HEARING LOSS

Summary

The veteran, who served from November 1986 to November 1989, appeals the denial of an initial compensable disability rating for a left ear hearing loss. The veteran contended that based on a January 2024 VA examination, he should receive at least a 10 percent rating, citing specific audiometric results and the rating schedule. The Board reviewed the evidence, including two VA audiological examinations from June 2023 and January 2024. The June 2023 examination showed a left ear puretone average of 54 decibels and 96 percent speech discrimination, resulting in a Level I designation and a noncompensable rating. The January 2024 examination showed a left ear puretone average of 55 decibels and 74 percent speech discrimination, resulting in a Level V designation. The Board applied the rating schedule, noting that for a compensable rating, the non-service-connected right ear must be assigned a Level I designation, which it was. The Board found that when applying the correct methodology using the January 2024 results (Level V for the left ear and Level I for the right ear), the resulting rating was still noncompensable (zero percent). The Board rejected the veteran's attorney's argument that the results warranted a 10 percent rating, explaining that the attorney overlooked the correct application of the rating schedule when only one ear is service-connected. The Board concluded that the evidence did not meet the criteria for a compensable rating, and the benefit-of-the-doubt rule did not apply as the evidence favored the denial.

Rationale

Mechanical application of rating schedule to audiometric findings does not establish entitlement to a compensable rating.; Veteran's contention regarding a 10% rating overlooked correct application of rating schedule for single-ear hearing loss.; Impairment is contemplated by rating criteria; no extraschedular consideration warranted.

Full Decision Text

Citation Nr: A26040029
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 260204-638503
DATE: April 29, 2026

ORDER

Entitlement to an initial compensable disability rating for a left ear hearing loss disability is denied.

FINDINGS OF FACT

1. VA audiometric testing (contracted) in June 2023 revealed a 54 decibel puretone threshold average and speech discrimination was measured at 96 percent in the left ear. No worse than Level I hearing loss in left ear has been shown and the Veteran is not in receipt of service connection for right ear hearing loss.

2. VA audiometric testing (contracted) in January 2024 revealed a 55 decibel puretone threshold average and speech discrimination was measured at 74 percent in the left ear. No worse than Level V hearing loss in left ear has been shown and the Veteran is not in receipt of service connection for right ear hearing loss.

CONCLUSION OF LAW

The criteria for entitlement to an initial compensable disability rating for a left ear 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.

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The Veteran served on active duty from November 1986 to November 1989.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2025 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). Notably, the March 2025 rating decision was a Higher-Level Review (HLR) decision, issued in response to a November 2024 VA Form 20-0996, Decision Review Request: HLR, which requested review of a November 2023 rating decision that (in pertinent part) granted service connection for a left ear hearing loss disability, rated noncompensable (0 percent). 

In the February 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the November 2023 agency of original jurisdiction (AOJ) decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. 

If the Veteran would like VA to consider any evidence that was submitted 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. 

Entitlement to an initial compensable disability rating for a left ear hearing loss disability

The Veteran seeks an initial compensable disability rating for his service-connected left ear hearing loss disability and contends he was incorrectly assigned a noncompensable disability rating when, based on the results from a VA examination conducted in January 2024, he should be assigned at least a 10 percent disability rating. See February 2026 Notice of Disagreement.

As an initial matter, the Board observes that the January 2024 VA examination was conducted after the November 2023 rating decision and that, in this case, the Board ordinarily may only consider the evidence of record at the time of that rating decision since the March 2025 rating decision on appeal is a HLR decision. However, the Board also observes that when the matter of the initial rating to be assigned for the Veteran's left hearing loss disability was addressed in the March 2025 rating decision, the AOJ considered the January 2024 VA examination findings. For this reason, the Board will also consider the January 2024 VA examination report in this decision. See Bolds v. McDonough, 37 Vet. App. 359 (2024) (holding that the evidence submission limits under the Appeals Modernization Act (AMA) are waivable claims processing rules, subject to Secretarial waiver).

For the following reasons, and with consideration of the January 2024 VA examination report, the Board finds that the Veteran's left ear hearing loss disability has not met the criteria for a compensable disability at any point of the appeal period.

Disability
 Veteran's left hearing loss disability was addressed in the March 2025 rating decision, the AOJ considered the January 2024 VA examination findings. For this reason, the Board will also consider the January 2024 VA examination report in this decision. See Bolds v. McDonough, 37 Vet. App. 359 (2024) (holding that the evidence submission limits under the Appeals Modernization Act (AMA) are waivable claims processing rules, subject to Secretarial waiver).

For the following reasons, and with consideration of the January 2024 VA examination report, the Board finds that the Veteran's left ear hearing loss disability has not met the criteria for a compensable disability at any point of the appeal period.

