Back to BVA DecisionsMIXEDService Branch NAVY Special Benefit NO SPECIAL BENEFIT Diagnostic Code 6200 Docket No. 231228-403897
CHRONIC SUPPURATIVE OTITIS MEDIA
PAUL R. CASEY · 2026 · Case ID: A26009188
Summary
The Veteran, who served in the U.S. Navy from November 1976 to July 1979, appeals a Department of Veterans Affairs (VA) rating decision concerning his left ear otitis media and bilateral hearing loss. The appeal stems from an October 2023 decision that granted service connection for otitis media, left ear, with a noncompensable rating, and continued a 10 percent rating for bilateral hearing loss. The period under review is from March 22, 2022, to October 19, 2023. The Veteran sought a compensable rating for otitis media, left ear, and a higher rating for bilateral hearing loss. The Board reviewed five VA hearing loss examinations and found that while the Veteran experienced chronic recurrent left ear infections and drainage, the examinations did not support active suppuration or aural polyps required for a higher rating for otitis media. For hearing loss, the Board analyzed multiple VA audiological examinations, noting inconsistencies in results. Ultimately, the Board found the evidence weighed against assigning a rating higher than 10 percent for bilateral hearing loss, denying the increased rating. Service connection for otitis media, left ear, with a 10 percent rating was granted.
Rationale
Chronic recurrent left ear infections noted; Examiners noted drainage affecting ability to work; 10 percent rating warranted for suppuration
Full Decision Text
Citation Nr: A26009188 Decision Date: 02/02/26 Archive Date: 02/02/26 DOCKET NO. 231228-403897 DATE: February 2, 2026 ORDER Entitlement to an initial compensable rating of 10 percent for otitis media, left ear, status post tympanomastoidectomy is granted. Entitlement to an initial rating in excess of 10 percent for bilateral hearing loss is denied. FINDINGS OF FACT 1. The evidence of record establishes that the Veteran had serious drainage from his left ear during the period on appeal. 2. Veteran's bilateral hearing loss has been manifested by hearing acuity of no worse than Level V in the right ear and no worse than Level IV in the left ear. CONCLUSIONS OF LAW 1. The criteria for entitlement to an initial rating of 10 percent for otitis media, left ear, status post tympanomastoidectomy have been met. 38 U.S.C. § 1155, 5107; 38 C.F.R. § 4.1-4.7, 4.21, 4.27, 4.87, Diagnostic Code 6200. 2. The criteria for entitlement to an initial rating in excess of 10 percent for a bilateral hearing loss disability have not been met. 38 U.S.C. § 1155, 5107; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.6, 4.7, 4.27, 4.85, 4.86, Diagnostic Code (DC) 6100. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Navy from November 1976 to July 1979. This appeal is being processed under the modernized review system, commonly referred to as the "AMA," as established by the Veterans Appeals Improvement and Modernization Act of 2017. 115 Pub. L. No. 55, 131 Stat. 1105. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2023 rating decision issued by a Department of Veterans Affairs (VA) regional office, an agency of original jurisdiction (AOJ). The Veteran timely initiated an appeal by submitting a December 2023 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), and elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time the AOJ issued the October 2023 rating decision on appeal, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801. The Board notes that the December 2023 VA Form 10182 only listed the issue of the rating for the Veteran's left ear otitis media and did not include the issue of the rating of the Veteran's hearing loss. However, Diagnostic Code 6200 instructs VA to separately evaluate hearing impairment due to chronic suppurative otitis media. See 38 C.F.R. § 4.87. Additionally, the Veteran's representative included the issue in the submitted argument. See July 2024 Written Presentation Brief. Therefore, the Board will address the issue of the Veteran's rating for his hearing loss. Increased Rating Disability ratings are determined by evaluating the extent to which a veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two ratings are potentially applicable, the higher rating will be assigned if the disability more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. See 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. See 38 C.F.R. § 4.3 -connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule). See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two ratings are potentially applicable, the higher rating will be assigned if the disability more nearly approximates the criteria required for that rating; otherwise, the lower rating will be assigned. See 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. See 38 C.F.R. § 4.3. The issue of entitlement to an initial compensable rating for otitis media, left ear, status post tympanomastoidectomy. The Veteran contends he is entitled to a compensable rating for his otitis media, left ear. See December 2023 VA Form 10182 Decision Review Request: