HEARING LOSS

Summary

The veteran, who served in the U.S. Navy from June 1973 to June 1977, appeals the denial of service connection for right ear hearing loss, claimed as secondary to service-connected tinnitus. The Board found that while the veteran has a current hearing loss and experienced noise exposure in service, the evidence did not establish a link to service or to his tinnitus. The veteran's MOS as a Cook and Communication Technician involved exposure to hazardous noise, and he reported pain and ringing in his ears during service. However, VA examinations in August 2017 and December 2025 found the right ear hearing loss unrelated to service, citing normal hearing sensitivity on entrance and discharge audiograms, and the immediate onset of acoustic trauma. The examiner noted the IOM study's limitations regarding delayed-onset hearing loss but found the veteran-specific audiometric data more persuasive. Regarding secondary service connection to tinnitus, the examiner found no scientific evidence that tinnitus causes or aggravates hearing loss. The Board afforded high probative weight to these December 2025 opinions, finding them well-reasoned and considering the veteran's lay statements and the IOM study's limitations. The Board noted the veteran's competence to report symptoms but found his lay testimony insufficient to establish etiology. Therefore, service connection for right ear hearing loss was denied, and the doctrine of reasonable doubt was not applied as the evidence weighed against the claim.

Rationale

Current disability established (bilateral hearing loss).; In-service event (noise exposure) established for left ear hearing loss and tinnitus.; Right ear hearing loss found unrelated to service based on audiograms and lack of delayed onset evidence.; Right ear hearing loss not caused or aggravated by service-connected tinnitus.

Full Decision Text

Citation Nr: 26002049
Decision Date: 02/12/26	Archive Date: 02/12/26

DOCKET NO. 18-39 691
DATE: February 12, 2026

ORDER

Entitlement to service connection for right ear hearing loss, to include as secondary to service-connected tinnitus, is denied.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that the Veteran's right ear hearing loss began during active service or is otherwise related to an in-service injury or disease.

2. The evidence of record persuasively weighs against finding that the Veteran's right ear hearing loss was caused or aggravated by his service-connected tinnitus.

CONCLUSION OF LAW

The criteria for entitlement to service connection for right ear hearing loss, to include as secondary to his service-connected tinnitus disability, have not been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.10.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Navy from June 1973 until

his honorable discharge in June 1977.  See June 1977 DD Form 214 (Certificate of

Release or Discharge from Active Duty).

This matter before the Board of Veterans' Appeals (Board) is on appeal from an

October 2017 rating decision of the Department of Veterans Affairs (VA) Regional

Office (RO), the Agency of Original Jurisdiction (AOJ).

The Veteran testified at a virtual hearing before the undersigned in September

2022.  A transcript of the proceeding is of record.

In February 2023, October 2024, April 2025, and December 2025 the Board remanded the case to the Regional Office for further development.  Specifically, the most recent Board remand directed the Regional Office to obtain adequate medical opinion(s).  In response, in December 2025, the Regional Office obtained new medical opinion(s).

The Board thus finds that the AOJ substantially complied with the remand directives in accordance with Stegall v. West, 11 Vet. App. 268, 271 (1998).

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service.  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a).  To establish a right to compensation for a present disability, an Appellant must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service - the so-called "nexus" requirement.  Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)).  Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303(d).

In addition, service connection for certain chronic diseases, may be established on a presumptive basis by showing that the condition manifested to a degree of 10 percent or more within one year from the date of separation from service.  38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258, 271-72 (2015).  Although the disease need not be diagnosed within the presumptive period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time.  38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a).

Additionally, for certain chronic diseases with potential onset during service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time.  If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim.  38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3
 lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time.  38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a).

Additionally, for certain chronic diseases with potential onset during service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time.  If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim.  38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Service connection may also be established on a secondary basis for a disability which is proximately due to, or the result of, a service-connected disability.  38 C.F.R. § 3.310(a).  Secondary service connection may also be established for a disorder which is aggravated by a service-connected disability; compensation may be provided for the degree of the disability (but only that degree) over and above the degree of disability existing prior to the aggravation.  38 C.F.R. § 3.310(b) (2017); Allen v. Brown, 8 Vet. App. 374 (1995).

Recently, in Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023), the Federal Circuit Court of Appeals held 38 U.S.C. § 1110 employs only "but-for" causation in direct and secondary service connection claims. Therefore, a service-connected disability need only be a contributing cause, not the contributing cause, to establish secondary service connection.

Entitlement to service connection for right ear hearing loss

The Appellant asserts that he is entitled to service connection for hearing loss.  See July 2017 VA Form 21-526EZ (Application for Disability Compensation and Related Compensation Benefits); see also March 2018 Notice of Disagreement (NOD).

As an initial matter, as these are related claims, the Board notes that during the pendency of this appeal, the Veteran was granted service connection for left ear hearing loss and tinnitus.  See June 2025 Rating decision; see also February 2023 Board decision (granting service connection for tinnitus).

