HEARING LOSS

WILLIAM H. DONNELLY · 2026 · Case ID: 26004888

DENIED

Summary

The veteran, an Army veteran who served from August 1985 to October 1989, appeals the denial of service connection for bilateral hearing loss and a bilateral eye disorder, including conjunctivitis, dry eye syndrome, and left eye optic nerve atrophy. The veteran claimed hearing loss was due to noise exposure from small arms fire and explosives during training, and that conjunctivitis was due to allergies and hay fever during service. The Board reviewed the veteran's DD-214, lay statements, and multiple VA audiological and ophthalmological examinations. For hearing loss, the Board found the private audiogram from August 2016 inadequate due to lack of Maryland CNC testing and inconsistency with later VA testing, and the VA audiological examination in July 2023 showed no current hearing loss meeting VA criteria. For the eye disorder, the Board noted prior denials of refractive error and focused on conjunctivitis, dry eye, and optic nerve atrophy. While service treatment records showed some eye irritation and prescriptions for allergies, the Board found no competent evidence linking these to service or to the later diagnoses of dry eye syndrome and optic nerve atrophy. VA examiners opined that the conditions were less likely than not related to service, citing the absence of in-service complaints or diagnoses and the multifactorial nature of dry eye. The Board found the VA examiner opinions probative and the evidence weighed against the claim. Service connection for both bilateral hearing loss and the bilateral eye disorder was denied.

Rationale

No current hearing loss disability for VA purposes.; VA audiological examination in July 2023 showed normal speech recognition and pure tone thresholds.; Private audiogram from August 2016 deemed inadequate as a matter of law and inconsistent with subsequent testing.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

18-01 188

Full Decision Text

Citation Nr: 26004888
Decision Date: 04/23/26 Archive Date: 04/23/26

DOCKET NO. 18-01 188
DATE: April 23, 2026

ORDER

Entitlement to service connection for bilateral hearing loss is denied.

Entitlement to service connection for a bilateral eye disorder, to include conjunctivitis, dry eye syndrome, and left eye optic nerve atrophy, is denied.

FINDINGS OF FACT

1. The Veteran does not have a current hearing loss disability for VA purposes.

2. The Veteran's bilateral eye disorder is not etiologically related to service or due to a service-connected disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for bilateral hearing loss are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for service connection for a bilateral eye disorder, to include conjunctivitis, dry eye syndrome, and left eye optic nerve atrophy, are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the U.S. Army from August 1985 to October 1989. These matters come to the Board of Veterans' Appeals (Board) on appeal from March 2016 and April 2018 rating decisions by the agency of original jurisdiction (AOJ) of the United States Department of Veterans Affairs (VA).

The Veteran testified at a February 2021 hearing held before a Veterans Law Judge (VLJ). A transcript of the hearing is associated with the claims file. The presiding VLJ is not available to participate in the adjudication of the claim, as required under 38 C.F.R. § 20.604, and so the Veteran was offered the opportunity for another hearing in January 2022. The Veteran responded in February 2022 and declined an additional hearing. Accordingly, the Board may proceed on the merits of the appeal without scheduling a new hearing.

In July 2021, June 2022, and June 2024, the Board remanded these matters for further evidentiary development. The matters are again before the Board. D'Aries v. Peake, 22 Vet. App. 97, 105 (2008); Stegall v. West, 11 Vet. App. 268, 271 (1998).

Service Connection

Service connection will be granted if it is shown that the Veteran suffers from a disability resulting from personal injury suffered or disease contracted in the line of duty, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty, during active military service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Disorders diagnosed after discharge will still be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d); see also Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994).

In order to establish service connection on a direct basis, the record must contain competent evidence of: (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Some chronic diseases may be presumed to have been incurred in service, if they become manifest to a degree of ten percent or more within the applicable presumptive period. 38 U.S.C. §§ 1101(3), 1112(a); 38 C.F.R. §§ 3.307(a), 3.309(a). For those listed chronic conditions, a showing of continuity of symptoms affords an alternative route to service connection. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F. 3d 1331 (Fed. Cir. 2013). Sensorineural hearing loss is an organic disease of the nervous system and is a listed chronic condition with a presumptive period of one year following separation from service.

Service connection may also be warranted for disability proximately due
the applicable presumptive period. 38 U.S.C. §§ 1101(3), 1112(a); 38 C.F.R. §§ 3.307(a), 3.309(a). For those listed chronic conditions, a showing of continuity of symptoms affords an alternative route to service connection. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F. 3d 1331 (Fed. Cir. 2013). Sensorineural hearing loss is an organic disease of the nervous system and is a listed chronic condition with a presumptive period of one year following separation from service.

