HEARING LOSS

B. MULLINS · 2026 · Case ID: 26005052

DENIED

Summary

The Veteran served in the United States Army from November 1993 to November 1996. The Veteran appeals the denial of service connection for left ear hearing loss, traumatic brain injury (TBI), and a cervical spine disorder. The Veteran also appeals the denial of a compensable evaluation for service-connected right ear hearing loss. The Board denied service connection for left ear hearing loss, finding no medical evidence of a current disability meeting VA criteria, despite the Veteran's lay reports of noise exposure. For the TBI claim, the Board found the Veteran's assertions not credible, noting negative service treatment records, lack of in-service complaints, and no reported TBI during a post-service PTSD examination, with a later report of a possible post-service TBI. The cervical spine claim was denied due to negative service treatment records and post-service treatment for a sprain occurring after service, contradicting the Veteran's assertions of an in-service event. The Board denied a compensable evaluation for right ear hearing loss, as the VA audiological examination showed a noncompensable level of impairment, and the Veteran failed to report for a follow-up examination without good cause. The Veteran's service was under honorable conditions.

Rationale

No current medical evidence of disability for left ear hearing loss.; Service treatment records negative for complaints or diagnosis.; Post-service VA audiological exam did not meet disability criteria.; Failed to report for scheduled VA examination without good cause.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

6100

Docket No.

17-15 553

Full Decision Text

Citation Nr: 26005052
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 17-15 553
DATE: April 29, 2026

ORDER

The appeal as to the claim of entitlement to service connection for left ear hearing loss is denied.

The appeal as to the claim of entitlement to service connection for a traumatic brain injury (TBI) is denied.

The appeal as to the claim of entitlement to service connection for a cervical spine disorder is denied.

Entitlement to a compensable evaluation for service-connected right ear hearing loss is denied.

FINDINGS OF FACT

1. The Veteran does not have a current left ear hearing loss disorder for VA purposes.

2. The Veteran does not have a current TBI disorder that is etiologically related to his active service.

3. The Veteran does not have a current cervical spine disorder that is etiologically related to his active service.

4. Throughout the pendency of the appeal, the Veteran's hearing impairment has been no worse than Level I in the right ear.

CONCLUSIONS OF LAW

1. The criteria for establishing entitlement to service connection for left ear hearing loss disorder have not been met. 38 U.S.C. §§ 1110, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.385 (2021).

2. The criteria for establishing entitlement to service connection for a TBI disorder have not been met. 38 U.S.C. §§ 1110, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2021).

3. The criteria for establishing entitlement to service connection for a cervical spine disorder have not been met. 38 U.S.C. §§ 1110, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2021).

4. The criteria for establishing a compensable evaluation for service-connected right ear hearing loss have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. § 4.85, Diagnostic Code 6100 (2021).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service in the United States Army from November 1993 to November 1996, with an additional period of service in the Army Reserve. His service was under honorable conditions.

These matters come before the Board of Veterans' Appeals (Board) from a May 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

In December 2025, the Veteran testified at a virtual hearing before the undersigned Veterans Law Judge (VLJ). A transcript of this hearing has been prepared and associated with the evidence of record.

In January 2023, April 2023, and September 2023 decisions, the Board remanded the issues for further evidentiary development.

In September 2023, Gruber and Tripp LLC was appointed as the administrator or custodian for the Veteran. Review of records uploaded into VA's secondary document management system, VBMS, included a June 2023 note which advised that the Veteran should only receive "written" forms of communication as he is under the care of Mental Health Intensive Case Management. Review of the record indicates that his service-connected posttraumatic stress disorder (PTSD) has been evaluated as 100 percent disabling since August 1, 2015.

In October 2023, multiple Examination Scheduling Requests were associated with the record. However, there is no indication that the requests were sent to the Custodian or Administrator identified in the record, or that the Veteran's representative was contacted to aid in the notification process. Thus, in a July 2024 decision, the Board remanded the issues to make an additional attempt to schedule the requested VA examinations. The issues have returned to the Board for further appellate consideration.

