KNEE IMPAIRMENT OF

JONATHAN HAGER · 2026 · Case ID: A26007571

GRANTED

Summary

The veteran, who served in the Army from April 1974 to June 1974, appeals the denial of service connection for chronic migraine headaches, gastritis, left ear hearing loss, left knee injury, and low back injury. The Board recharacterized the left knee claim as tendonitis/tendinosis, meniscal tear, and osteoarthritis, and the low back claim as thoracolumbar intervertebral disc disorder secondary to the knee condition. Service connection for the left knee disability was granted, with the Board finding the evidence evenly balanced and resolving doubt in the veteran's favor, supported by a private physician's opinion linking the condition to an in-service injury. The thoracolumbar spine disorder was also granted secondary to the service-connected left knee, based on a private physician's opinion stating the back pain was more likely than not due to the knee injury. Service connection for chronic migraine headaches, secondary to service-connected tinnitus, was granted, with the Board finding the evidence evenly balanced and resolving doubt in the veteran's favor, supported by a VA examination and private physician's opinion. The claim for gastritis, secondary to chronic migraine headaches, was also granted based on a private physician's opinion linking it to migraine medication. The appeal for left ear hearing loss was dismissed as moot, as service connection had already been granted by the RO with an effective date of May 18, 2019, the date of the initial claim.

Rationale

Evidence evenly balanced regarding relation to service; Reasonable doubt resolved in veteran's favor; Private physician opinion linked condition to in-service injury

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

200701-94719

Full Decision Text

Citation Nr: A26007571
Decision Date: 01/27/26 Archive Date: 01/27/26

DOCKET NO. 200701-94719
DATE: January 27, 2026

ORDER

Entitlement to service connection for left knee tendonitis/tendinosis, left knee meniscal tear, and left knee joint osteoarthritis (left knee disability) is granted.

Entitlement to service connection for unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder (thoracolumbar spine disability), secondary to service-connected left knee disability, on a causation basis, is granted.

Entitlement to service connection for chronic migraine headaches, secondary to service-connected tinnitus, on a causation basis, is granted.

Entitlement to service connection for gastritis, secondary to service-connected chronic migraine headaches, on a causation basis, is granted.

Entitlement to service connection for left ear hearing loss is dismissed.

FINDINGS OF FACT

1. The evidence is at least evenly balanced as to whether the Veteran's left knee disability is related to an in-service injury.

2. The evidence is at least evenly balanced as to whether the Veteran's thoracolumbar spine disability is caused by his service-connected left knee disability.

3. The evidence is at least evenly balanced as to whether the Veteran's chronic migraine headaches are caused by his service-connected bilateral tinnitus and the claim being granted was filed on May 18, 2019 and was continuously pursued.

4. The evidence is at least evenly balanced as to whether the Veteran's gastritis is caused by the medication used to treat his service-connected chronic migraine headaches.

5. In a June 30, 2022 rating decision, the RO granted service connection on a secondary causation basis for left ear hearing loss, and assigned an effective date May 18, 2019 for bilateral hearing loss, the date of claim.

CONCLUSIONS OF LAW

1. With reasonable doubt resolved in favor of the Veteran, the criteria for service connection for left knee disability have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

2. With reasonable doubt resolved in favor of the Veteran, the criteria for service connection for thoracolumbar spine disorder, secondary to left knee disability, on a causation basis, are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

3. With reasonable doubt resolved in favor of the Veteran, the criteria for service connection for chronic migraine headaches, secondary to bilateral tinnitus, on a causation basis, are met, with regard to the claim filed on May 18, 2019, which was continuously pursued. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. With reasonable doubt resolved in favor of the Veteran, the criteria for service connection for gastritis, secondary to chronic migraine headaches, on a causation basis, are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310.

5. The criteria for dismissal of the Veteran's appeal for entitlement to service connection for left ear hearing loss have been met, as the benefit sought has been granted in full, to include consideration of the effective date consequences of a grant of service connection based on an earlier claim or alternative theory of entitlement. 38 U.S.C. § 7105.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from April 1974 to June 1974.

This case comes before the Board of Veterans' Appeals (Board) from a February 2020 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). Prior to that decision, the RO denied entitlement to service connection for chronic migraine headaches, gastritis, left ear hearing loss, left knee injury/condition, and low back injury in an August 2019 rating decision. Following a November 2019 supplemental claim, in the rating decision on appeal, the RO declined to readjudicate the claims, finding new and relevant evidence had not been received.

