TINNITUS

M. C. GRAHAM · 2025 · Case ID: A25105802

DENIED

Summary

The Veteran, an Air Force veteran who served from September 1980 to March 1986, appeals the denial of service connection for tinnitus. The Veteran claims tinnitus is due to hazardous noise exposure during service, specifically from flightline operations and munitions maintenance, and also claims it is secondary to his service-connected bilateral hearing loss. The Board noted the Veteran's MOS involved high probability of hazardous noise exposure and that he has a current diagnosis of recurrent tinnitus. However, two VA examinations in December 2022 and March 2024 both concluded that the Veteran's tinnitus was less likely than not related to military noise exposure, citing a lack of documented onset during service or within one year of discharge, and the Veteran's own reports of onset ten years post-service. The examiners also noted the Veteran's post-service occupational and recreational noise exposures. The Board found these VA opinions persuasive and adequately explained, outweighing the Veteran's arguments and lay testimony. The Board also noted that the secondary claim for tinnitus due to hearing loss was not raised at the time of the AOJ's decision and therefore did not warrant a remand. The Board denied service connection for tinnitus, finding the evidence persuasively against the claim and not in approximate balance, thus the benefit of the doubt doctrine was not applicable.

Rationale

No in-service event recalled for tinnitus onset.; VA examiners found less likely than not relation to military noise exposure.; No documentation of tinnitus in service or within one year of discharge.; Secondary claim to hearing loss not raised at time of AOJ decision.

Service Branch

AIR FORCE

Special Benefit

NO SPECIAL BENEFIT

Docket No.

241009-480728

Full Decision Text

Citation Nr: A25105802
Decision Date: 12/09/25 Archive Date: 12/09/25

DOCKET NO. 241009-480728
DATE: December 9, 2025

ORDER

The issue of entitlement to service connection for tinnitus is denied.

FINDING OF FACT

The evidence weighs persuasively against finding that the Veteran's tinnitus is etiologically related to service or secondary to his service-connected bilateral hearing loss.

CONCLUSION OF LAW

The criteria for entitlement to service connection for tinnitus have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309(a), 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from September 1980 to March 1986. The Board of Veterans' Appeals (Board) thanks the Veteran for his service to our country.

In September 2023, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of the February 2023 initial rating decision, issued by a Department of Veterans Affairs (VA) Regional Office (known as the agency of original jurisdiction (AOJ)), denying service connection for tinnitus. In a January 2024 HLR rating decision, the AOJ identified a pre-decisional duty to assist error and transferred the appeal to the Supplemental Claim decision review option for additional development. In July 2024, the AOJ issued the decision on appeal, which again denied the claim based on the evidence of record at the time of that decision.

In the October 2024 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket.

Therefore, the Board may only consider the evidence of record at the time of the July 2024 supplemental claim decision on appeal, as well as any evidence submitted by the Veteran or representative 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 supplemental claim decision on appeal and prior to receipt of the VA Form 10182, or (2) more than 90 days following receipt of 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 claim, 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

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Notwithstanding the lack of evidence of disease or injury during service, service connection may still be granted if all of the evidence, including that pertinent to service, establishes that the disability was incurred in service. See 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d); Cosman v. Principi, 3 Vet. App. 503 (1992). 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).

Certain chronic diseases (including tinnitus as an organic disease of the nervous system) may be presumed to have been incurred in service if it becomes manifest to a degree of 10 percent or more within a specified period of time post-service (one year for the aforementioned disease). 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307, 3.309. 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). Subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. 38 § C.F.R. 3.303(b).

Service connection may also be established on a secondary basis for a disability which is proximately 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) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995); Ward v. Wilkie, 31 Vet. App. 233, 239 (2019). Further, service connection may not be awarded on the basis of aggravation without establishing a pre-aggravation baseline level of disability and comparing it to the current level of disability. 38 C.F.R. § 3.310(b).