In July and August 2024, notice was sent to the Veteran's Custodian of record attempting to schedule the requested VA examinations. In an October 2024 Report of General Information, the RO had a telephone conversation with the Veteran regarding his ability to attend examinations, and the Veteran stated that he was no longer interested in pursuing his appeal. The RO informed the Veteran that the appeal would have to be withdrawn in writing. In November 2024, notice was sent to the Veteran and his Custodian of record noting the Veteran's desire to discontinue his appeal, with an explanation as to how to
to make an additional attempt to schedule the requested VA examinations. The issues have returned to the Board for further appellate consideration.

In July and August 2024, notice was sent to the Veteran's Custodian of record attempting to schedule the requested VA examinations. In an October 2024 Report of General Information, the RO had a telephone conversation with the Veteran regarding his ability to attend examinations, and the Veteran stated that he was no longer interested in pursuing his appeal. The RO informed the Veteran that the appeal would have to be withdrawn in writing. In November 2024, notice was sent to the Veteran and his Custodian of record noting the Veteran's desire to discontinue his appeal, with an explanation as to how to formally withdraw the appeal. Neither the Veteran nor his Custodian completed a written withdraw of the appeal.

Thereafter, the RO attempted to schedule multiple examinations in December 2024, and January 2025. The examinations were scheduled to take place in January 2025; however, they were cancelled at the Veteran's request. In February 2025, the RO emailed the Custodian regarding the Veteran's intention and willingness to attend a VA examination. In a February 2025 response, the Custodian emailed the RO and indicated that he was no longer the Veteran's Custodian, and told the RO to contact the Veteran. In May 2025, the Veteran spoke with the RO with respect to guidance as to how he could be removed from the Fiduciary program. In an October 2025 letter, the Veteran's treating physician submitted a letter as per the RO's instruction, indicating that the Veteran is capable of financial decision making. In January 2026, the Veteran submitted a letter indicating his desire to be removed from the fiduciary program. In a March 2026 rating decision, the Veteran was found to be competent for VA purposes as of October 23, 2025. 38 C.F.R. § 3.353 (2021).

Under 38 C.F.R. § 3.655 (a), when entitlement to a benefit cannot be established without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination or reexamination, action shall be taken in accordance with 38 C.F.R. § 3.655 (b). Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, and death of an immediate family member. 38 C.F.R. § 3.655(a).

Pursuant to 38 C.F.R. § 3.655(b), when a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record. In contrast, when the examination was scheduled in connection with, among other things, a claim for increase, "the claim shall be denied." A claim for service connection is an "original compensation claim" for purposes of 38 C.F.R. § 3.655 (b). Turk v. Peake, 21 Vet. App. 565, 570 (2008).

The examination cancellation notice in the record reflects that the agency of original jurisdiction (AOJ) followed the regular process for scheduling an examination and notifying the Veteran of that examination and there is no indication that the notice was sent to an incorrect address, such as notification letters being returned as undeliverable. The Veteran has not indicated that he had good cause for failure to report for the scheduled examination. In fact, the Veteran indicated that he did not want to appear for the examinations because he is no longer interested in pursuing his claim. Therefore, the Board finds that he failed to report for an examination scheduled in connection with his claim for entitlement to service connection for left ear hearing loss, TBI, and cervical spine disorders. The next question to be addressed under 38 C.F.R. § 3.655 (a) is whether entitlement to the benefits sought can be established without the scheduled examination. For the reasons indicated below, the Board finds that it cannot, and this claim will therefore be decided based on the evidence of record.

The Board has limited the discussion below to the relevant evidence required to support its findings of fact and conclusions of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545, 552 (2008); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed.
scheduled examination. For the reasons indicated below, the Board finds that it cannot, and this claim will therefore be decided based on the evidence of record.

Service Connection - Legal Criteria

Service connection is granted for disability resulting from disease or injury incurred in or aggravated by active duty. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303 (d). Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995).