For VA purposes, impaired hearing will be considered a disability when the auditory threshold for any of the frequencies of 500, 1000, 2000, 3000 and 4000 Hertz is 40 decibels or greater; the auditory thresholds for at least three of these frequencies are 26 decibels or greater; or speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385.

First, the Board finds that there is a current disability.  See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d).  The Veteran was afforded VA examinations in August 2017 and March 2023.  The VA examiners diagnosed the Veteran with bilateral hearing loss.  Additionally, the October 2017 Rating decision has found the Veteran to have bilateral hearing loss.

Second, the Board finds that there was an in-service event, injury or disease.  See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d).  The AOJ has determined that the Veteran sustained noise exposure in service sufficient to cause left ear hearing loss.  See June 2025 Rating decision; see also June 2025 VA examination.  The Veteran's Military Occupational Specialty (MOS) was Cook and Communication Technician exposed the Veteran to hazardous noise exposure.  During the June 2022 Hearing, the Veteran testified to being exposure to aircraft noise and needing to turn up the volume on his headphones and feeling pain and ringing in his ears in service subsequent to the noise exposure.  See Hearing Transcript pp. 5-7.  Affording the Veteran the benefit of the doubt, the Board finds that the second element of direct service connection, an in-service event, injury, or disease, has been met.

However, the Board finds that the evidence of record does not support a finding that the Veteran's right ear hearing loss is related to active service or to his service-connected tinnitus disability. 

Following the Board's December 2025 Remand, the new medical opinions were obtained regarding the Veteran's right ear hearing loss.  As to direct service connection, the examiner found the Veteran's right ear hearing loss to be unrelated to service because the Veteran's MOS has a low probability of noise exposure and the Veteran's audiograms at
 Transcript pp. 5-7.  Affording the Veteran the benefit of the doubt, the Board finds that the second element of direct service connection, an in-service event, injury, or disease, has been met.

However, the Board finds that the evidence of record does not support a finding that the Veteran's right ear hearing loss is related to active service or to his service-connected tinnitus disability. 

Following the Board's December 2025 Remand, the new medical opinions were obtained regarding the Veteran's right ear hearing loss.  As to direct service connection, the examiner found the Veteran's right ear hearing loss to be unrelated to service because the Veteran's MOS has a low probability of noise exposure and the Veteran's audiograms at entrance and discharge demonstrated normal hearing sensitivity.  The examiner noted the Veteran's reporting of onset of hearing loss in service but found the audiograms more persuasive given that they are the objective standard for determining noise injury, particularly because acoustic trauma on the auditory system is immediate or rapid in its onset.  The examiner noted the Institute of Medicine's (IOM) 2006 report regarding delayed onset hearing loss as well as the American College of Occupational Medicine Noise and Hearing Conservation Committee's finding that "[m]ost scientific evidence indicates that previously noise-exposed ears are not more sensitive to future noise exposure and that hearing loss from noise does not progress (in excess of what would be expected from the addition of age-related threshold shifts) once the exposure to noise is discontinued."  The examiner noted the Veteran's exposure to loud noises while in service, but found that based on the time of onset and what is known about the auditory system, the more likely cause of the Veteran's right ear hearing loss is post-service noise exposure or age-related changes in the auditory system.  The examiner noted the shortcomings of the IOM study, namely that there have been insufficient longitudinal studies to rule out delayed onset hearing loss, but that the study found that based on the evidence that is available, there is no sufficient scientific evidence to support delayed-onset noise-induced hearing loss in individuals who demonstrated normal hearing sensitivity immediately following the period of noise exposure, and the study's limitations do not outweigh the Veteran-specific audiometric data showing no in-service noise-induced change.

As to secondary service connection between the Veteran's right ear hearing loss and service-connected tinnitus, the examiner found the Veteran's right ear hearing loss was not caused or aggravated by his service-connected tinnitus.  In sum, the examiner reasoned that there is no current medical literature which supports the proposition that tinnitus causes or aggravates hearing loss.  The examiner noted that "[w]hile tinnitus is often a symptom associated with hearing loss, there is no scientific evidence that tinnitus itself leads to, worsens, or directly contributes to a decline in hearing thresholds."

The Board affords the December 2025 medical opinions high probative weight as they considered the Veteran's lay statements, explained the limitations of the IOM study when discussed within the rationale, and provided a well-reasoned rational that considered the specific circumstances of the Veteran's case.

The Board notes that the Veteran has reported experiencing hearing loss at the time of discharge.  While the Veteran is competent to report symptoms he personally perceived, he does not have the requisite medical expertise or training to establish an etiology of a medical condition.  See Layno v. Brown, 6 Vet. App. 465 (1994); see also Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006).

For the above reasons, entitlement to service connection for bilateral hearing loss is denied.

In reaching this decision the Board considered the doctrine of reasonable doubt, however, as the evidence persuasively weighs against the Veteran's claim, the doctrine is not for application.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

 

 

Gregory Deemer

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	D. Makarenko, Associate 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.