Service connection may also be warranted for disability proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). This permits service connection not only for a disability caused by a service-connected disability, but for the degree of disability resulting from aggravation of a disability by a service-connected disability. See Allen v. Brown, 7 Vet. App. 439, 448 (1995). In the case of aggravation by a service-connected disability, a Veteran may be compensated for the degree of disability over and above the degree of disability existing prior to the aggravation. Id.; see also 38 C.F.R. § 3.310(b).

In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether the weight of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant.

Bilateral Hearing Loss:

The Veteran contends that she is entitled to service connection for bilateral hearing loss. She asserts that her claimed bilateral hearing loss was caused by noise exposure from small arms fire and explosives during training.

As referenced by the Board in July 2021, the Veteran's DD-214 reflects that she is in receipt of expert badges for the M-16 rifle and hand grenade. In correspondence dated October 2021, the Veteran endorsed difficulty hearing clearly. She stated that unless someone was within close proximity to her, she was unable to hear them clearly as it would just be a muffled sound. The Veteran further reported that she had to increase the volume on her television to hear it, and that some people would speak louder so that she could hear them.

Regulations require an auditory threshold at 500, 1000, 2000, 3000, or 4000 Hertz of 40 decibels or greater; or auditory thresholds for at least three of those frequencies at 26 decibels or greater; or speech recognition scores using the Maryland CNC Test of less than 94 percent, in order to establish a hearing loss disability for VA purposes. 38 C.F.R. § 3.385. Importantly, the numerical requirements mean that lay evidence is insufficient to establish a hearing loss disability for VA purposes; specialized testing is required under 38 C.F.R. § 4.85. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011).

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. 38 C.F.R. § 4.85(a).

The record reflects the Veteran was afforded a VA audiological examination in July 2023. The pure tone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 10 10 10 20 20

LEFT 5 15 10 20 15

Maryland CNC speech audiometry revealed speech recognition ability of 96 percent in the right ear and 94 percent in the left ear.

There are no other probative reports of audiological examinations during the relevant period. The Board acknowledges that the record contains a private audiogram dated August 2016, which the Board, in its June 2024 remand, characterized as demonstrative of hearing loss for VA purposes. The Board is bound by favorable determinations made by the AOJ or Board unless, however, shown to be clearly and unmistakably erroneous. 38 C.F.R. § 3.104(c). Such is the case here. As there is no indication that this audiometry test used the Maryland CNC word list, it is inadequate as a matter of law. 38 C.F.R. § 4.85. Further, its findings are inconsistent with the progressive and chronic nature of the disability in light of the subsequent and valid testing performed in July 2023. Consequently, there is no competent evidence that the Veteran has a current disability of hearing loss for VA purposes. 38 C.F.R. § 3.385.

Despite subjective complaints of hearing problems, the record does not establish a current hearing loss disability for VA purposes. 38 C.F.R. § 3.385. In the absence of a current disability, there is no valid claim, and service connection is not warranted. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

Bilateral Eye Disorder:

The Veteran contends that she is entitled to service connection for an eye disorder. The Veteran asserts that her conjunctivitis occurred when she had allergies and hay fever during service. She stated that she was treated for allergies and eye disorders during service on several occasions and that she took over the counter Visine for associated "red eye." The Veteran reported that she occasionally experienced problems with conjunctivitis at least twice a year that was sometimes accompanied by frequent allergy attacks. The Veteran stated that since her separation from service, she has continued to experience painful, swollen, red eyes that are sensitive to light with blurred vision.

At the outset, the Board notes that in its June 2024 decision, entitlement to service connection for a bilateral eye refractive error, to include myopia and astigmatism, was denied. In so finding, the Board determined that the Veteran did not have a superimposed disease or injury during service with respect to the refractive error. Therefore, the issue before the Board is to determine whether service connection is warranted for the Veteran's other eye disorders of conjunctivitis, dry eye syndrome, and left eye optic nerve atrophy.

Service treatment records reflect that the Veteran was assessed with defective vision at an April 1985 enlistment examination. The Board notes that in a Report of Medical History upon enlistment, the Veteran reported that she had vision in both eyes, did not wear glasses or contact lenses, and denied eye trouble. At an optometry consultation on the same date, the Veteran was assessed with myopia, which was reviewed and considered in the Veteran's profile. In August 1985, the Veteran underwent an eye consultation and was provided with an eye glass prescription. Thereafter, service treatment records dated June 1986 reflect that the Veteran complained of a cold with running, itchy eyes with some swelling. The Veteran was provided with lozenges for her cold. In an undated treatment note, it was reported that the Veteran complained of sore throat, sneezing, and watery eyes for two days. It was noted that the Veteran was seen for a sore throat six days prior. On physical examination, a runny, stuffy nose was noted, and that a white spot in the rear of the throat as well as a slightly swollen left lymph node were also observed. The Veteran was assessed with a cold and possible virus, and was prescribed lozenges, aspirin, and eye drops. In August 1987, the Veteran underwent a subsequent eye consultation and was assessed with simple myopia with astigmatism. As the Veteran wore contact lenses, she was provided with a prescription for eyeglasses at a January 1989 eye consultation. Upon separation from service, myopia continued to be identified as well as corrected vision at a September 1989 separation examination. In a Report of Medical History at separation, the Veteran denied eye trouble.