Some chronic diseases are subject to presumptive service connection, although, not otherwise established as incurred or aggravated by service if manifest to a compensable degree, within an applicable time limit, provided that the rebuttable presumptive provisions of § 3.307 are also satisfied. See also 38 C.F.R. §§ 3.303, 3.309.

Hearing loss is considered a chronic disease under 38 C.F.R. § 3.309 (a) because this condition is an organic disorder of the nervous system. For this chronic disease to be presumed service-connected, under this provision, it must manifest to a degree of 10 percent within one year from the date of termination of such service. See 38 C.F.R. § 3.307 (a)(3).

In the absence of proof of a current disability, there can be no valid claim for service connection. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992) (finding service connection presupposes a current diagnosis of the condition claimed). The requirement that a current disability be present is satisfied, "when a claimant has a disability at the time a claim for VA disability compensate on is filed or during the pendency of that claim . . . even though the disability resolves prior to the Secretary's adjudication of the claim." McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

Lay evidence is competent to establish the presence of observable symptomatology and "may provide sufficient support for a claim of service connection." Layno v. Brown, 6 Vet. App. 465, 469 (1994). When a condition is capable of lay observation and may be diagnosed by its unique and readily identifiable features, the presence of the disorder is not a determination "medical in nature."

Also, 38 U.S.C. § 1154 (a) requires that VA give 'due consideration' to 'all pertinent medical and lay evidence' in evaluating a claim for disability. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Specifically, '[l]ay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional.' Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006).

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by
, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional.' Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006).

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (2012); 38 C.F.R. §§ 3.102, 4.3 (2021); see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990).

1. Entitlement to service connection for left ear hearing loss.

The Veteran contends that his current left ear hearing loss disorder is related to his active service.

For the purposes of applying the laws administered by VA, hearing impairment is considered a disability when the auditory threshold level 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. 38 C.F.R. § 3.385.

Service treatment records, including the June 1993 induction examination, are negative for complaints of, treatment for, or a diagnosis of a left ear hearing loss disorder.

Post-service records include a VA audiological examination in April 2016. At the time, the Veteran reported that he was exposed to acoustic trauma during service as an air and missile defense crewmember. The audiological examination report notes the following puretone thresholds in decibels:

HERTZ

500 1000 2000 3000 4000

LEFT 35 25 15 20 25

The examiner stated that the Veteran's speech audiometry revealed a speech recognition score of 94 percent in the left ear. Upon review of the claims file, the examiner noted that the Veteran had some left ear hearing loss that was not considered a disability for VA purposes.

VA outpatient treatment records dated in March 1997 through March 2026 do not demonstrate a reported history or complaints of left ear hearing loss. Likewise, Social Security Administration (SSA) records do not demonstrate a reported history or complaints of left ear hearing loss.

As noted above, in connection with his claim of entitlement to service connection claim for left ear hearing loss, the Veteran was scheduled for a VA audiological examination on January 28, 2026; however, he failed to report for the examination and good cause was not shown for his absence, as he indicated that he did not want to attend a VA examination or pursue his claim. As noted above, pursuant to 38 C.F.R. § 3.655(b), when a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record.

Regarding the Veteran's claimed left ear hearing loss disorder, while not disputing the Veteran's reports of in-service noise exposure, the Board must stress that there is no medical evidence of record showing that the Veteran has ever had sufficient hearing impairment in his left ear to qualify as a disability for VA compensation purposes. See 38 C.F.R. § 3.385.

The Board recognizes that the Veteran might sincerely believe that he has a left ear hearing loss disability that is related to his active service. In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on his symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report on that of which he or she has personal knowledge); see also Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Although the Veteran is competent to report his symptoms, he does not possess the medical expertise required to provide a competent opinion concerning the etiology of the disability at issue. In any event, the Veteran's lay opinion is clearly of less probative value than the VA audiological testing that does not demonstrate a current left ear hearing loss disorder for VA compensation purposes.

Accordingly, the Board must conclude that service connection is not warranted for the claimed left ear hearing loss disability.

2. Entitlement to service connection for a TBI.

The Veteran contends that his current TBI is related to his active service.