Board Appeal (Notice of Disagreement). This appeal stems from an October 19, 2023 rating decision which granted service connection for otitis media, left ear and assigned a noncompensable rating with an effective date of March 22, 2022. Therefore, the period on review is from March 22, 2022 to October 19, 2023. Otitis media is rated pursuant to diagnostic code 6200 for chronic suppurative otitis media. A 10 percent rating is assigned during suppuration, or with aural polyps. Suppuration is defined by Merriam-Webster as "the formation of, conversion into, or process of discharging pus." The Veteran was afforded two examinations in conjunction with this claim. Both the April 2022 and November 2022 examinations found that the Veteran did not have active suppuration or aural polyps. However, both the April 2022 and November 2022 examiners noted that the Veteran experiences chronic recurrent left ear infections. Furthermore, the April 2022 examination found that the Veteran had serious discharge in the external ear canal and the examiner noted that the Veteran experienced constant drainage which affected his ability to work. Therefore, a rating of 10 percent is warranted for chronic suppurative otitis media during suppuration for the entire period on appeal. There is no higher rating available. Accordingly, a 10 percent evaluation for chronic suppurative otitis media is hereby granted for the entire appeal period. The issue of entitlement to a rating in excess of 10 percent for bilateral hearing loss. Hearing loss is evaluated through the mechanical application of a veteran's audiometric test results to the rating tables set forth in the Rating Schedule under DC 6100. 38 C.F.R. § 4.85; Doucette v. Shulkin, 28?Vet. App.?366, 367 (2017). For VA compensation purposes, an examination for hearing impairment must be conducted by a state-licensed audiologist and must include a puretone audiometry test as well as a controlled speech discrimination test (Maryland CNC), without the use of hearing aids. 38 C.F.R. § 4.85(a). The Rating Schedule utilizes three tables to evaluate hearing impairment: Tables VI, VIA, and VII. Table VII is used to determine the percentage evaluation by combining Roman numeral designations for the level of hearing impairment in each ear. These Roman numeral designations are obtained from Tables VI or VIA. Table VI is based on a combination of puretone threshold average and speech discrimination percentage. The Roman numerals range from I to XI. A higher Roman numeral is assigned based on a combination of a higher puretone threshold average and a lower speech discrimination percentage score. If the use of speech discrimination score is not appropriate, then Table VIA is the appropriate source of the Roman numeral designation, which is based solely on puretone threshold average. 38 C.F.R. § 4.85(c). Puretone threshold average is the average of the puretone thresholds at the 1000, 2000, 3000, and 4000 Hertz (Hz) frequencies. 38?C.F.R. § 4.85(d). Table VIA may be used for "exceptional patterns of hearing impairment," where the puretone thresholds at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hz) are 55 decibels (dB) or more, or where the puretone thresholds are 30 dB or less at 1000 Hz and 70 dB or more at 2000 Hz. 38 C.F.R. § 4.86 Puretone threshold average is the average of the puretone thresholds at the 1000, 2000, 3000, and 4000 Hertz (Hz) frequencies. 38?C.F.R. § 4.85(d). Table VIA may be used for "exceptional patterns of hearing impairment," where the puretone thresholds at each of the four specified frequencies (1000, 2000, 3000, and 4000 Hz) are 55 decibels (dB) or more, or where the puretone thresholds are 30 dB or less at 1000 Hz and 70 dB or more at 2000 Hz. 38 C.F.R. § 4.86. Where the puretone thresholds are 30 dB or less at 1000 Hz and 70 dB or more at 2000 Hz, the Roman numeral derived from Table VIA will be elevated to the next higher Roman numeral. The Veteran contends he is entitled to a higher rating for his bilateral hearing loss. See July 2024 Written Brief Presentation. This appeal stems from an October 19, 2023 rating decision which continued the 10 percent rating for bilateral hearing loss with an effective date of March 22, 2022. Therefore, the period on review is from March 22, 2022 to October 19, 2023. During the relevant period, the Veteran underwent five VA hearing loss examinations. The VA examination in April 2022 produced the following results: 1000 Hz 2000 Hz 3000 Hz 4000 Hz Average Right (dB) 35 40 55 65 48.75 Left (dB) 35 40 50 50 43.75 Speech discrimination scores were 100% in the right ear and 94% in the left ear. The examiner found that the use of speech discrimination scores for both ears was appropriate. Applying the results to Table VI, the findings yield a numeric designation of Level I in the right ear and Level I in the left ear. The resulting rating evaluation pursuant to Table VII is zero percent. The Veteran underwent a VA hearing loss examination in October 2022 with the following results: 1000 Hz 2000 Hz 3000 Hz 4000 Hz Average Right (dB) 40 45 60 60 51.25 Left (dB) 50 50 55 65 55.00 Speech