HEARING LOSS

Summary

The Veteran served in the United States Air Force from August 2001 to December 2007. The Veteran appealed the April 2021 rating decision which granted service connection for bilateral hearing loss with a noncompensable rating and denied service connection for headaches and bleeding ears. The Board reviewed the evidence of record, including a March 2021 VA audiological examination. The examination results indicated a puretone threshold average of 37.5 decibels and speech recognition of 100 percent in the right ear (Level I), and a puretone average of 50 decibels and speech recognition of 90 percent in the left ear (Level II). Applying the mechanical formula in 38 C.F.R. § 4.85, the intersection of Level I (better ear) and Level II (poorer ear) on Table VII results in a noncompensable (zero percent) disability rating for bilateral hearing loss. The Board found the VA examination adequate and probative, concluding the evidence persuasively weighs against an initial compensable rating. For headaches and bleeding ears, the Board found the evidence persuasively weighs against a current disability. VA treatment records and the March 2021 VA examiner's findings indicated no current diagnosis or objective evidence of these conditions. The Board noted the holding in Saunders v. Wilkie, which requires evidence of functional impairment of earning capacity for symptoms alone, and found the Veteran had not met this standard. Therefore, service connection for headaches and bleeding ears was denied. The Board denied entitlement to an initial compensable disability rating for bilateral hearing loss, service connection for headaches, and service connection for bleeding ears.

Rationale

VA audiometric testing results applied to rating schedule yielded noncompensable rating; Evidence persuasively weighs against entitlement to a compensable rating

Full Decision Text

Citation Nr: A26033909
Decision Date: 04/13/26	Archive Date: 04/13/26

DOCKET NO. 210910-184058
DATE: April 13, 2026

ORDER

1. Entitlement to an initial compensable disability rating for bilateral hearing loss is denied.

2. Entitlement to service connection for a headache disability is denied.

3. Entitlement to service connection for bleeding ears is denied.

FINDINGS OF FACT

1. VA audiometric testing showed the Veteran had a 37.5 decibel puretone threshold average in the right ear and 50 decibel puretone threshold average in the left ear. Speech discrimination was measured at 100 percent in the right ear and 90 percent in the left ear. This equates to a designation of I in the right ear and II in the left ear.

2. The evidence of record persuasively weighs against a finding that the Veteran has a present headache disability, to include symptoms that cause functional impairment of earning capacity.

3. The evidence of record persuasively weighs against a finding that the Veteran has a present bleeding ears, to include symptoms that cause functional impairment of earning capacity.

CONCLUSIONS OF LAW

1. The criteria for entitlement to an initial compensable disability rating for bilateral hearing loss disability have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.3, 4.85, Diagnostic Code (DC) 6100.

2. The criteria for service connection for a headache disability is not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for entitlement to service connection for bleeding ears have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the United States Air Force from August 2001 to December 2007.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from an April 2021 rating decision issued by the Agency of Original Jurisdiction (AOJ), which granted service connection for bilateral hearing loss disability and denied service connection for bleeding ears and headaches, among other claims.

In September 2021, the Veteran timely appealed the decision as to the above-listed issues to the Board by submitting a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) (NOD) and a requesting Hearing before a Veterans Law Judge. In a March 2025 email, the Veteran stated that he would like to opt out of the hearing and have the case sent to a Veterans Law Judge for direct judgment. Thus, the Board finds that the Veteran's hearing request has been withdrawn. When a Hearing request is withdrawn, the Board considers the evidence of record at the time of the April 2021 AOJ decision on appeal, in addition to evidence submitted within 90 days from the March 13, 2025 hearing withdrawal date, which is June 11, 2025. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

The Board notes that the Veteran and/or his attorney did not submit additional evidence within 90 days of the March 2025 hearing withdrawal.

If evidence was associated with the claims file during a period of time when additional evidence was not allowed, the Board has not considered it in this decision. 38 C.F.R. § 20.300. If the Veteran would like VA to consider any evidence that was added to the claims file that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Initial Rating

1. Entitlement to an initial compensable disability rating for bilateral hearing loss

The Veteran contends that his bilateral hearing loss disability warrants a compensable disability rating. 

Disability?ratings?are determined by evaluating the extent to which a veteran's service-connected?disability?adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing the symptomatology with the criteria set forth in the Schedule for
. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Initial Rating

1. Entitlement to an initial compensable disability rating for bilateral hearing loss

The Veteran contends that his bilateral hearing loss disability warrants a compensable disability rating. 