Pursuant to the Board's remand in July 2021, the Veteran was afforded a VA examination in December 2021. The Veteran reported that her eye symptoms started around 1986 with symptoms of dry, photophobic, swollen, itchy,
In August 1987, the Veteran underwent a subsequent eye consultation and was assessed with simple myopia with astigmatism. As the Veteran wore contact lenses, she was provided with a prescription for eyeglasses at a January 1989 eye consultation. Upon separation from service, myopia continued to be identified as well as corrected vision at a September 1989 separation examination. In a Report of Medical History at separation, the Veteran denied eye trouble.

Pursuant to the Board's remand in July 2021, the Veteran was afforded a VA examination in December 2021. The Veteran reported that her eye symptoms started around 1986 with symptoms of dry, photophobic, swollen, itchy, red, and irritated eyes. The Veteran stated that she tried many different eyedrops, to include tears, as well as NSAIDs and antihistamines. She noted that she also tried punctal plugs, but was not sure if it really helped. The examination report referenced a March 2019 diagnosis of dry eye, May 2018 diagnosis of conjunctivitis, and December 2021 diagnosis of optic atrophy. Nevertheless, as noted by the Board in June 2022, the VA examiner subsequently indicated in the examination report that dry eye syndrome had its onset in 1989 with no explanation provided to support the conclusion. Further, in rendering a negative nexus opinion, the VA examiner appeared to rely upon an absence of documented complaints or treatment. A medical opinion based solely on the absence of documentation in the record is inadequate and the medical opinion is inadequate if it does not take into account the Veteran's reports of symptoms and history (even if recorded in the course of the examination). Dalton v. Peake, 21 Vet. App. 23 (2007). Due to the inadequacies of the VA examination report and opinion, the Board, in June 2022, directed that another VA medical opinion (and examination if necessary) be obtained.

The Veteran was afforded a subsequent VA examination in December 2022, which was performed by the same VA examiner. The Veteran reported that her eye discomfort from dry eye and conjunctivitis started around 1986, and that optic nerve atrophy was diagnosed in December 2021. She further endorsed a gradual onset of ocular discomfort with environmental allergies, but did not provide the VA examiner with onset details for her optic nerve atrophy. The Veteran stated that she experienced current symptoms of dry, photophobic, swollen, itchy, red, and irritated eyes. Contrary to the prior December 2021 VA examination report, the VA examiner indicated an onset date of March 2019 for dry eye syndrome.

The VA examiner opined that chronic conjunctivitis is an additional symptom of allergies, and that allergic rhinitis and allergic conjunctivitis have the same cause, and are both common symptoms of environmental allergies. Nevertheless, the VA examiner indicated that there was no evidence of conjunctivitis during the Veteran's service, but rather is related to the Veteran's chronic allergy symptoms. The VA examiner further opined that dry eye is not caused by or aggravated by allergic rhinitis, as they are separate and distinct diagnoses. The VA examiner further indicated that there was no evidence of dry eye during service. Concerning optic nerve atrophy, the VA examiner opined that the disability did not have its onset during service and is not otherwise related to service. The VA examiner noted that there was no evidence of optic nerve atrophy during service, and that the diagnosis came much later. As with dry eye, the VA examiner similarly opined that optic nerve atrophy was not caused by or aggravated by allergic rhinitis, as they are separate and distinct diagnoses that do not relate to each other.

The VA examiner submitted an addendum opinion in August 2023 and associated with the claims file in September 2023. The VA examiner opined that there was no nexus to connect optic nerve atrophy to service, as there was no mention of the disability prior to its diagnosis, and that there is no mechanism to connect allergies to optic nerve atrophy. The VA examiner further opined that many have concurrent ocular allergies and dry eye, and that symptoms of the two disorders often overlap. The VA examiner opined that the Veteran's allergic rhinitis would be related to any ocular allergy as well, as patients often have both, and that the Veteran had taken antihistamine eyedrops in the past for allergic conjunctivitis. The VA examiner further opined that dry eye syndrome has several etiologies that are multifactorial and "not easy" to delineate, as they include hormones, meibomian gland dysfunction, allergic reactions, systemic inflammatory conditions, and medications. The
and that there is no mechanism to connect allergies to optic nerve atrophy. The VA examiner further opined that many have concurrent ocular allergies and dry eye, and that symptoms of the two disorders often overlap. The VA examiner opined that the Veteran's allergic rhinitis would be related to any ocular allergy as well, as patients often have both, and that the Veteran had taken antihistamine eyedrops in the past for allergic conjunctivitis. The VA examiner further opined that dry eye syndrome has several etiologies that are multifactorial and "not easy" to delineate, as they include hormones, meibomian gland dysfunction, allergic reactions, systemic inflammatory conditions, and medications. The VA examiner indicated that there was no clear event to show a causative event of dry eye, and that many patients have concurrent ocular allergies and dry eye.