In the July 2020 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on April 17, 2024 before the undersigned Veterans Law Judge, and a transcript of the hearing has been associated with
RO). Prior to that decision, the RO denied entitlement to service connection for chronic migraine headaches, gastritis, left ear hearing loss, left knee injury/condition, and low back injury in an August 2019 rating decision. Following a November 2019 supplemental claim, in the rating decision on appeal, the RO declined to readjudicate the claims, finding new and relevant evidence had not been received.

Therefore, the Board may only consider the evidence of record at the time of the February 2020 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 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.

Based on the evidence discussed below, the claim for entitlement to service connection for a left knee injury/condition has been recharacterized as entitlement to service connection for left knee tendonitis/tendinosis, left knee meniscal tear, and left knee joint osteoarthritis to reflect the Veteran's current diagnoses. For the same reason, the claim for entitlement to service connection for low back injury has been recharacterized as entitlement to service connection for unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder.

Moreover, as discussed below, the claims for entitlement to service connection for left ear hearing loss and chronic migraine headaches involve the issue of concurrent elections, which resulted in grants of entitlement to service connection for left ear hearing loss and chronic migraine headaches prior to this instant decision. Nevertheless, the Board will consider the claims of entitlement to service connection and whether an earlier effective date is warranted based on an earlier claim or alternative theory of entitlement. See Concepcion-Maldonado, 38 Vet. App. 294, 302 (2025) ("mootness is a case-specific inquiry requiring the [Board] to reckon with the individual circumstances of the appeal and the implications for appellant's ability to obtain full relief"); Stender v. Wilkie, No. 19-0068, 2020 U.S. App. Vet. Claims LEXIS 520, *5-*7 (Mar. 27, 2020) (mem dec) (Falvey, J.) (the Board erred in granting service connection based on the Camp Lejeune Contaminated Water (CLCW) presumption without considering other theories of entitlement that could warrant an earlier effective date because of the effective date of the CLCW presumption); Bethea v. Derwinski, 2 Vet. App. 252, 254 (1992) (single judge decisions may be relied upon for any persuasiveness or reasoning they contain).

New and Relevant Evidence

VA will readjudicate a claim if new and relevant evidence is presented or secured. 38 C.F.R. § 3.156(d). New evidence is evidence not previously part of the record before agency adjudicators. 38 C.F.R. § 3.2501(a)(1). "Relevant evidence" is evidence that tends to prove or disprove a matter in issue. Id.

The preliminary question is whether new and relevant evidence was received for the five appealed claims of entitlement to service connection after the initial August 2019 rating decision. In this regard, the Veteran provided medical records for his left knee disability and thoracolumbar spine disorder prior to the February 2020 rating decision. In addition, the Veteran and his spouse provided new information regarding each claimed disability during the April 2024 hearing, and medical reports, opinions, and journal entries related to his left knee disability, thoracolumbar spine disability, gastritis, left ear hearing loss, and migraines within the 90-day evidentiary window following the Board hearing. The testimony, journal entries, medical records and opinions are new as they were not previously part of the actual record before agency adjudicators. Moreover, the evidence tends to prove a matter at issue with regard to each claim, as discussed below. Readjudication of the issues of entitlement to service connection for left knee disability, thoracolumbar spine disorder, chronic migraine headaches, gastritis, and left hearing loss is therefore warranted.

Direct and Secondary Service Connection

Service connection will be granted if the evidence demonstrates that current disability resulted from an injury or disease incurred in active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service disease or injury; and (3) a relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first 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).

Secondary service connection under 38 C.F.R. § 3.310(a) is warranted for disability proximately due to or the result of a service-connected disease or injury. Historically, "secondary service connection was considered a product of regulation, rather than statute." Adams v. Collins, 38 Vet. App. 273, 286 (2025) (citing Frost v. Shulkin, 29 Vet. App. 131, 137 (2017) ("Secondary service connection for VA benefit purposes is not addressed in any statute")). However, 38?U.S.C. § 1110 "plainly requires compensation when a service-connected disease or injury is a but-for cause of a present-day disability." Spicer v. McDonough, 61 F. 4th 1360, 1366 (Fed. Cir. 2023). Moreover, "[t]he but-for causation standard is not limited to a single cause and effect, but rather contemplates multi-causal links." Id. at 1364.