Disability?ratings?are determined by evaluating the extent to which a veteran's service-connected?disability?adversely affects his ability to function under the ordinary conditions of daily life, including employment, by comparing the symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating?Schedule). The percentage?ratings?in the?Rating?Schedule represent the average impairment in earning capacity resulting from service-connected diseases and injuries and their residual conditions in civilian occupations. The percentage ratings are generally adequate to?compensate?for considerable?loss?of working time from exacerbation or illness proportionate to the severity of the?disability. 

Hearing?loss?is evaluated under?38?C.F.R. §?4.85, DC 6100 using a mechanical formula. Disability?ratings?for service-connected?hearing?loss?range from noncompensable to 100 percent and are determined by inserting numbers, which are assigned based on the results of audiometric evaluations, into Table VI in Diagnostic Code (DC) 6100. See Lendenmann v. Principi,?3?Vet. App.?345, 349?(1992). The?Rating?Schedule establishes eleven Roman numeral auditory acuity levels that range from Level I (essentially normal?hearing?acuity) to Level XI (profound deafness.?Id.?The level of auditory acuity is based on the average puretone threshold (derived from the results of puretone audiometric tests in the frequencies 1000, 2000, 3000, and 4000 Hertz) and organic impairment of hearing acuity (measured by controlled speech discrimination test; Maryland CNC). See 38?C.F.R. §?4.85, Table VI. 

The columns in Table VI represent nine categories of decibel?loss?as measured by puretone threshold averages. The rows in Table VI represent nine categories of organic impairment of?hearing?acuity as measured by speech discrimination tests. The numeric designation of impaired?hearing?(Levels I through XI) is determined for each ear by intersecting the column that represents the relevant puretone threshold average with the row that represents the relevant speech discrimination test result.?Id. 

Exceptional patterns of?hearing?impairment are provided for in?38?C.F.R. §?4.86. When the puretone threshold 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 is evaluated separately. 38?C.F.R. §?4.86(a). 

The percentage evaluation is derived from Table VII in?38?C.F.R. §?4.85?by intersecting the row that corresponds to the numeric designation for the ear with better hearing?acuity (as determined by Table VI) and the column that corresponds to the numeric designation level for the ear with the poorer?hearing?acuity (as determined by Table VI). For example, if the better ear has a numeric designation Level of "V" and the poorer ear has a numeric designation Level of "VII," the percentage evaluation is 30 percent. See?id. 

In the April 2021 rating decision, the AOJ awarded service connection and assigned a noncompensable or zero disability rating?for his bilateral hearing loss?disability, effective November 30, 2020. 

After a careful review of the evidence of record, the Board finds that the evidence persuasively weighs against an initial compensable?disability?rating?for the bilateral hearing loss disability. The reasons follow. 

In March 2021, the Veteran had a VA audiological examination. His puretone thresholds, in decibels, and his Maryland CNC test results were as follows:

 	 	 	HERTZ 	 	Maryland CNC 

 	1000 	2000 	3000 	4000 	 

RIGHT 	20	40	45 	45 	100

LEFT 	35 	50 	55	60	90

Using the right ear puretone average of 37.5 decibels from the
 of the evidence of record, the Board finds that the evidence persuasively weighs against an initial compensable?disability?rating?for the bilateral hearing loss disability. The reasons follow. 

In March 2021, the Veteran had a VA audiological examination. His puretone thresholds, in decibels, and his Maryland CNC test results were as follows:

 	 	 	HERTZ 	 	Maryland CNC 

 	1000 	2000 	3000 	4000 	 

RIGHT 	20	40	45 	45 	100

LEFT 	35 	50 	55	60	90

Using the right ear puretone average of 37.5 decibels from the March 2021 VA examination and a speech recognition score of 100 percent; the right ear received a designation of I under Table VI. Because the left ear had a puretone average of 50 decibels and speech recognition score of 90 percent, it received a designation of II under Table VI. The intersection of row I for the better ear and column II for the poorer ear on Table VII establishes that the Veteran's bilateral hearing loss disability warrants a noncompensable or zero percent?disability?rating. 

