TINNITUS

Summary

The Veteran served in the United States Marine Corps from August 1974 to April 1976. The Veteran appealed the denial of service connection for bilateral hearing loss and sought service connection for tinnitus. The Board granted service connection for tinnitus, finding it to be a chronic condition with continuity of symptomatology, supported by the Veteran's credible lay testimony and a favorable VA examiner opinion linking it to noise exposure. The VA examiner opined the tinnitus was at least as likely as not caused by military noise exposure due to the Veteran's MOS as an engineer and denial of prior tinnitus. The Board found the Veteran's statements regarding tinnitus credible. However, service connection for bilateral hearing loss was denied. While the RO made favorable findings that the Veteran had bilateral hearing loss and was exposed to noise during service, the March 2023 VA examiner opined the hearing loss was less likely than not related to service. This opinion was based on the Veteran's service treatment records showing normal hearing at enlistment and separation, with no significant permanent shift or complaints of hearing loss. The Board found the evidence weighed against the claim, and the benefit of the doubt doctrine did not apply as the preponderance of evidence was against the claim.

Rationale

Chronic disease under 38 C.F.R. § 3.309(a); Continuity of symptomatology established; Favorable VA examiner opinion linking to noise exposure

Full Decision Text

Citation Nr: A25070499
Decision Date: 08/20/25	Archive Date: 08/20/25

DOCKET NO. 230420-341423
DATE: August 20, 2025

ORDER

Service connection for tinnitus (claimed as ringing in ears) is granted.

Service connection for bilateral hearing loss is denied. 

FINDINGS OF FACT

1. The Veteran's bilateral tinnitus had its onset during service and continued since that time. 

2. The Veteran's bilateral hearing loss was not incurred in or caused by an event during military service; was not shown as chronic in service and did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury or disease.

CONCLUSIONS OF LAW

1. The criteria for service connection for tinnitus are met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for bilateral hearing loss are not met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Marine Corps from August 1974 until his discharge under honorable conditions in April 1976. 

This matter is before the Board of Veterans' Appeals (Board) on appeal of an April 2023 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).

Given the date of the rating decision on appeal, the Veteran's appeal is governed by the modernized review system, known by the Board as the AMA.  38 C.F.R. §§ 3.2400, 19.2. 

In his April 20, 2023, Notice of Disagreement to the Board, the Veteran selected the evidence docket.  Accordingly, the Board may only review evidence of record at the time of the rating decision on appeal, and that which was submitted with the Notice of Disagreement or within 90 days of its receipt.  38 C.F.R. § 20.303.

Therefore, the Board may only consider the evidence of record at the time of the April 2023 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 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 claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Service connection for tinnitus (claimed as ringing in ears).

The Veteran is seeking service connection for tinnitus. See October 2022 VA 21-526EZ, April 2023 VA 10182, and September 2023 Appellate Brief. 

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303.  The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

Under section 3.310(a) of VA regulations, service connection may be established on a secondary basis for a disability which is due to or the result of service-connected disease or injury. 38 C.F.R. § 3.
 5107; 38 C.F.R. § 3.303.  The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

Under section 3.310(a) of VA regulations, service connection may be established on a secondary basis for a disability which is due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) caused by or (b) aggravated by a service-connected disability.  Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc); see also Spicer v. McDonough, 61 F.4th 1360, 1363 (Fed. Cir. 2023) (invalidating the requirement of "proximate cause" and instead held a "but for" causation or aggravation is enough to show entitlement to secondary service connection).

Certain chronic diseases will be presumed related to service if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service, with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

Tinnitus is recognized by VA as a "chronic disease" under 38 C.F.R. § 3.309 (a), such that the presumptive provisions of 38 C.F.R. §§ 3.303 (b), 3.307, and 3.309 apply. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258 (2015).

During the March 2023 VA examination, the Veteran reported recurrent tinnitus since 1975 during his active service. The tinnitus started in his right ear only but now it is bilateral. The examiner opined that the Veteran's tinnitus was at least as likely as not caused by or a result of military noise exposure. The rationale was that the Veteran denied tinnitus prior to induction to military service, and he was exposed to excessive noise during service as an engineer which has a high probability of hazardous noise exposure. 