Entitlement to service connection for left knee disability.

The knee and lower leg conditions disability benefit questionnaire (DBQ) that the Veteran submitted in November 2019 contains diagnoses of left knee tendonitis/tendinosis, left knee meniscal tear, and left knee joint osteoarthritis. The current disability requirement has thus been met.

In its February 2020 rating decision, the RO favorably found that the evidence shows that a qualifying event, injury or disease was incurred during the Veteran's service as his service treatment records show that he was seen for chondromalacia of left knee in service in May 1974. The Board is also bound by this favorable finding, 38 C.F.R. § 3.104(c), and the in-service injury element has thus been met.

The remaining issue is thus whether there is a relationship between the current left knee disability and the in-service injury. There is one positive opinion in the evidentiary record.

In the private DBQ the Veteran submitted in November 2019, he stated that he has experienced pain and swelling in his left knee following a fall in basic training while wearing and carrying heavy equipment. He continues to experience constant pain rated as a two out of three, as well as exacerbations of the pain at least once per month. The physician recorded pain on palpitation and movement, and marked that there was not a history of recurrent infusion, that joint stability testing was not performed, and that the Veteran uses an occasional knee brace for his left knee pain.

During
is thus whether there is a relationship between the current left knee disability and the in-service injury. There is one positive opinion in the evidentiary record.

During his April 2024 Board hearing, the Veteran testified that he has experienced left knee pain after a fall during service. The Veteran's spouse, a nurse, was also present at the hearing. She and the Veteran were engaged during basic training and married after service. His wife testified that the Veteran complained of chronic left knee pain following his injury in service, which she has treated with Tylenol and ibuprofen.

In May 2024, the Veteran submitted a letter from the Orthopedic Institute at Renaissance. The orthopedist stated that the Veteran's knee pain is more likely than not from the injuries he sustained while he was in the military.

The Veteran separately provided a letter dated June 20, 2023 from Dr. N.K., who completed the November 2019 DBQ. The physician recounted the Veteran's reports of hurting his knee in 1974 during a fall when he was "carrying all of the equipment." The following day, his left knee was swollen and painful. The physician stated that since then, the Veteran has been suffering from left knee pain in various degrees, requiring the use of NSAIDs for pain relief. The physician opined that "[h]is knee problem is likely 50% related injury sustained while in Basic Training in the Military at Fort Jackson."

In the June 2023 opinion letter, the physician considered the Veteran's lay statements regarding an in-service injury, the progression and treatment of left knee pain following service, and the diagnoses and examination reflected in the private November 2019 DBQ. As the "medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion," including the Veteran's lay statements, the opinion is adequate and entitled to substantial probative weight in finding that a nexus exists between the Veteran's diagnosed left knee disability and his in-service injury. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) ("most of the probative value of a medical opinion comes from its reasoning").

For the above reasons, the evidence is at least evenly balanced as to whether the Veteran's left knee disability is related to service. As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, entitlement to service connection for left knee disability is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

Entitlement to service connection for thoracolumbar spine disability.

In its February 2020 rating decision, the RO favorably found that the Veteran has a current diagnosed back condition. Specifically, records from the Veteran's treating orthopedist that the Veteran submitted to VA, and considered in the February 2020 rating decision on appeal, contain a diagnosis of unspecified thoracic, thoracolumbar and lumbosacral intervertebral disc disorder. The current disability requirement has therefore been met.

During his April 2024 Board hearing, the Veteran explained that he began to experience low back pain after he injured his left knee. The pain became more pronounced immediately following separation and continues to present.

The Veteran is now service connected for his left knee disability. As the Veteran and his representative contend service connection is warranted on a secondary causation basis, the issue is whether his thoracolumbar intervertebral disc disorder is proximately due to or the result of his service connected left knee disability.

To this point, the Veteran submitted an orthopedic office clinic note in May 2024. In the assessment/plan section, the physician recorded "back pain, chronic" with the note that "this chronic back pain he has is due more likely than not due to the knee injury while he was in the Army."