The Board finds that the clinical findings within the March 2021 VA examination are adequate and probative for rating purposes. The examination results establish no more than a noncompensable disability rating for the Veteran's bilateral hearing loss disability during the period on appeal. The Board has considered the functional impact of the Veteran's?disability?and the results of the audiological examinations of record. Therefore, the mechanical application of the Rating Schedule to the audiometric findings does not establish entitlement to a compensable disability rating during this part of the appeal period. 

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether entitlement to a compensable disability rating for bilateral hearing loss disability is warranted. Rather, the evidence persuasively weighs against the claim. The benefit of the doubt doctrine, see 38 U.S.C. § 5107(b), is therefore not for application. Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application.

Service Connection

Service connection may be granted for a disability resulting from injury or disease incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). The three-element test to establish service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the disease or injury incurred or aggravated during service.

Entitlement to service connection for headaches

Entitlement to service connection for bleeding ears

The Veteran asserts that his headaches and bleeding ears had their onset during service or are otherwise related to service.

After carefully reviewing the evidence of record, the Board finds that the evidence persuasively weighs against the claims for service connection for headaches or bleeding ears. The reasons follow.

As to the first element of a service-connection claim, evidence of a current disability, the AOJ made a finding in the April 2021 rating decision on appeal that the Veteran did not have a current disability for headaches and/or bleeding ears. The Board agrees that the evidence persuasively weighs against a finding that the Veteran has headaches and/or bleeding ears during or in close proximity to the appeal period. For instance, the April 2021 VA examiner found that the Veteran did not now have or had been diagnosed with an ear or peripheral vestibular condition. The examiner noted that there was no objective evidence of bleeding ears established on examination.

The examiner's findings are supported by the treatment records. For example, VA treatment records from March 2008 showed that the Veteran denied any hearing loss, tinnitus, earaches, or headaches. The examiner found that the Veteran's external ears were normal and canals were clear. A February 2011 VA treatment record showed that the Veteran had no previous history of ear symptoms and no headache syndromes. The February 2011 VA treating physician noted that the Veteran's head and ears were normal. There are not more recent treatment records during the evidentiary window showing that the Veteran has headaches or bleeding ears.

While the Veteran has alleged he has headaches and bleeding ears, he has not alleged, nor does the evidence show, that he has symptoms that cause functional impairment of earning capacity. The Board acknowledges the holding in Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), wherein the U.S. Court of Appeals for the Federal Circuit (Federal
 were clear. A February 2011 VA treatment record showed that the Veteran had no previous history of ear symptoms and no headache syndromes. The February 2011 VA treating physician noted that the Veteran's head and ears were normal. There are not more recent treatment records during the evidentiary window showing that the Veteran has headaches or bleeding ears.

While the Veteran has alleged he has headaches and bleeding ears, he has not alleged, nor does the evidence show, that he has symptoms that cause functional impairment of earning capacity. The Board acknowledges the holding in Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018), wherein the U.S. Court of Appeals for the Federal Circuit (Federal Circuit) held that symptoms alone, absent a specific diagnosis or otherwise identified disease or injury, could constitute a disability provided there is evidence of functional impairment of earning capacity. The Veteran has not alleged, and the evidence does not persuasively show, that the Veteran's symptoms have caused functional impairment of earning capacity. Therefore, under Saunders, the Board cannot make a finding that the Veteran has current headaches and/or bleeding ears.

On August 10, 2022, the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxins Act of 2022 (PACT Act) was enacted. Section 303 of this law provides that, if a veteran submits a claim for service connection with evidence of disability and evidence of participation in a toxic exposure risk activity ("TERA"), and such evidence is not sufficient to establish a service connection for the disability, the Secretary shall obtain a medical opinion as to whether it is at least as likely as not that there is a nexus between certain disabilities and the toxic exposure risk activities during service. 38 U.S.C. § 1168.

However, as the evidence persuasively weighs against a finding that the Veteran has a current disability of headaches and/or bleeding ears, the Board finds that no additional development is needed to satisfy a regulatory or statutory duty pursuant to 38 U.S.C. § 1168 and 38 C.F.R. § 20.802(a) under the AMA.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for headaches and/or bleeding ears is warranted. Rather, the evidence persuasively weighs against the claims. The benefit of the doubt doctrine, see 38 U.S.C. § 5107(b), is therefore not for application. Lynch, 21 F.4th 776. 

 

A. P. SIMPSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	N. Griffin, 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.