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.

Diagnostic Codes (DCs) are assigned by the rating officials to individual disabilities. DCs provide rating criteria specific to a particular disability. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of a veteran. 38 C.F.R. § 4.3.

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 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. If impaired hearing is service connected in only one ear, as is the case here, the non-service-connected ear is assigned a numeral designation of I. 38 C.F.R. § 4.85(f).

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.

Turning to the relevant evidence, in a June 2023 statement, the Veteran reported difficulty hearing everyday sounds such as birds chirping and crickets and that he would have to get closer to people to try and hear them. He stated that he had his cell phone on speaker and the highest volume to hear people and that due to his hearing loss, he asked others to repeat themselves frequently, especially when there is background noise present. The Veteran also indicated that other people often told him that he talked too loudly.

In June 2023, the Veteran underwent a VA audiological examination (contracted
 designation Level of "V" and the poorer ear has a numeric designation Level of "VII," the percentage evaluation is 30 percent. See id.

Turning to the relevant evidence, in a June 2023 statement, the Veteran reported difficulty hearing everyday sounds such as birds chirping and crickets and that he would have to get closer to people to try and hear them. He stated that he had his cell phone on speaker and the highest volume to hear people and that due to his hearing loss, he asked others to repeat themselves frequently, especially when there is background noise present. The Veteran also indicated that other people often told him that he talked too loudly.

In June 2023, the Veteran underwent a VA audiological examination (contracted) which showed that the Veteran's puretone thresholds, in decibels, were as follows:

HERTZ	1000	2000	3000	4000	AVERAGE

LEFT	45	45	60	65	54

Speech discrimination tests used the Maryland CNC word list and revealed speech recognition ability of 96 percent in the left ear.

Using the left ear puretone average of 54 decibels from the June 2023 VA examination and a speech recognition score of 96 percent; the left ear received a designation of Level I under Table VI. See 38 C.F.R. § 4.85. The right ear is not service-connected; therefore, it received a designation of Level I. 38 C.F.R. § 4.85(f). Table VIa will not be taken into consideration for the left ear because the puretone threshold in decibels are not above 55 decibels for each of the frequencies of 1000, 2000, 3000, and 4000 Hertz, nor is it shown that the Veteran had a puretone threshold of 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. See 38 C.F.R. § 4.86. The intersection of row I and column I on Table VII establishes that under the June 2023 VA examination, the Veteran's left ear hearing loss is entitled to a zero percent or a noncompensable disability rating. See 38 C.F.R. § 4.85, DC 6100.

During the June 2023 VA examination, the Veteran stated he could hear but not clearly and that his hearing was worse at a distance and with other noise present (in groups). The examiner documented functional impact of hearing loss in the Veteran's own words as, "I have to ask people to repeat all the time," and daily life impacts of communication difficulty and frustration, with work activities affected as the Veteran having to ask people to repeat themselves two or three times and it could be frustrating for all involved.

In January 2024, the Veteran underwent another VA audiological examination (contracted). The examiner documented that the Veteran reported difficulty hearing and understanding speech clearly, especially in noisy or group environments and that hearing was worse if someone was at a distance or not looking in his direction. He stated that he needed to ask people for frequent repetition and had to turn up the volume. Upon audiological examination, the Veteran's puretone thresholds, in decibels, were as follows:

HERTZ	1000	2000	3000	4000	AVERAGE

LEFT	50	50	55	65	55

Speech discrimination tests used the Maryland CNC word list and revealed speech recognition ability of 74 percent in the left ear.

Using the left ear puretone average of 55 decibels from the January 2024 VA examination and a speech recognition score of 74 percent; the left ear received a designation of Level V under Table VI. See 38 C.F.R. § 4.85. Table VIa will not be taken into consideration for the left ear because the puretone threshold in decibels are not above 55 decibels for each of the frequencies of 1000, 2000, 3000, and 4000 Hertz, nor is it shown that the Veteran had a puretone threshold of 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. See 38 C.F.R. § 4.86. The right ear is not service-connected, therefore it received a designation of Level I. 38 C.F.R. § 4.85(f). The intersection of row V for the left ear and column I for the non-service connected right ear on Table VII establishes that under the January 2024 VA examination, the Veteran's left ear hearing loss is entitled to a zero percent or a noncompensable disability rating. See 38 C.F.R. § 4.85, DC 6100. In
 a puretone threshold of 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. See 38 C.F.R. § 4.86. The right ear is not service-connected, therefore it received a designation of Level I. 38 C.F.R. § 4.85(f). The intersection of row V for the left ear and column I for the non-service connected right ear on Table VII establishes that under the January 2024 VA examination, the Veteran's left ear hearing loss is entitled to a zero percent or a noncompensable disability rating. See 38 C.F.R. § 4.85, DC 6100. In the examination report, the examiner noted functional impact in the Veteran's own words as, "I have to say what and ask people to repeat themselves" and daily life impacts of communication difficulty and work activities affected of frustration having to ask people to repeat themselves.