The Veteran has not been afforded a VA examination to evaluate his thoracolumbar spine disorder and VA has not provided an opinion regarding direct or secondary service connection. This private opinion is the only opinion of record. Reading the record as a whole, to include the Veteran's lay statements regarding his initial in-service left knee injury and subsequent back pain, the opinion is adequate and entitled to substantive probative weight in determining that secondary service connection on a causation basis is warranted. See Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012) (medical reports must be read as a whole and in the context of the evidence of record).

For the above reasons, the evidence is at least evenly balanced as to whether the Veteran's thoracolumbar spine disorder is related to his service-connected left knee disability. As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, entitlement to service connection for thoracolumbar spine disorder is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

Entitlement to service connection for chronic migraine headaches.

The Veteran filed his initial claim for tinnitus and chronic migraine headaches on May 18, 2019. In an August 2019 rating decision, the RO granted entitlement to service connection for tinnitus, effective May 18, 2019, the date of the claim, and denied entitlement to service connection for chronic migraine headaches. As discussed in the introduction, in November 2019, the Veteran filed a supplemental claim for chronic migraine headaches, and in the February 2020 rating decision on appeal, the RO declined to readjudicate the claims, finding new and relevant evidence had not been received.

From the February 2020 rating decision, two appeal streams emerged related to the claim of entitlement to service connection for chronic migraine headaches.

The first appeal stream stems from the Veteran's July 2020 VA Form 10182. By letter dated September 19, 2020, the Board notified the Veteran that his appeal has been placed on the hearing docket. At this point, 38 C.F.R. § 3.2500(b) applies, which states, "With regard to the adjudication of a claim or an issue as defined in § 3.151(c), a claimant who has filed for review under one of the options available under paragraph (a) of this section may not, while that review is pending final adjudication, file for review under a different available option." 38 C.F.R. § 3.2500(a) includes supplemental claims.

The second appeal stream began in March 2022, when the Veteran filed a supplemental claim, VA Form 2-0995, for his previously-denied service connection claim for migraine headaches. Pursuant to 38 C.F.R. § 3.2500(b), this was an improper concurrent election, with the Veteran filing for review under a different available option, the supplemental claim, while the Board review was pending final adjudication.

In a July 2022 rating decision, the RO, seemingly unaware of the docketed Board appeal, granted service connection for chronic migraine headaches, secondary to service-connected tinnitus on a causation basis. This grant necessarily includes finding that all of the criteria for secondary service connection have been met. Under the AMA, the Board is bound by favorable findings made by the RO. 38 C.F.R. § 3.104(c). After his April 2024 Board hearing, the Veteran submitted a July 2022 headaches VA examination report and opinion, the report containing the current diagnosis of migraines, and the physician opining that the Veteran's "claimed chronic migraine headaches, is/are at least as likely as not (50 percent or greater probability) proximately due to or the result of the [V]eteran's tinnitus (bilateral)." In light of the totality of the circumstances, and after resolving all reasonable doubt in the Veteran's favor, the most persuasive evidence weighs in favor of finding that the Veteran's chronic migraine headaches was caused by the Veteran's service-connected tinnitus. Accordingly, the Board finds that granting service connection for chronic migraine headaches secondary to service-connected tinnitus is the decision that is the most consistent
2022 headaches VA examination report and opinion, the report containing the current diagnosis of migraines, and the physician opining that the Veteran's "claimed chronic migraine headaches, is/are at least as likely as not (50 percent or greater probability) proximately due to or the result of the [V]eteran's tinnitus (bilateral)." In light of the totality of the circumstances, and after resolving all reasonable doubt in the Veteran's favor, the most persuasive evidence weighs in favor of finding that the Veteran's chronic migraine headaches was caused by the Veteran's service-connected tinnitus. Accordingly, the Board finds that granting service connection for chronic migraine headaches secondary to service-connected tinnitus is the decision that is the most consistent with VA's policy to administer the law under a broad and liberal interpretation consistent with the facts of the case. 38 C.F.R. §§ 3.303(a).

Although entitlement to service connection for chronic migraine headaches has been granted by the RO, the Board must nevertheless consider other theories of entitlement that could warrant an earlier effective date. Cf. Stender v. Wilkie, No. 19-0068, 2020 U.S. App. Vet. Claims LEXIS 520, *5-*7 (Mar. 27, 2020) (mem dec) (Falvey, J.) (the Board erred in granting service connection based on the Camp Lejeune Contaminated Water (CLCW) presumption without considering other theories of entitlement that could warrant an earlier effective date because of the effective date of the CLCW presumption); Bethea v. Derwinski, 2 Vet. App. 252, 254 (1992) (single judge decisions may be relied upon for any persuasiveness or reasoning they contain).

