability rating for tinnitus is not warranted. In reaching its decision in this matter, the Board considered the application of an extraschedular rating. The applicable law in this regard provides the following: To accord justice . . . to the exceptional case where the schedular evaluations are found to be inadequate, the Under Secretary for Benefits or the Director, Compensation and Pension Service, upon field station submission, is authorized to approve on the basis of the criteria set forth in this paragraph an extra-schedular evaluation commensurate with the average earning capacity impairment due exclusively to the service- connected disability or disabilities. The governing norm in these exceptional cases is: A finding that 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) (1999). As discussed above, the medical evidence reflects that the appellant's tinnitus is manifested by constant ringing in the ears and as such, meets the criteria for the 10 percent evaluation pursuant to Diagnostic Code 6260. The 10 percent disability evaluation is the maximum evaluation provided for pursuant to Code 6260. In view of these findings and in the absence of evidence of extraordinary symptoms, the undersigned concludes that the schedular criteria adequately contemplates the nature and severity of the appellant's tinnitus and that the record does not suggest, based upon these findings documented within the clinical reports, that the appellant has an "exceptional or unusual" tinnitus disability. Moreover, the Board finds no evidence of an exceptional disability picture as manifested by related factors such as marked interference with employment or frequent hospitalizations due solely to the appellant's reported tinnitus. It is not shown by the evidence that the appellant has required hospitalization in the remote or recent past for his tinnitus or his hearing loss. In addition, there is no record of extensive outpatient treatment for this condition. With respect to employment, there is no evidence within the record to establish that the appellant's service- connected tinnitus has interfered with his employability beyond that which is contemplated by the currently assigned 10 percent evaluation. As such, it cannot be concluded that the overall disability picture presented by the evidence in the claims folder reflects "marked interference" in employment. In the absence of any evidence which reflects that this disability is exceptional or unusual such that the regular schedular criteria are inadequate to rate it, an extraschedular rating on the basis of employment handicap is not in order. Accordingly, in view of the above, the Board finds that the appellant's tinnitus is appropriately evaluated at the 10 percent level. In reaching this conclusion, the Board has weighed the evidence of record and finds that the preponderance of the evidence is against the appellant's claim. Consequently, as the weight of the evidence in favor of the appellant's claim does not approximate the weight of the evidence against his claim, the doctrine of the benefit of the doubt is not for application. 38 U.S.C.A. § 5107(b) (West 1991). C. Earlier Effective Date for Compensable Disability Evaluation for Service-Connected Bilateral Hearing Loss Applicable law and VA regulations provide that the effective date of an award of service connection shall be the day following the date of discharge or release from active service if the application for VA disability compensation benefits is received within one year of such date; otherwise, the date of receipt of the claim, or the date entitlement arose, whichever is later. 38 U.S.C.A. § 5110 (West 1991); 38 C.F.R. § 3.400(b) (2) (i) (1999). Generally, claims for service connection must be made on the appropriate form specified by the Secretary. 38 C.F.R. § 3.151(a) (1999). Informal claims are "any communication or action, indicating an intent to apply for one or more benefits under the laws administered by the Department of Veterans Affairs, from a claimant, his or her duly authorized representative, a Member of Congress, or some person acting as next friend of a claimant who is not sui juris may be considered an informal claim. Such informal claim must identify the benefit sought." 38 C.F.R. § 3.155 (a) (1999). The Board observes that establishing a claim for VA benefits -- even an "informal" claim -- requires a claimant at a minimum to "identify the benefit sought." 38 C.F.R. § 3.155(a) (1999) (an informal claim must identify the benefit sought). However, the Board is mindful that the Court has held that a veteran need not specify with precision the appropriate legal provision for a benefit he is seeking and that the VA's statutory duty to assist requires a liberal reading of documents and evidence to include consideration of issues reasonably raised therein. Stanton v. Brown, 5 Vet. App. 563, 570 (1993); McGrath v. Brown, 5 Vet. App. 57, 60 (1993); EF v. Derwinski, 1 Vet. App. 324, 326 (1991); Akles v. Derwinski, 1 Vet. App. 118, 121 (1991). The requirements of § 3.155(a) and the holdings of the Court are not at odds with one another. Instead, the principles to be garnered from the jurisprudence of the Court are that VA, in determining what type of claim is being made or what type of benefit is being sought, should not require or expect a claimant to cite "chapter and verse" when stating a claim for benefits. For example, VA should not require a claimant to cite specific regulatory provisions by number ("chapter") in order to identify the benefit sought, e.g., "I claim VA benefits under 38 C.F.R. § 4.16(a)," and it should not require a claimant to use precise legal terminology ("verse") to identify the benefit sought, e.g., "I claim entitlement to VA compensation benefits based on individual unemployability." Rather, the benefit sought may be stated in layman's terms, e.g., "I can't work anymore because of my leg," (where the claims file shows that the veteran is service-connected for a knee disability). Similarly, VA should not require a claimant to use specific medical terms or diagnoses to identify the disorder for which VA benefits are sought. Rather VA should strive to understand what disability is being claimed to the extent that it may be reasonably interpreted based on the statements of the veteran and the evidence of record in the given case. After a thorough review of all of the evidence of record, the Board concludes that the veteran did not reasonably raise a claim for service connection for bilateral hearing loss until February 6, 1995. There is no objective evidence that the veteran ever filed a claim seeking entitlement to service connection for the aforementioned disability any earlier than that time. Although the veteran filed a claim for nonservice-connected pension in January 1972, there was no reference to any hearing loss disability. Medical treatment records submitted by the veteran at that time were silent as to any hearing disability. Accordingly, the Board concludes that the effective date for the grant of service connection for the appellant's bilateral hearing loss is February 6, 1995, the date of receipt of his original claim. 38 C.F.R. § 3.400(b) (2) (i) (1999). In reaching this determination, the Board rejects the appellant's assertion that his attempt to file a claim for service connection for bilateral hearing loss was rejected by VA personnel in 1954. Specifically, the appellant claims that he was informed that he could not file a claim for service connection until the age of 65. Despite this allegation, however, the evidence of record revealed that the veteran did in fact file a claim in January 1972, at the age of 42. Prior to February 6, 1995, there is no objective evidence of a claim for service connection for bilateral hearing loss. Under these circumstances, the veteran has failed to effectively raise a claim of service connection for bilateral hearing loss prior to February 6, 1995. Accordingly, for the reasons and bases noted above, the Board concludes that the preponderance of the evidence is against the claim for an effective date for service connection for bilateral hearing loss earlier than February 6, 1995. Accordingly, the appellant's claim must be denied. ORDER An increased initial disability rating, in excess of 20 percent, for bilateral hearing loss is denied. An increased initial disability rating, in excess of 10 percent, for tinnitus is denied. An earlier effective date, prior to February 6, 1999, for the grant of service connection for bilateral hearing loss is denied. BETTINA S. CALLAWAY Member, Board of Veterans' Appeals