Tinnitus is a condition capable of lay observation.  See Charles v. Principi, 16 Vet. App. 370 (2002).  The Veteran's assertion of tinnitus is competent evidence, and the Board has no reason to doubt the credibility of such assertion.  In this case, the Board finds the Veteran is competent to report the symptoms he experienced, and the Board finds his statements about tinnitus credible. See Layno v. Brown, 6 Vet. App. 465 (1994); see also Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).  The Veteran reported that his tinnitus began in 1975 during his active service, has continued, and even spread from only one ear to both since then. See March 2023 VA examination.

Given that tinnitus (organic disease of the nervous system) is a chronic disease under 38 C.F.R. § 3.309(a), an award of service connection is appropriate based on evidence of continuity of symptomatology.  Walker v. Shinseki, 708 F.3d 1331, 1336-40 (Fed. Cir. 2013). 

Accordingly, service-connection for tinnitus is granted. 

1. Service connection for bilateral hearing loss.

The Veteran is seeking service connection for bilateral hearing loss. See December 2022 VA 21-526EZ, April 2023 VA 10182, and September 2023 Appellate Brief.

The Veteran is seeking service-connection for bilateral sensorineural hearing loss and tinnitus. See March 2021 VA 21-526EZ and July 2021 VA 10182. 

Service connection for certain chronic diseases, including sensorineural
atology.  Walker v. Shinseki, 708 F.3d 1331, 1336-40 (Fed. Cir. 2013). 

Accordingly, service-connection for tinnitus is granted. 

1. Service connection for bilateral hearing loss.

The Veteran is seeking service connection for bilateral hearing loss. See December 2022 VA 21-526EZ, April 2023 VA 10182, and September 2023 Appellate Brief.

The Veteran is seeking service-connection for bilateral sensorineural hearing loss and tinnitus. See March 2021 VA 21-526EZ and July 2021 VA 10182. 

Service connection for certain chronic diseases, including sensorineural hearing loss, 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 presumption 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).

For the showing of chronic disease in 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).

For the purposes of applying the laws administered by VA, impaired hearing is considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, and 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of those frequencies 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. It has been established that 38 C.F.R. § 3.385 does not preclude service connection for a current hearing disability where hearing was within normal limits on audiometric testing at separation from service if there is sufficient evidence to demonstrate a medical relationship between the Veteran's in-service exposure to loud noise and current disability. See Hensley v. Brown, 5 Vet. App. 155 (1993).

The RO made favorable findings that 1) the Veteran has been diagnosed with a disability as the March 2023 Disability Benefits Questionnaire showed bilateral hearing loss; and 2) that the Veteran was exposed to high probable noise during his military service based on his military occupational series engineer, construction, facilities, and equipment. See April 2023 Rating Decision. The Board is bound by these favorable findings. 38 C.F.R. § 3.104(c). Thus, the question becomes whether the Veteran's current bilateral hearing loss is related to his in-service noise exposure.

The March 2023 VA examiner opined that the Veteran's bilateral hearing loss was not at least as likely as not caused by or a result of an event in military service. The rationale was that the Veteran's service treatment records (STR) showed normal hearing at enlistment and separation and there was not a significant permanent shift in hearing thresholds between enlistment and separation or complaint of hearing loss in the STR or at separation. This is consistent with the record as the Veteran's hearing examination at separation appeared to test with better results than those in his enlistment hearing examination. See March 2023 STR-Medical. 

About the etiology of his hearing loss, the March 2023 VA examiner stated that the Veteran reported noise exposure during service and no civilian noise exposure. The Veteran also did not submit a statement about the history of his hearing loss. 

As such, the weight of the evidence is against the claim, and it must be denied at this time on both a direct theory of service connection and as a chronic condition. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, because the preponderance of the evidence is against the claim, there is no reasonable doubt to resolve in the Veteran's favor. See 
ment hearing examination. See March 2023 STR-Medical. 

About the etiology of his hearing loss, the March 2023 VA examiner stated that the Veteran reported noise exposure during service and no civilian noise exposure. The Veteran also did not submit a statement about the history of his hearing loss. 

As such, the weight of the evidence is against the claim, and it must be denied at this time on both a direct theory of service connection and as a chronic condition. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine; however, because the preponderance of the evidence is against the claim, there is no reasonable doubt to resolve in the Veteran's favor. See 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 C.F.R. § 3.102. Accordingly, the Veteran's claim for service connection for bilateral hearing loss is denied.  

G. William Riggs

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	N.H.

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.