Here, the RO assigned the effective date of March 28, 2022 for the Veteran's chronic migraine headaches based on the date VA received the Veteran's supplemental claim after the February 2020 rating decision. The effective date was not based on a specific theory of entitlement, either direct or secondary service connection, but the procedural history of the second appeal stream. By the RO's account, the February 2020 rating decision on appeal became final and was reopened by the March 2022 supplemental claim. See 38 U.S.C. § 7105(c); 38 C.F.R. §§ 3.156(b), 20.1103. However, the Veteran had continuously pursued the initial August 2019 denial of entitlement to service connection for chronic migraine headaches with the November 2019 supplemental claim, see 38 C.F.R. § 3.2500(c), and the February 2020 rating decision remained pending before the Board until this instant decision. Accordingly, the Board is granting service connection for migraine headaches even though the AOJ has already granted service connection for this disability, because in implementing this grant of service connection the AOJ should consider the May 18, 2019, the date of claim, as the relevant date of claim. Dismissal based on the prior, AOJ grant of service connection is therefore not appropriate because the Board's grant of service connection for the same disability could well result in an earlier effective date upon implementation of the decision for the above reasons. Johnson v. Collins, 38 Vet. App. 151, 158 (2025) (quoting Bailey v. Wilkie, 33 Vet. App. 188, 203-04 (2021) (remanding to "preserve[ ] the possibility of an earlier effective date and safeguard[ ] against any preclusive effect of the later RO decision"); Warren v. McDonald, 28 Vet. App. 214, 221 (2016) (remanding because the later grant by the RO "was only able to grant service connection" effective the date of the second claim)).

For the above reasons, the evidence is at least evenly balanced as to whether the Veteran's chronic migraine headaches are related to his service-connected bilateral tinnitus. As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, the May 18, 2019, claim for entitlement to service connection for chronic migraine headaches, secondary to service-connected bilateral tinnitus, on a causation basis, must be granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

Entitlement to service connection for gastritis.

In May 2024, the Veteran submitted a letter from his private physician that referenced the Veteran's diagnosed gastritis. The current disability requirement has thus been met.

During his April 2024 Board hearing, the Veteran contended that his gastritis is due to the medication he takes for his migraines. The Veteran is service connected
must be resolved in favor of the Veteran, the May 18, 2019, claim for entitlement to service connection for chronic migraine headaches, secondary to service-connected bilateral tinnitus, on a causation basis, must be granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

Entitlement to service connection for gastritis.

In May 2024, the Veteran submitted a letter from his private physician that referenced the Veteran's diagnosed gastritis. The current disability requirement has thus been met.

During his April 2024 Board hearing, the Veteran contended that his gastritis is due to the medication he takes for his migraines. The Veteran is service connected for migraines, with the effective date now May 18, 2019. Moreover, the Veteran is competent and credible to report that he observed gastritic symptoms following the use of migraine medication. Layno v. Brown, 6 Vet. App. 465, 470 (1994) (lay testimony is competent to prove that . . . a claimant exhibited certain lay-observable symptoms and the time that those symptoms appear").

Within 90 days after the Board hearing, the Veteran submitted a March 2024 letter from his private physician, Dr. N. K. The physician wrote that the Veteran's "gastritis was most likely caused by the use of medications to treat his migraine headaches."

This is the only opinion of record, as the Veteran was not afforded a VA examination for his gastritis during the evidentiary window for this instant appeal. Reading the opinion in the context of the record as a whole, to include the Veteran's statements regarding onset and use of medication to manage migraines, this opinion is adequate and entitled to substantive probative weight in determining that the secondary service connection on a causation basis is warranted. See Monzingo v. Shinseki, 26 Vet. App. 97, 106 (2012) (the fact that the rationale provided by an examiner "did not explicitly lay out the examiner's journey from the facts to a conclusion," did not render the examination inadequate).

For the above reasons, the evidence is at least evenly balanced as to whether the Veteran's gastritis is related to his service-connected migraines. As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, entitlement to secondary service connection for gastritis, on a causation basis, is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

Entitlement to service connection for left ear hearing loss.