The Veteran is competent to describe the effects of his hearing loss on his daily functioning, such as having difficulty understanding speech clearly or difficulty conversing, particularly when background noise is present, and needing others to repeat themselves, as reported in the June 2023 statement and during the June 2023 and January 2024 VA examinations. The Veteran has been provided objective, controlled speech discrimination tests using the appropriate VA-approved Maryland CNC word list during his VA audiological examinations in June 2023 and January 2024. The speech discrimination test specifically assesses word comprehension and assigns a speech recognition ability percentage. The disability ratings are derived by a mechanical application of the rating schedule which incorporates both the puretone threshold average and the speech recognition ability percentage. Lendenmann, 3 Vet. App. at 349. The examination results establish no more than a noncompensable or zero percent disability rating for the left ear. The Board has considered the functional impact of the Veteran's disability and the results of the audiological examinations of record. Mechanical application of the Rating Schedule to the audiometric findings does not establish entitlement to a compensable disability rating at any point of the appeal period.

In Doucette v. Shulkin, 28 Vet. App. 366 (2017), the U.S. Court of Appeals for Veterans Claims held that the rating criteria for hearing loss contemplate the functional effects of decreased hearing and difficulty understanding speech in an everyday work environment, as these are precisely the effects that VA's audiometric tests are designed to measure. Thus, when a claimant's hearing loss results in an inability to hear or understand speech or to hear other sounds in various contexts, those effects are contemplated by the schedular rating criteria. The Veteran does not report symptoms associated with this disability that are not contemplated by the rating criteria or have otherwise been left uncompensated or unaccounted for by his assigned schedular rating. 38 C.F.R. §§ 4.85, 4.86, DC 6100. As such, referral for extraschedular consideration is not warranted.

In written argument attached to the February 2026 Notice of Disagreement, the Veteran's attorney contended that the Veteran should receive at least a 10 percent rating for his left ear hearing loss disability based on the January 2024 VA examination report. Specifically, the attorney stated:

Under 38 CFR 4.85 Evaluation of hearing impairment, [the January 2024 VA examination] lays out the following results under 38 CFR Table VI:  

"	Right ear has puretone threshold average of 40 with word recognition of 84% - Numeric designation - II

"	Left ear has puretone threshold average of 55dB with word recognition of 74% - Numeric designation V

Referencing Table VII, these numeric designations indicate at least a 10% disability rating. 

(Emphasis original). 

This contention by the attorney overlooks, however, that the Veteran is not service-connected for a hearing loss disability in the right ear.  As addressed above, if impaired hearing is service-connected in only one ear, in order to determine the percentage evaluation from Table VII, the non-service-connected ear will be assigned a Roman Numeral designation for hearing impairment of I. See 38 C.F.R. § 4.85(f). Once the Level I designation is applied to the results from the January 2024 VA examination for the right ear, the Veteran is appropriately assigned a zero percent or a noncompensable disability rating for his left ear hearing loss disability.

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?

In sum, the persuasive weight of the evidence is against the claim for a higher rating for the Veteran's left ear hearing loss disability. The impairment associated with this disability is contemplated by the rating criteria, which consider the average impairment resulting from a service-connected disability. See 38 U.S.C. § 1155; 
 ear will be assigned a Roman Numeral designation for hearing impairment of I. See 38 C.F.R. § 4.85(f). Once the Level I designation is applied to the results from the January 2024 VA examination for the right ear, the Veteran is appropriately assigned a zero percent or a noncompensable disability rating for his left ear hearing loss disability.

(Continued on the next page)

?

In sum, the persuasive weight of the evidence is against the claim for a higher rating for the Veteran's left ear hearing loss disability. The impairment associated with this disability is contemplated by the rating criteria, which consider the average impairment resulting from a service-connected disability. See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Absent audiometric and speech discrimination scores showing that the Veteran's left ear hearing loss disability meets the schedular criteria for an increased initial rating, any functional impairment does not warrant a higher rating than is already assigned. See 38 C.F.R. § 4.85; Lendenmann, 3 Vet. App. at 349. Thus, the benefit-of-the-doubt rule does not apply, and entitlement to an initial compensable disability rating for a left ear hearing loss disability is denied. See 38 U.S.C. § 5107; 38 C.F.R. § 4.3; 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)

 

 

A. ISHIZAWAR

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	D. Cheng, 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.