Service treatment records, including the June 1993 induction examination, are negative for complaints of, treatment for, or a diagnosis of a TBI disorder.

Post-service records include a VA PTSD examination in May 2016. At the time, the Veteran did not report that he experienced a head injury or TBI during service. The examiner reviewed the record and found that a TBI was not shown.

VA outpatient treatment records dated in March 1997 through September 2018 demonstrate do not demonstrate a reported history or complaints of a TBI.

An October 2018 VA record notes the Veteran's report of a possible post-service TBI in 2014, when he hit his head on a steel bar in jail. A February 2019 VA record notes the Veteran's report that he was hit in the head with the butt of a rifle by a Serbian soldier during service, but he was not hospitalized due to a head injury. He also reported that he experienced a few head injuries after service to include being run over by a four wheeled vehicle, but he explained that he was not hospitalized for those injuries. A January 2021 VA record shows the Veteran reported a history of a TBI.

As noted above, in connection with his claim of entitlement to service connection claim for a TBI, the Veteran was scheduled for a VA examination on January 10, 2025; however, he failed to report for the examination and good cause was not shown for his absence, as he indicated that he did not want to attend a VA examination or pursue his claim. As noted above, pursuant to 38 C.F.R. § 3.655(b), when a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record.

The Board has reviewed the Veteran's contentions, that his current TBI began during active service. While the Board has considered these statements, it does not find them to be credible. In this regard, the Veteran's service treatment records are negative for complaints of, or treatment for a head injury or TBI. Moreover, following separation from service, the Veteran underwent a May 2016 VA PTSD examination. At the time, the Veteran did not report that he experienced a head injury or TBI during service. In addition, post-service records dated in March 1997 through September 2018, do not document complaints of, treatment for, or a diagnosis of a TBI. It was not until February 2019 that he suggested he was hit in the head with the butt of a rifle by a Serbian soldier during service. Moreover, he explained that he was not hospitalized due to a head injury. Further, he also reported that he experienced a few head injuries after service, including being run over by a four wheeled vehicle. Therefore, as the medical evidence of record directly contradicts the Veteran's present assertions, the Board does not find the Veteran's assertions to be credible.

Upon consideration of the evidence of record, the Board finds that service connection is not warranted for a TBI. Here, the record does not demonstrate a current diagnosis of a TBI. In this regard, service treatment records and post-service treatment records are negative for a diagnosis of a TBI. The Board notes that the Veteran is competent to report symptoms of a TBI. However, the evidence fails
not hospitalized due to a head injury. Further, he also reported that he experienced a few head injuries after service, including being run over by a four wheeled vehicle. Therefore, as the medical evidence of record directly contradicts the Veteran's present assertions, the Board does not find the Veteran's assertions to be credible.

Upon consideration of the evidence of record, the Board finds that service connection is not warranted for a TBI. Here, the record does not demonstrate a current diagnosis of a TBI. In this regard, service treatment records and post-service treatment records are negative for a diagnosis of a TBI. The Board notes that the Veteran is competent to report symptoms of a TBI. However, the evidence fails to demonstrate that he suffers from a current disability that manifested during, or as a result of, active service.

To the extent that the Veteran contends that he has a diagnosis of the claimed TBI or that such disorder is related to his active service, the Board finds that such opinion is more suited to the realm of medical, rather than lay, expertise. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). There is no indication that the Veteran has had any specialized education, training, or experience in determining the diagnosis or etiology of a TBI disorder. Therefore, his opinion as to the diagnosis or etiology of such disorder is not competent medical evidence. In any event, the Veteran's lay opinion is clearly of less probative value than the VA examiner's opinion, who found that the Veteran did not have a current assessment of a TBI.

Further, the Board notes that it has fully considered the record which does include assertions from the Veteran about observable symptoms (which he is qualified to report). In this regard, despite the lack of a formal diagnosis, symptoms may count as a disability for VA compensation purposes if they cause functional impairment. See Saunders v. Wilkie, 886 F.3d 1356 (2018). However, as above, in this case while the Veteran has reported symptoms with respect to his claimed current TBI disorder, he has also (simultaneously) denied symptoms of, or a diagnosis of a TBI.

