HEARING LOSS

Summary

The Veteran served in the Missouri Army National Guard from February to June 1970 on active duty for training. The Veteran was granted service connection for bilateral hearing loss in August 2025 with a noncompensable rating. The Veteran sought an initial compensable rating for this condition. A July 2025 VA audiological examination revealed puretone thresholds indicating a Level II impairment for the right ear and Level IV for the left ear, with speech discrimination scores of 86% and 82% respectively. The Veteran reported functional impairments, including difficulty hearing in noisy environments and understanding speech at a distance. A June 2025 private audiogram was deemed inadequate for rating purposes as it was completed by a hearing instrument specialist and used an inappropriate word list. The Board found that the Veteran's hearing loss did not meet the criteria for a compensable rating based on the VA examination results and the application of Tables VI and VII of 38 C.F.R. § 4.85. The Board concluded that the evidence weighed against a compensable rating, rendering the benefit of the doubt doctrine inapplicable. Therefore, entitlement to an initial compensable disability rating for bilateral hearing loss was denied.

Rationale

VA audiological examination results calculated to Level II (right ear) and Level IV (left ear) impairment.; Speech discrimination scores of 86% (right) and 82% (left) were within normal limits for rating purposes.; Private audiogram deemed inadequate for rating purposes.; Functional impairments reported by the Veteran are contemplated by the schedular criteria.

Full Decision Text

Citation Nr: A26040743
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 260331-642738
DATE: April 30, 2026

ORDER

An initial compensable disability rating for the service-connected bilateral hearing loss disability is denied.

FINDING OF FACT

The Veteran's service-connected bilateral hearing loss disability approximates a hearing impairment of no greater than Level II for the right ear and Level IV for the left ear.

CONCLUSION OF LAW

The criteria for an initial compensable disability rating for the service-connected bilateral hearing loss disability are not met.  38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86, Diagnostic Code 6100.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active duty for training (ACDUTRA or ADT) from February to June 1970, with additional service in the Missouri Army National Guard.

This case is before the Board of Veterans' Appeals (Board) on appeal from a March 5, 2026, Department of Veterans Affairs (VA) Regional Office (RO) Higher-Level Review (HLR) rating decision.  In that decision, the RO denied entitlement to an initial compensable disability rating for the service-connected bilateral hearing loss disability.

By way of history, in an August 2, 2025, rating decision, the RO granted service connection for a bilateral hearing loss disability and assigned an initial noncompensable disability rating, effective from July 7, 2025.  On February 25, 2026, VA received the Veteran's VA Form 20-0996 Decision Review Request: Request for HLR.  Thereafter, the RO issued the March 5, 2026, rating decision.

On March 31, 2026, VA received the Veteran's VA Form 10182 Decision Review Request: Notice of Disagreement (NOD).  The Veteran selected the Direct Review docket.  The NOD specified the March 5, 2026, HLR rating decision, rather than the March 10, 2026, rating decision discussed below, and identified only the issue of increased rating for bilateral hearing loss.

Therefore, the Board will decide the appeal based on the evidence of record at the time of the August 2, 2025, rating decision reviewed by the March 5, 2026, HLR rating decision.  38 C.F.R. § 20.301.

Next, while the Board is cognizant of Williams v. McDonough, 37 Vet. App. 305 (2024), it should be noted that there is no indication that the Veteran wishes to switch dockets, and it is in the Veteran's interest to issue a decision as early as possible due to his advanced age.  Doing so will also enable the Veteran to more promptly continue to pursue the claim following this decision if he so wishes.  Furthermore, the Veteran's attorney representative, who signed and submitted the NOD, is presumed to be aware of the ability to switch dockets.