Pursuant to the Board's most recent June 2024 remand, a VA medical opinion was obtained in September 2024. The VA examiner opined that the Veteran's claimed eye disorders are less likely than not caused by service. The VA examiner indicated that there was no objective evidence that any of the Veteran's complaints were caused by service, as they had all occurred after separation. The VA examiner further opined that the Veteran's eye disorders are less likely than not proximately due to or the result of a service-connected disability, or aggravated beyond their natural progression by a service-connected disability. The VA examiner referenced two normal in-service ocular examinations aside from a documented refractive error.

In addendum opinions obtained in January 2025 and April 2025, the VA examiner noted that the Veteran had an episode of watery eyes when she had an attack of allergic rhinitis during service. The VA examiner indicated that the cause for the watery eyes was that it was a reaction to allergens causing irritation and itchiness and not a lack of tear production as in dry eye syndrome. The VA examiner stated that the cause of the watery eyes were allergies and not dry eyes, which was why the drops and other remedies did not work. The VA examiner reported that the treatment should have been directed at the allergies. The VA examiner further indicated that there were no other complaints of dry eyes during service, and that her symptoms were related to allergies and not dry eyes. The VA examiner opined that allergic rhinitis does not typically cause optic atrophy aside from particularly rare instances of fungal infections, which was not the case for the Veteran. The VA examiner further reported that the Veteran had two ophthalmic examinations that showed normal conjunctiva and no evidence of any chronic allergic conjunctivitis. Therefore, the VA examiner opined that the claimed disability was less likely than not caused by service-connected allergic rhinitis.

The VA examiner further opined that there was no evidence that the Veteran's claimed eye disorders were aggravated by service-connected allergic rhinitis. The VA examiner referenced service treatment records dated June 1986 and noted that the Veteran was not assessed as to her eye symptoms as it was in the context of a cold. The VA examiner also highlighted the Veteran's September 1989 separation examination in which the Veteran denied eye trouble. The VA examiner indicated that complaints of eye swelling and irritation in post-service treatment records were assessed in the context of allergic rhinitis. The VA examiner drew attention to treatment records dated June 2016 that noted the Veteran's reports of itchy eyes, with normal extraocular movements, pupils, conjunctiva, no hyperemia of the conjunctiva, and no discharge from the conjunctiva on eye examination. The findings of a private October 2015 RAST (radioallergosorbent) test and post-service diagnoses of rhinitis and food allergy were also cited in reference to the Veteran's lay assertions of an increase in symptoms following service. Consequently, the VA examiner opined that the record showed that the Veteran's service-connected rhinitis had associated eye symptoms that are not associated with the Veteran's current claimed eye disorders.

The Board finds that the opinions of the December 2022 and September 2024 VA examiners, when read together with their respective addendums during the appellate period, are entitled to probative weight, as the opinions considered and addressed the Veteran's lay statements, were based on the Veteran's treatment histories, and provided sufficient supporting rationales for the opinions, as well as considered all applicable possible theories. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Further, there are no probative opinions to the contrary.

The Veteran has asserted a belief in a connection, but has offered no competent evidence in support of this belief. She is a lay person, and not
Board finds that the opinions of the December 2022 and September 2024 VA examiners, when read together with their respective addendums during the appellate period, are entitled to probative weight, as the opinions considered and addressed the Veteran's lay statements, were based on the Veteran's treatment histories, and provided sufficient supporting rationales for the opinions, as well as considered all applicable possible theories. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Further, there are no probative opinions to the contrary.

The Veteran has asserted a belief in a connection, but has offered no competent evidence in support of this belief. She is a lay person, and not competent to offer a probative opinion on nexus in these matters. Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011).

(Continued on the next page)

In sum, the evidence is against the claim. The Veteran's conjunctivitis, dry eye syndrome, and optic nerve atrophy did not manifest until well after active service and are not otherwise shown to be related to service or service-connected allergic rhinitis. As there is no competent and credible evidence to support any finding of a nexus between active service or service-connected allergic rhinitis and the aforementioned eye disorders, service connection for the claimed disability is not warranted.

WILLIAM H. DONNELLY

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board G.A. Ong, 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.

Analyze in VA Law Explorer