Therefore, there is neither evidence of a diagnosis of a TBI disorder, nor symptoms causing any functional impairment. Without a current disability, there can be no valid claim for service connection. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

Accordingly, the Board must conclude that service connection is not warranted for the claimed TBI disability.

3. Entitlement to service connection for a cervical spine disorder.

The Veteran contends that his current cervical spine disorder is related to his active service.

Service treatment records, including the June 1993 induction examination, are negative for complaints of, treatment for, or a diagnosis of a cervical spine disorder.

Post-service records include VA outpatient treatment records dated in March 1997 through August 2001, which are negative for complaints of, treatment for, or a diagnosis of cervical spine disorder.

A September 2001 VA record shows the Veteran sought treatment for pain in his neck following a motor vehicle accident. The examiner assessed a cervical spine sprain and a possible non-displace fracture of C6. The Veteran was given medication and cervical collar. Subsequent VA outpatient treatment records demonstrate occasional complaints for ongoing neck pain. SSA records do not demonstrate a reported history or complaints of neck pain.

As noted above, in connection with his claim of entitlement to service connection claim for a cervical spine disorder, the Veteran was scheduled for a VA examination on January 10, 2025; however, he failed to report for the examination and good cause was not shown for his absence, as he indicated that he did not want to attend a VA examination or pursue his claim. As noted above, pursuant to 38 C.F.R. § 3.655(b), when a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record.

The Board has reviewed the Veteran's contentions, that his current cervical spine disorder began during active service. While the Board has considered these statements, it does not find them to be credible. In this regard, the Veteran's service treatment records are negative for complaints of, or treatment for a cervical spine disorder. In addition, post-service records dated in March 1997 through August 2001 do not document complaints of, treatment for, or a diagnosis of a cervical spine disorder. It is not until September 2001 that he sought treatment for a cervical spine injury following a motor vehicle accident. Therefore, as the medical evidence
conjunction with an original compensation claim, the claim shall be rated based on the evidence of record.

The Board has reviewed the Veteran's contentions, that his current cervical spine disorder began during active service. While the Board has considered these statements, it does not find them to be credible. In this regard, the Veteran's service treatment records are negative for complaints of, or treatment for a cervical spine disorder. In addition, post-service records dated in March 1997 through August 2001 do not document complaints of, treatment for, or a diagnosis of a cervical spine disorder. It is not until September 2001 that he sought treatment for a cervical spine injury following a motor vehicle accident. Therefore, as the medical evidence of record directly contradicts the Veteran's present assertions, the Board does not find the Veteran's assertions to be credible.

The Board finds that the evidence of record does not support entitlement to service connection for a cervical spine disorder. While the Veteran has a current cervical spine sprain disability, the Board does not find that the evidence supports any particular event, injury, or illness during service related to such disorder.

In this regard, the Board notes that the Veteran's service treatment records are negative for complaints of, or a diagnosis of cervical spine disorder. Moreover, a September 2001 VA post-service record demonstrates that the Veteran was treated for a cervical spine sprain following a motor vehicle accident. Thus, the Veteran's cervical spine sprain occurred several years after his separation from service. Despite the Veteran's assertions, there is no medical evidence of record that establishes an etiological relationship between his cervical spine sprain and his active service.

Finally, the Board recognizes that the Veteran believes that he has a current cervical spine disorder that has manifested as a result of his active service. In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on his symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a veteran is competent to report on that of which he or she has personal knowledge); see also Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). While the Veteran is competent to provide testimony to establish the occurrence of medical symptoms, he is not medically qualified to prove a matter requiring medical expertise. See Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007). The diagnosis and etiology of the aforementioned claimed disorder is a complex medical determination outside the realm of common knowledge of a lay person.