The Board is required to analyze the credibility and probative value of the evidence, account for any evidence that it finds persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. See Daye v. Nicholson, 20 Vet. App. 512, 516 (2006). It is noted that competency of evidence differs from weight and credibility. The former is a legal concept determining whether testimony may be heard and considered by the trier of fact, while the latter is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Cartwright v. Derwinski, 2 Vet. App. 24, 25 (1991) ("although interest may affect the credibility of testimony, it does not affect competency to testify"). In determining whether statements are credible, the Board may consider internal consistency, facial plausibility, and consistency with other evidence submitted on behalf of the claimant. Caluza v. Brown, 7 Vet. App. 498 (1995).

A claimant bears the evidentiary burden to establish entitlement to the benefit sought. See Fagan v. Shinseki, 573 F.3d 1282, 1287-88 (2009). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). The benefit of the doubt applies when the evidence for and against is in "approximate balance" or "nearly equal," but does not apply when the evidence persuasively favors one side or the other. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

The issue of entitlement to service connection for tinnitus.

The Veteran contends service connection is warranted for tinnitus due to hazardous noise exposure in service, including being subjected to constant flightline noise while working in munitions, and secondary to his bilateral hearing loss. See October 2022 VA Form 21-4138; January 2025 Appellate Brief.

The issue of entitlement to service connection for tinnitus.

In the July 2024 rating decision on appeal, the AOJ favorably found a qualifying event in service, as the Veteran's military occupational specialty (MOS) of munitions system specialist had a high probability of hazardous noise exposure, and that he has a current diagnosis of recurrent tinnitus. 38 C.F.R. § 3.104(c). Accordingly, the Board must determine whether the Veteran's recurrent tinnitus had its onset during service; was noted in service or within a year of discharge with continuous symptoms since; manifested to a degree of 10 percent within the first post-service year; is at least as likely as not related to an in-service injury, event, or disease; or is caused or aggravated by his service-connected bilateral hearing loss.

Turning to the evidence of record, the Veteran was afforded a VA examination in December 2022. At that time, the Veteran reported recurrent tinnitus that began within the last ten years with no specific event recalled. In an accompanying medical opinion, the VA examiner opined the Veteran's recurrent tinnitus was less likely than not related to military noise exposure, as the "Veteran reported onset of hearing loss was 10 yrs ago which is 25 yrs post separation. Review of file found report of tinnitus until time of claim. Veteran served in the Air Force Sept 80 to March 86 with MOS of munitions systems maintenance which has a high probability of hazardous noise exposure. Worked supplying munitions from storage and maintenance to flight line with engines running. HP muffs worn occasionally. No use of firearms after basic training. MOS has a high probability of hazardous noise exposure. Although noise exposure is conceded, research does not support delayed onset of tinnitus, therefore tinnitus is less than likely as not to have resulted due to military noise exposure."

In January 2024 at a higher-level review informal conference, the Veteran "stated he was in the Air Force and worked around loud noises (heavy equipment, munitions, and aircraft) on a daily basis as a Munitions Systems Specialist. He recalls there being 'ear muffs' in the cabin of trucks, but he doesn't recall having any other personal ear protection assigned to him. He stated he has a consistent and constant ringing in his ears which is most disruptive when he tries to sleep. He stated that the same VA examiner who provided a negative medical nexus for his tinnitus, also provided a positive medical nexus for his bilateral hearing loss as related to this military noise exposure. He therefore argued that there is sufficient evidence to show that his tinnitus is also related to his six years of active duty service on the flightline and around loud noises. He noted he was never around any other loud noises following his service." See January 2024 HLR informal conference worksheet.