discrimination scores were 80% in the right ear and 80% in the left ear. The examiner found that the use of speech discrimination scores for both ears was appropriate. Applying the results to Table VI, the findings yield a numeric designation of Level IV in the right ear and Level IV in the left ear. The resulting rating evaluation pursuant to Table VII is 10 percent. The Veteran underwent a VA hearing loss examination in November 2022 with the following results: 1000 Hz 2000 Hz 3000 Hz 4000 Hz Average Right (dB) 60 65 65 70 65 Left (dB) 60 60 60 60 60 Speech discrimination scores were 96% in the right ear and 96% in the left ear. The examiner found that the use of speech discrimination scores for both ears was appropriate. Applying the results to Table VI, the findings yield a numeric designation of Level II in the right ear and Level II in the left ear. An exceptional pattern of hearing impairment under 38 C.F.R. § 4.86 was shown in both the right and left ears. Utilizing Table VIA yields a numeric designation of Level V for the right ear and Level IV for the left ear. The resulting rating evaluation pursuant to Table VII is 10 percent. The Veteran underwent a VA hearing loss examination in May 2023 with the following results: 1000 Hz 2000 Hz 3000 Hz 4000 Hz Average Right (dB) 50 50 60 70 57.5 Left (dB) 50 50 60 55 53.75 Speech discrimination scores were 88% in the right ear and 100% in the left ear. The examiner found that the use of speech discrimination scores for both ears was appropriate. Applying the results to Table VI, the findings yield a numeric designation of Level III in the right ear and Level I in the left ear. The resulting rating evaluation pursuant to Table VII is zero percent. The Veteran underwent a VA hearing loss examination in July 2023 with the following results: 1000 Hz 2000 Hz 3000 Hz 4000 Hz Average Right (dB) 50 45 50 60 51.25 Left (dB) 50 50 60 55 53.75 Speech discrimination scores were 88% in the right ear and 100% in the left ear. The examiner found that the use of speech discrimination scores for both ears was appropriate. Applying the results to Table VI, the findings yield a numeric designation of Level III in the right ear and Level I in the left ear. The resulting rating evaluation pursuant to Table VII is zero percent. The Veteran underwent a VA hearing loss examination in July 2023 with the following results: 1000 Hz 2000 Hz 3000 Hz 4000 Hz Average Right (dB) 50 45 50 60 51.25 Left (dB) 45 35 55 55 47.5 Speech discrimination scores were 80% in the right ear and 80% in the left ear. The examiner found that the use of speech discrimination scores for both ears was appropriate. Applying the results to Table VI, the findings yield a numeric designation of Level IV in the right ear and Level III in the left ear. The resulting rating evaluation pursuant to Table VII is 10 percent. The Board notes that the Veteran's representative requested the issue be remanded for a new medical examination. See July 2024 Written Brief Presentation. However, as noted above, the Veteran received five audiological examinations during the pendency of this claim. Additionally, the Board acknowledges that more than two years have passed since the Veteran last underwent a VA hearing loss examination. However, the mere passage of time does not render an otherwise adequate examination inadequate. Palczewski v. Nicholson, 21 Vet. App. 174, 180-81 (2007). In this instance, the Board notes that no correspondence or other communication was received from the Veteran prior to the issuance of the October 2023 rating decision on appeal in which the Veteran suggested that his bilateral hearing loss disability had worsened since the July 2023 VA hearing loss examination. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). Therefore, the Board finds that a remand for another VA examination is not necessary to adjudicate this claim. In assessing the evidence of record, the Board recognizes that the Veteran is competent to provide evidence regarding the lay observable symptoms of his hearing impairment. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465, 470 (1994). However, as audiometric testing conducted by a state-licensed audiologist is required to evaluate the severity of his hearing impairment for VA compensation purposes and there is no evidence of record establishing that he is a state-licensed audiologist, his is not competent to provide evidence regarding the severity of his hearing loss in terms of puretone thresholds and speech discrimination percentages. Therefore, in that regard, the Board must rely on the medical evidence of record. Continued Next Page In sum, the Board finds that the evidence of record weighs against assigning a rating in excess of 10 percent for the Veteran's bilateral hearing loss disability for the entire period on review. See Lynch v. McDonough, 21 F.4th 776, 781-82 (2021) (en banc). Accordingly, a rating in excess of 10 percent for the Veteran's bilateral hearing loss disability is denied. Paul R. Casey Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. M. Disselkamp 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.