The Veteran filed his initial claim for hearing loss on May 18, 2019. After a July 2019 VA examination, in the August 2019 rating decision, the RO granted entitlement to service connection for right ear hearing loss and denied the claim for left ear hearing loss, finding that the evidence does not show current audiometric findings that meet the criteria for hearing loss in his left ear for VA purposes. The Veteran continuously pursued his claim of entitlement to service connection for left ear hearing loss by filing a supplemental claim in November 2019, and VA Form 10182 after the RO's February 2020 denial, which was docketed by the Board and remained pending until this instant decision. 38 C.F.R. § 3.2500(c).

While this claim remained pending, the Veteran filed Form VA 21-526EZ in March 2022 for an increased rating for his hearing loss. As the Veteran was service-connected for right ear hearing loss, he was entitled to file for an increased rating for his service-connected disability. See Chisholm v. Collins, 38 Vet. App. 140, 143 (U.S. 2025) ("while a supplemental claim needs to be filed on a form prescribed by the Secretary, it doesn't need to be filed on a supplemental claim form); 38 C.F.R. § 3.2500(a)(2).

The Veteran attended a hearing loss VA examination in April 2022. Based on those audiometric findings, in a June 2022 rating decision, the RO granted entitlement to service connection for left ear hearing loss and evaluated the new disability with his right ear hearing loss, increasing the rating of bilateral hearing loss to 10 percent, effective March 28, 2022, the date of his Form VA 21-526EZ.

Within the evidentiary window following his Board hearing, the Veteran submitted the report for the April 2022 VA examination, confirming a current disability of left ear hearing loss for VA disability purposes. The record also contains a VA positive nexus opinion for hearing loss, dated July 2019. The Board is
attended a hearing loss VA examination in April 2022. Based on those audiometric findings, in a June 2022 rating decision, the RO granted entitlement to service connection for left ear hearing loss and evaluated the new disability with his right ear hearing loss, increasing the rating of bilateral hearing loss to 10 percent, effective March 28, 2022, the date of his Form VA 21-526EZ.

Within the evidentiary window following his Board hearing, the Veteran submitted the report for the April 2022 VA examination, confirming a current disability of left ear hearing loss for VA disability purposes. The record also contains a VA positive nexus opinion for hearing loss, dated July 2019. The Board is bound by favorable findings made by the AOJ. 38 C.F.R. § 3.104 (c). In light of the totality of the circumstances, and after resolving all reasonable doubt in the Veteran's favor, the most persuasive evidence weighs in favor of finding that the Veteran's left ear hearing loss was incurred in or caused by active duty service. Accordingly, the Board finds that granting service connection for left ear hearing loss is the decision that is the most consistent with VA's policy to administer the law under a broad and liberal interpretation consistent with the facts of the case. 38 C.F.R. §§ 3.303(a).

Importantly, the effective date for bilateral hearing loss, to include left ear hearing loss, is now May 18, 2019, the date of claim. Therefore, the grant represents a grant of the benefit sought in full because the effective date assigned is based on the date of claim, and there is no earlier filed claim upon which an earlier effective date could be based or alternative theory on which a grant of service connection could be based that would result in an earlier effective date when the grant of service connection is implemented.

Thus, there remains no specific determination with which the claimant disagrees or any benefit that would result from the Board's grant of service connection in this case where service connection has already been granted effective the date of claim. Concepcion-Maldonado v. Collins, 38 Vet. App. 294, 302 (U.S. 2025) ("mootness is a case-specific inquiry requiring the [Board] to reckon with the individual circumstances of the appeal and the implications for appellant's ability to obtain full relief"); Johnson v. Collins, 38 Vet. App. 151, 158 (2025) (quoting Bailey v. Wilkie, 33 Vet. App. 188, 203-04 (2021) (remanding to "preserve[ ] the possibility of an earlier effective date and safeguard[ ] against any preclusive effect of the later RO decision"); Warren v. McDonald, 28 Vet. App. 214, 221 (2016) (remanding because the later grant by the RO "was only able to grant service connection" effective the date of the second claim)).

Therefore, dismissal of the appeal with regard to the claim for service connection for left ear hearing loss is warranted. 38 U.S.C. § 7105(d) ("The Board may dismiss any appeal which fails to identify the specific determination with which the claimant disagrees").

Jonathan Hager

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board H. T. Mowell, 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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