To establish service connection there must be a current diagnosis, an in-service event or injury, and a nexus that connects the in-service event or injury to the current diagnosis. Here, there is a current diagnosis of a cervical spine sprain. The Board notes that, however, there is no evidence of an in-service event or injury to cause the current diagnosis. Therefore, there is no way to establish a nexus because there is no injury during service. In fact, the record demonstrates that the Veteran's current cervical spine injury occurred several years after separation from service.

Accordingly, the Board must conclude that service connection is not warranted for the claimed cervical spine disability.

Increased Rating - Legal Criteria

Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4 (2021). The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 3.321 (a), 4.1 (2021).

Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7 (2021).

In accordance with 38 C.F.R. §§ 4.1, 4.2 (2021) and Schafrath v. Derwinski, 1 Vet. App. 589 (1991), the Board has reviewed all evidence of record pertaining to the history of the service-connected disabilities at issue. The Board has found nothing in the historical record which would lead to the conclusion that the current evidence of record is not adequate for rating purposes. Moreover, the Board is of the opinion that this case
will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7 (2021).

In accordance with 38 C.F.R. §§ 4.1, 4.2 (2021) and Schafrath v. Derwinski, 1 Vet. App. 589 (1991), the Board has reviewed all evidence of record pertaining to the history of the service-connected disabilities at issue. The Board has found nothing in the historical record which would lead to the conclusion that the current evidence of record is not adequate for rating purposes. Moreover, the Board is of the opinion that this case presents no evidentiary considerations which would warrant an exposition of remote clinical histories and findings pertaining to the disability.

In both initial rating claims and subsequent increased rating claims, the Board must discuss whether "staged ratings" are warranted, and if not, why not. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007).

The basis of disability evaluation is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10 (2021).

It is not expected, especially with the more fully described grades of disabilities, that all cases will show all the findings specified; findings sufficiently characteristic to identify the disease and the disability therefrom are sufficient; and above all, a coordination of rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21 (2021).

4. Entitlement to a compensable evaluation for service-connected right ear hearing loss.

The Veteran contends that his service-connected right ear hearing loss disability is more severe than his current noncompensable rating.

Disability ratings for hearing loss disability are derived from mechanical application of the rating schedule to the numeric designations resulting from audiometric testing. See Lendenmann v. Principi, 3 Vet. App. 345 (1992).

The rating schedule establishes 11 auditory hearing acuity levels based upon average puretone thresholds and speech discrimination. 38 C.F.R. § 4.85.

An examination for hearing impairment for VA purposes must be conducted by a state-licensed audiologist and must include a controlled speech discrimination test (Maryland CNC) and a puretone audiometry test. Examinations will be conducted without the use of hearing aids. See Id.

Table VI, "Numeric Designation of Hearing Impairment Based on Puretone Threshold Average and Speech Discrimination," is used to determine a Roman numeral designation (I through XI) for hearing impairment based on a combination of the percent of speech discrimination (horizontal rows) and the puretone threshold average (vertical columns). The Roman numeral designation is located at the point where the row and column intersect. 38 C.F.R. § 4.85(b).

Table VIa, "Numeric Designation of Hearing Impairment Based Only on Puretone Threshold Average," is used to determine a Roman numeral designation (I through XI) for hearing impairment based only on puretone threshold average. Table VIa is used when the examiner certifies that the use of the speech discrimination test is not appropriate due to language difficulties, inconsistent speech discrimination scores, etc., or when indicated under the provisions of § 4.86. 38 C.F.R. § 4.85(c).

"Puretone threshold average" as used in Tables VI and VIa is the sum of the puretone thresholds at 1000, 2000, 3000 and 4000 Hertz and divided by four. This average is used in all cases (including those of § 4.86) to determine a Roman numeral designation from Tables VI and VIa. 38 C.F.R. § 4.85(d).

Table VII, "Percentage Evaluations of Hearing Impairment," is used to determine the percentage evaluation by combining the Roman numeral designations for hearing impairment in each ear. The horizontal rows represent the ear having better hearing and the vertical columns represent the ear having the poorer hearing. The percentage evaluation is located at the point where the row and the column intersect. 38 C.F.R. § 4.85(e).

