BVA9500490 DOCKET NO. 93-03 916 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs (VA) Regional Office (RO) in San Francisco, California THE ISSUES 1. Entitlement to service connection for defective hearing of the left ear. 2. Entitlement to an increase in the 10 percent evaluation currently assigned for hypertension. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESSES AT HEARING ON APPEAL The veteran and his wife ATTORNEY FOR THE BOARD Christopher Maynard, Associate Counsel INTRODUCTION The veteran had active service from February 1941 to June 1960. National Guard duty prior to February 1941 brings the veteran's total active service to more than 20 years. By rating action dated in March 1974, service connection for bilateral defective hearing was denied by the RO. A notice of disagreement with the denial of service connection for defective hearing was received in April 1974. By rating action dated in June 1974, service connection for defective hearing of the right ear was granted by the RO. The veteran was notified by letter of July 1974 that the grant of service connection for defective hearing of the right ear was considered an allowance of all the benefits sought in his notice of disagreement and that his notice of disagreement was considered withdrawn. The veteran has recently testified regarding his exposure to acoustic trauma in the various duty assignments he had during service and his chronic bilateral hearing problems since his discharge from service. In view of the above, the Board prefers to address the matter of service connection for defective hearing of the left ear on a de novo basis. CONTENTIONS OF APPELLANT ON APPEAL The veteran asserts that he was exposed to acoustic trauma on a routine basis during service, first as an instructor on the rifle range, and later from aircraft engine noises while working as the staff transportation officer. The veteran argues that there was a significant change in his hearing during service and believes that his present defective hearing is related to service. The veteran also argues that his service-connected hypertension has worsened and warrants a higher rating. 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 favors the grant of service connection for defective hearing of the left ear but is against the claim of an increased rating for hypertension. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. The veteran's defective hearing in the left ear, first diagnosed in April 1971, was probably caused by exposure to acoustic trauma during service. 3. The veteran's hypertension is well controlled with medication, without evidence of definite symptoms or diastolic pressures predominantly 110 or more. CONCLUSIONS OF LAW 1. Hearing loss of the left ear was incurred in service. 38 U.S.C.A. §§ 1110, 1131, 5107, 7104 (West 1991); 38 C.F.R. §§ 3.102, 3.303, 3.385 (1993). 2. The schedular criteria for a rating in excess of 10 percent for hypertension are not met. 38 U.S.C.A. § § 1155, 5107, 7104 (West 1991); 38 C.F.R. § § 3.321, Part 4, 4.3, 4.7, Code 7101 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Board notes that the veteran's claims are well grounded within the meaning of 38 U.S.C.A.§ 5107, and is satisfied that all relevant facts have been properly developed in accordance with this law. I. Service Connection The service medical records show increased threshold readings in the left ear, especially at the higher frequencies, on the veteran's retirement examination in March 1960, when compared to previous audiological data gathered during the fifties. The record also shows that the veteran was treated in June 1960 for complaints of recurrent blocking in the left ear with some pain. High frequency hearing loss (bilaterally) was first diagnosed on an audiological evaluation performed at an Air Force medical facility, apparently in April 1971. As noted above, service connection for defective hearing of the right ear was granted by rating action dated in June 1974. The veteran's testimony regarding his exposure to acoustic trauma during service is credible and, when considered with the slight increase in threshold readings during his lengthy active service, the Board finds it reasonable to conclude that the veteran's defective hearing of the left ear was also probably service related. Accordingly, it is the decision of the Board that service connection for defective hearing of the left ear is warranted. II. Increased Rating By rating action dated in November 1960, service connection was granted for hypertension based on diagnosis and treatment with medication during service. A 10 percent evaluation was assigned and that rating has remained in effect ever since. The medical evidence of record shows no significant change in the veteran's overall symptoms for many years and it appears that his hypertension has been well controlled with medication. On VA examination in July 1990, the veteran's blood pressure was 160/80, 150/80 and 148/80. Atherosclerotic changes in the aorta were noted on X-ray examination but there was no evidence of heart enlargement and an EKG was interpreted as within normal limits. The diagnoses included hypertension, primarily systolic. When examined by VA in September 1992, the veteran denied any history of dizziness or syncopal episodes. There was no history of shortness of breath, chest pains, palpitations, orthopnea or paroxysmal nocturnal dyspnea. The veteran had a forty year history of hypertension and was on Procardia XL, 30 mg., one per day. The examination report indicated that the veteran was found to have near systolic murmur about nine months earlier and had an echocardiogram in February 1992, which showed focal calcification of the aortic valve but with good motility, good left ventricular contraction and no chamber dilatation. On examination, the veteran's blood pressure was 130/80 and there was no evidence of jugular distention or carotid bruits. A grade II/V midsystolic murmur over the aortic area was noted without radiation to carotids. X-ray studies of the chest showed the heart and great vessels were unremarkable other than some aortic elongation and calcification in transverse aorta. The diagnoses included primary hypertension, on antihypertensive medications, and calcified aortic valve, asymptomatic. The veteran is currently assigned a 10 percent evaluation for hypertension under DC 7101. In order to receive a higher evaluation, the veteran would have to demonstrate diastolic readings predominantly of 110 or more with definite symptoms. The evidentiary record indicates that the veteran's diastolic pressure has been predominantly less than 100 for many years and has never been over 110. Thus, it appears that his hypertension is well controlled with medication. The heart and vascular findings on VA examinations in July 1990 and September 1992 included no evidence of such elevated readings or definite symptoms as would support the grant of an increased rating. The veteran is service connected only for hypertension. Pertinent clinical findings in his available outpatient records are in accord with the above picture. Accordingly, it is the decision of the Board that the medical evidence of record does not support a rating higher than the 10 percent evaluation currently assigned for hypertension. ORDER Service connection for defective hearing of the left ear is granted. An increased rating for hypertension is denied. J. J. SCHULE 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 (CONTINUED ON NEXT PAGE) 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.