Finally, following the March 5, 2026, HLR rating decision, in a March 10, 2026, rating decision, the RO granted service connection for vertigo and combined the hearing loss and vertigo into a single disability rated under 38 C.F.R. § 4.87, Diagnostic Code 6205.  The RO assigned an initial disability rating of 30 percent for the combined disability, effective from December 2, 2025, discontinuing the noncompensable rating for the bilateral hearing loss disability as of that date, with the 30 percent rating assigned under Diagnostic Code 6205, in part, based on hearing impairment.  However, the August 2, 2025, rating decision reviewed by the March 5, 2026, rating decision was issued four months prior to the effective date of the combined disability.  Here, the initial rating for bilateral hearing loss remains in effect from July 7 to December 2, 2025, and as such, the present decision may consider assignment of a higher initial rating for bilateral hearing loss as of the August 2, 2025, rating decision.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider regarding claim(s) that have been denied by this decision in whole or in part, he 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
 of the combined disability.  Here, the initial rating for bilateral hearing loss remains in effect from July 7 to December 2, 2025, and as such, the present decision may consider assignment of a higher initial rating for bilateral hearing loss as of the August 2, 2025, rating decision.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider regarding claim(s) that have been denied by this decision in whole or in part, he 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[s], considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a Supplemental Claim are included with this decision.

Increased Rating

Entitlement to an initial compensable disability rating for the service-connected bilateral hearing loss disability.

Disability ratings are determined by applying the criteria set forth in VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity.  Individual disabilities are assigned separate diagnostic codes.  See 38 U.S.C. §1155; 38 C.F.R. § 4.1.  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 for that rating.  Otherwise, the lower rating will be assigned.  See 38 C.F.R. § 4.7.  Any reasonable doubt regarding a degree of disability will be resolved in favor of the veteran.  38 C.F.R. § 4.3.  When the evidence is in relative equipoise, the veteran is accorded the benefit of the doubt.  38 U.S.C. § 5107(b).

When an appeal arises from the initially assigned disability rating, consideration must be given as to whether staged ratings should be assigned to reflect entitlement to a higher rating at any point during the pendency of the claim.  Fenderson v. West, 12 Vet. App. 119 (1999).  Moreover, staged ratings are appropriate in any increased-rating claim in which distinct time periods with different ratable symptoms or differing levels of severity can be identified.  Hart v. Mansfield, 21 Vet. App. 505 (2007).

Impaired hearing is defined as a disability under VA law when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels (dB) 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.  The threshold for normal hearing is from 0 to 20 decibels; higher threshold levels indicate some degree of hearing loss.  Hensley v. Brown, 5 Vet. App. 155, 157 (1993).

Evaluations of defective hearing range from noncompensable to 100 percent based on the organic impairment of hearing acuity.  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.  38 C.F.R. § 4.85(a).

Hearing impairment is measured by the results of controlled speech discrimination tests together with the average hearing threshold levels (which in turn, are measured by pure tone audiometric tests in the frequencies of 1000, 2000, 3000 and 4000 cycles per second (Hertz)).  See Lendenmann v. Principi, 3 Vet. App. 345, 349 (1992) (defective hearing is rated based on a mere mechanical application of the rating criteria).  The provisions of 38 C.F.R. § 4.85 establish eleven auditory acuity levels from I to XI. Table VI calculates the numeric designation of hearing impairment based on puretone threshold average and speech discrimination.  The designated Roman numeral is located at the point on the chart where the percentage of speech discrimination (horizontal rows) and puretone threshold average (vertical columns) intersect.

Table VIa calculates the numeric designation of hearing impairment based only on puretone threshold average; and, it is used when the examiner certifies that the use of the speech discrimination test is not appropriate because of language difficulties, inconsistent speech discrimination
, 349 (1992) (defective hearing is rated based on a mere mechanical application of the rating criteria).  The provisions of 38 C.F.R. § 4.85 establish eleven auditory acuity levels from I to XI. Table VI calculates the numeric designation of hearing impairment based on puretone threshold average and speech discrimination.  The designated Roman numeral is located at the point on the chart where the percentage of speech discrimination (horizontal rows) and puretone threshold average (vertical columns) intersect.