Provisions for evaluating exceptional patterns of hearing impairment are as follows:

(a) When the puretone thresholds at each of the four specified frequencies (1000, 2000, 3000 and 4000 Hertz) is 55 decibels or more, the rating specialist will
(d).

Provisions for evaluating exceptional patterns of hearing impairment are as follows:

(a) When the puretone thresholds at each of the four specified frequencies (1000, 2000, 3000 and 4000 Hertz) is 55 decibels or more, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa, whichever results in the higher numeral. Each ear will be evaluated separately.

(b) When the puretone thresholds are 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIa, whichever results in the higher numeral; the numeral will then be elevated to the next higher Roman numeral. Each ear will be evaluated separately. 38 C.F.R. § 4.86.

The Veteran underwent a VA audiometric examination in April 2016. The Veteran's puretone thresholds were as follows:

HERTZ

1000 2000 3000 4000

RIGHT 30 40 30 35

LEFT 25 15 20 25

The puretone average for his right ear was 34. The puretone average for his left ear was 21. Speech recognition was 94 percent for his right ear and 94 percent for the left ear. The examiner diagnosed right ear sensorineural hearing loss.

Applying the values above to Table VI results in a Level I Roman numeral designation for the right ear and a Level I Roman numeral designation for the left ear. Application of Level I and Level I designations to Table VII results in a noncompensable evaluation. The right ear does not demonstrate an exceptional pattern of hearing impairment under the provisions of 38 C.F.R. §§ 4.86(a) or 4.86(b). The examiner noted that the Veteran's current right ear hearing loss disability did impact ordinary conditions of daily life, to include difficulty hearing low pitched sounds, and hearing others speaking to him from a distance.

As noted above, in connection with his claim of entitlement to service connection claim for a cervical spine disorder, the Veteran was scheduled for a VA audiological examination on January 28, 2025; however, he failed to report for the examination and good cause was not shown for his absence, as he indicated that he did not want to attend a VA examination or pursue his claim. As noted above, pursuant to 38 C.F.R. § 3.655(b), when a claimant fails to report for an examination scheduled in conjunction with an original compensation claim, the claim shall be rated based on the evidence of record.

Upon review of the evidence of record, it is evident that the criteria for a compensable evaluation for the Veteran's right ear hearing loss under Diagnostic Code 6100 are not met. Although the aforementioned VA audiological evaluation clearly shows that the Veteran has right ear hearing loss, it does not show sufficient hearing impairment to warrant a compensable evaluation during the appeal period.

The Court has held that, "in addition to dictating objective test results, a VA audiologist must fully describe the functional effects caused by a hearing disability in his or her final report." Martinak v. Nicholson, 21 Vet. App. 447, 455 (2007). In this regard, the 2016 VA examiner noted that the Veteran's right ear hearing loss impacted ordinary conditions of daily life, to include his ability to hear low pitched sounds, and hearing others speaking to him from a distance.

The Board acknowledges that a layperson is competent to testify regarding the onset and continuity of symptomatology. Heuer v. Brown, 7 Vet. App. 379, 384 (1995). However, the rating schedule for hearing loss is a reasonable exercise of the Secretary's rulemaking authority. Martinak, 21 Vet. App. 447. Whereas the Veteran's right ear hearing loss has not been shown by medical or lay evidence to be worse than that measured during audiological evaluation.

Accordingly, a compensable evaluation for service-connected right ear hearing loss is not warranted.

B. MULLINS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Sara Schinner
acknowledges that a layperson is competent to testify regarding the onset and continuity of symptomatology. Heuer v. Brown, 7 Vet. App. 379, 384 (1995). However, the rating schedule for hearing loss is a reasonable exercise of the Secretary's rulemaking authority. Martinak, 21 Vet. App. 447. Whereas the Veteran's right ear hearing loss has not been shown by medical or lay evidence to be worse than that measured during audiological evaluation.

Accordingly, a compensable evaluation for service-connected right ear hearing loss is not warranted.

B. MULLINS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Sara Schinnerer, Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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