13-06 684, 13-06 684

Veteran served on active duty Apr 1989–Jul 1991 and appealed VA RO April 2011 rating decision; Board remanded in Sept 2015 and returned for appellate review.
Two main claims on appeal: (1) initial compensable rating for status-post fracture of the distal fifth right metacarpal (right little finger/hand); (2) initial rating in excess of 10% for bilateral hearing loss.
VA obtained examinations for hand/finger (May 2010, Mar 2013, Feb 2016) and audiometric exams (May 2010, Feb 2016); Board found exam reports adequate and VCAA duties satisfied.
Hand evidence: complaints of pain, tenderness, visible deformity, occasional grip weakness and functional difficulty with fine tasks, but objective testing showed full range of motion in digits, generally preserved grip strength, no ankylosis, and examiners concluded pain did not cause functional loss.
Hearing evidence: pure tone and speech discrimination testing in 2010 and 2016 produced audiometric profiles that map to non‑compensable schedular ratings under DC 6100 and Tables VI/VII; no exceptional pattern met.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Initial compensable rating for right distal 5th metacarpal (little finger)	Veteran argues pain, deformity, reduced grip cause greater functional loss and warrant a compensable rating or equivalent amputation rating	VA contends exams show preserved range of motion/grip, no ankylosis, and pain does not produce functional loss sufficient for a compensable rating or amputation equivalent	Denied — preponderance shows no compensable rating available under applicable DCs; not equivalent to amputation
Initial rating >10% for bilateral hearing loss	Veteran contends audiometric results warrant >10% combined rating	VA contends audiometric scores and speech discrimination map to non‑compensable (0%) under DC 6100; no exceptional pattern	Denied — audiometric testing corresponds to non‑compensable ratings for entire appeal period

Scott v. McDonald, 789 F.3d 1375 (Fed. Cir.) (staged ratings and claims for increase principles)
Mayfield v. Nicholson, 444 F.3d 1328 (Fed. Cir.) (VCAA notice requirements)
Vazquez-Flores v. Shinseki, 580 F.3d 1270 (Fed. Cir.) (notice for increase claims)
Barr v. Nicholson, 21 Vet. App. 303 (exam adequacy standard)
Martinak v. Nicholson, 21 Vet. App. 447 (requirement that exam address functional effects)
Stefl v. Nicholson, 21 Vet. App. 120 (adequacy of examiner rationale and consideration of history)
DeLuca v. Brown, 8 Vet. App. 202 (consideration of functional loss from pain, weakness, fatigability)
Mitchell v. Shinseki, 25 Vet. App. 32 (pain-caused limitation and rating analysis)
Lendenmann v. Principi, 3 Vet. App. 345 (mechanical application of audiometric tables)
Sowers v. McDonald, 27 Vet. App. 472 (limitations on applying minimum compensable rating under §4.59)
Butts v. Brown, 5 Vet. App. 532 (appropriate selection of diagnostic code and equivalence to amputation)