In March 2024, the Veteran was afforded another VA examination. The Veteran again reported recurrent tinnitus that began ten years ago with no specific event recalled. In an accompanying medical opinion, the March 2024 VA examiner found the Veteran's tinnitus was less likely than not caused by or a result of military noise exposure, noting "Veteran reports onset of tinnitus approximately 10 yrs ago which is consistent with report when seen for C&P evaluation 12-16-22. Veteran served in the Air Force Sept 80 to March 86 with MOS of munition system specialist. Veteran described training with transporting bombs/explosives from storage to flight line a distance of 1 to 2 miles weekly if not daily. Maintained qualifications monthly at ranges. Veteran had other occupational noise exposure from working as motorcycle mechanic until in 50s, then switching to automotive mechanic. Recreational noise exposure from participating in a gun club for 2 yrs with firing at ranges weekly as well as riding a motorcycle since youth. Research does not support a delayed onset of tinnitus as a result of hazardous noise, therefore tinnitus is less likely than not the result of military noise exposure."

As to a nexus to service, the Board notes that the Veteran reported his tinnitus began well after leaving service. See December 2022 and March 2024 VA examinations. The evidence of record, including the Veteran's VA treatment records, also does not document a complaint or diagnosis of tinnitus prior to the Veteran's October 2022 initial claim. Accordingly, the evidence is persuasively against a finding that the Veteran's tinnitus had its onset during service, was noted in service or within a year of discharge
at ranges weekly as well as riding a motorcycle since youth. Research does not support a delayed onset of tinnitus as a result of hazardous noise, therefore tinnitus is less likely than not the result of military noise exposure."

As to a nexus to service, the Board notes that the Veteran reported his tinnitus began well after leaving service. See December 2022 and March 2024 VA examinations. The evidence of record, including the Veteran's VA treatment records, also does not document a complaint or diagnosis of tinnitus prior to the Veteran's October 2022 initial claim. Accordingly, the evidence is persuasively against a finding that the Veteran's tinnitus had its onset during service, was noted in service or within a year of discharge with continuous symptoms since, or manifested to a degree of 10 percent within the first post-service year.

Moreover, the December 2022 and March 2024 VA examiners found the Veteran's post-service tinnitus is less likely than not due to his in-service noise exposure or otherwise caused by his military service. Those opinions were prepared by medical experts competent to address the issue. The opinions were also informed by the evidence of record and are adequately explained with rationale. As such, the Board finds the opinions to be probative. Additionally, as there is no contrary competent opinion of record, the Board finds the December 2022 and March 2024 VA medical opinions to be persuasive.

Further, the Board notes that the Veteran, through his representative, is now claiming tinnitus secondary to his service-connected bilateral hearing loss. See January 2025 appellate brief. However, at the time of the July 2024 rating decision on appeal, the Veteran had not asserted that theory of service connection, and the evidence of record, including the December 2022 and March 2024 VA medical opinions, did not indicate the Veteran's recurrent tinnitus was secondary to his service-connected bilateral hearing loss. Accordingly, a secondary medical opinion was not warranted at that time. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 C.F.R. § 3.159 (c)(4). Under the AMA review system, a Board remand is only warranted to correct a duty to assist error committed by the AOJ that occurred prior to the decision on appeal. 38 C.F.R. § 20.802(a). As such, a remand is not warranted to obtain a secondary causation or aggravation medical opinion.

While the Veteran believes that his tinnitus is linked to service, to include his in-service noise exposure, as well as to his service-connected bilateral hearing loss, he has not been shown to be competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires specialized knowledge including of the nuances of tinnitus from noise exposure. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board finds that the December 2022 and March 2024 VA medical opinions of record carry more probative weight in this case.

In summary, the evidence is persuasively against granting entitlement to service connection for tinnitus in this case. In reaching the above conclusion, the Board has considered the benefit of the doubt doctrine. However, as the evidence is persuasively against the Veteran's claim, there is not an approximate balance of positive and negative evidence; accordingly, the benefit of the doubt doctrine is not applicable, and service connection for tinnitus must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990).

M. C. GRAHAM

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board S. Black, 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.

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