Table VIa calculates the numeric designation of hearing impairment based only on puretone threshold average; and, it is used when the examiner certifies that the use of the speech discrimination test is not appropriate because of language difficulties, inconsistent speech discrimination scores, etc., or when indicated under 38 C.F.R. § 4.86 (cases involving exceptional patterns of hearing impairment as explained below).

For cases involving exceptional patterns of hearing impairment, the schedular criteria provides that, 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.  38 C.F.R. § 4.86(a).  Each ear is evaluated separately.  Additionally, when the pure tone threshold is 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.  38 C.F.R. § 4.86(b).  Each ear will be evaluated separately.

After the appropriate Roman numeral is designated for each ear, these Roman numerals are applied to Table VII to ascertain the corresponding rating.  If hearing loss is service-connected for 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.  38 C.F.R. § 4.85(f).

During a July 2025 VA audiological examination, an audiogram revealed puretone thresholds (in decibels) as follows:

Hertz	1000 Hz	2000 Hz	3000 Hz	4000 Hz

Right	35	30	55	70

Left	35	35	65	75

Average puretone thresholds were 47.50 dB for the right ear and 52.50 dB for the left ear.  Speech discrimination testing using the Maryland CNC word list revealed scores of 86 percent for the right ear and 82 percent for the left ear.  The examiner certified that puretone test results were valid and that use of speech discrimination testing was appropriate.  Functional impairments reported by the Veteran included difficulty hearing noise when more than one person is talking, needing to rely more on visual cues, and difficulty understanding if the speaker is wearing a mask.  He reported understanding male voices more easily than female voices.  He had difficulty understanding a speaker at a distance of greater than 6 feet.  The examiner suggested that the Veteran's difficulty in localizing sounds would pose a safety risk in some occupational environments.  The examiner noted that the Veteran did require hearing aids.

Next, also of record is a June 2025 private audiogram submitted on July 7,2025.  However, this audiogram was completed by a hearing instrument specialist rather than a state-licensed audiologist.  Furthermore, speech discrimination testing accompanying that audiogram used the NU-6 word list rather than the Maryland CNC word list.  Accordingly, the June 2025 private audiogram is inadequate for rating purposes.  See 38 C.F.R. § 4.85.  

Here, the Veteran does not present with an exceptional pattern of hearing loss.

Application of the puretone threshold averages and speech discrimination scores from the July 2025 audiological examination to 38 C.F.R. § 4.85, Table VI, results in a numerical hearing impairment of Level II for the right ear and Level IV for the left ear.  Combining numerical impairments of Level II for the right ear and Level IV for the left ear using 38 C.F.R. § 4.85, Table VII, results in a noncompensable disability rating.  Impairment is derived primarily from a mechanical formula based on levels of puretone threshold average and speech discrimination.  See Lendenmann, 3 Vet. App. at 345. As noted above, the Veteran has reported impairments such as difficulty hearing speech.  However, functional impairment such as difficulty hearing speech is contemplated by
 38 C.F.R. § 4.85, Table VI, results in a numerical hearing impairment of Level II for the right ear and Level IV for the left ear.  Combining numerical impairments of Level II for the right ear and Level IV for the left ear using 38 C.F.R. § 4.85, Table VII, results in a noncompensable disability rating.  Impairment is derived primarily from a mechanical formula based on levels of puretone threshold average and speech discrimination.  See Lendenmann, 3 Vet. App. at 345. As noted above, the Veteran has reported impairments such as difficulty hearing speech.  However, functional impairment such as difficulty hearing speech is contemplated by the schedular criteria for hearing loss.  See Doucette v. Shulkin, 28 Vet. App. 366 (2017).  Accordingly, there is no basis for consideration of an extraschedular rating.

Based on the foregoing, the evidence persuasively weighs against assignment of an initial compensable disability rating for the service-connected bilateral hearing loss disability.  Accordingly, a compensable disability rating is not warranted, and the benefit of the doubt doctrine is inapplicable.  38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

 

 

L. B. CRYAN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	D. Small, Attorney Advisor

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.