HEARING LOSS

BETHANY L. BUCK · 2026 · Case ID: A26009007

MIXED

Summary

The veteran, who served from June 1965 to July 1985, appeals the denial of service connection for bilateral hearing loss (BHL), tinnitus, glaucoma, and pseudophakia, and the remand of claims for chronic obstructive pulmonary disease (COPD), asthma, and retinal detachment repair. The Board granted service connection for BHL, tinnitus, glaucoma, and pseudophakia. For BHL and tinnitus, the Board found the veteran's lay testimony credible and consistent with his service, and assigned high weight to a private medical opinion from Dr. C.A. that linked the conditions to in-service noise exposure, despite conflicting VA opinions that relied on incomplete service records and questioned the timing of symptom onset. For glaucoma and pseudophakia, the Board granted service connection as secondary to the veteran's service-connected diabetes mellitus, relying on a VA opinion that found it at least as likely as not that diabetes contributed to these conditions. The claims for COPD and asthma were remanded due to inadequate VA opinions that failed to address in-service respiratory complaints and TERA exposure. The retinal detachment repair claim was also remanded due to inadequate VA opinions regarding direct service connection, TERA, and its relationship to service-connected diabetes, glaucoma, and pseudophakia.

Rationale

Veteran's lay testimony found credible and consistent with service; Private medical opinion linked BHL to in-service noise exposure; VA opinions found inadequate due to reliance on incomplete records and failure to address post-service exposure mitigation

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250527-541894

Full Decision Text

Citation Nr: A26009007
Decision Date: 01/30/26 Archive Date: 01/30/26

DOCKET NO. 250527-541894
DATE: January 30, 2026

ORDER

Entitlement to service connection for bilateral hearing loss (BHL) is granted.

Entitlement to service connection for tinnitus is granted.

Entitlement to service connection for glaucoma is granted.

Entitlement to service connection for pseudophakia is granted.

REMANDED

Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded.

Entitlement to service connection for asthma is remanded.

Entitlement to service connection for retinal detachment repair is remanded.

FINDINGS OF FACT

1. The Veteran's credible lay statements establish that he was exposed to hazardous noise in the military.

2. The most credible medical opinion of record establishes that military noise exposure caused the Veteran's BHL.

3. The Veteran experienced ringing in his ears in service and has had such sensations ever since.

4. The credible medical opinion of record establishes that the Veteran's glaucoma was caused by his service-connected diabetes mellitus.

5. The credible medical opinion of record establishes that the Veteran's pseudophakia was caused by his service-connected diabetes mellitus.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for BHL have been met. 38?U.S.C. §§?1110, 1131, 5107; 38?C.F.R. §§?3.102, 3.303, 3.304.

2. The criteria for entitlement to service connection for tinnitus have been met. 38?U.S.C. §§?1110, 1131, 5107; 38?C.F.R. §§?3.102, 3.303, 3.304.

3. The criteria for entitlement to service connection for glaucoma have been met. 38?U.S.C. §§?1110, 1131, 5107; 38?C.F.R. §§?3.102, 3.303, 3.304, 3.310.

4. The criteria for entitlement to service connection for pseudophakia have been met. 38?U.S.C. §§?1110, 1131, 5107; 38?C.F.R. §§?3.102, 3.303, 3.304, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from June 1965 to July 1985.

This matter comes before the?Board of Veterans' Appeals?(Board) on appeal from a May 2025 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

In the May 27, 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on October 7, 2025 before the undersigned Veterans Law Judge. A copy of the hearing transcript is associated with the claims file.

Therefore, the Board may only consider the evidence of record at the time of the May 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his 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.

However, because the Board is remanding the claims of entitlement to service connection for COPD, asthma and right eye retinal detachment, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

The May 2025 rating decision considered the Veteran's entitlement to service connection for a single eye disability, which encompassed retinal detachment repair with primary open angle glaucoma and pseudophakia. stemming from the Veteran's original claim of entitlement to service connection for detached retina. The Board concludes that the state of the evidence regarding the separate disabilities of retinal detachment repair, glaucoma, and pseudophakia requires that each be considered separately.

1. Entitlement to service connection for BHL

The Veteran contends that his BHL is related to his service.

Generally, in
considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

1. Entitlement to service connection for BHL

The Veteran contends that his BHL is related to his service.

Generally, in order to prove service connection, a Veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called "nexus" requirement. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

In the May 2025 rating decision, the RO conceded a current diagnosis of BHL, based on the findings of a February 2025 VA examination. Under the AMA, the Board is bound by the AOJ's favorable findings. 38?C.F.R. §?3.104(c).

In February 2024, VA provided an opinion regarding the etiology of the Veteran's BHL. The Veteran reported exposure to noise during weapons training and while working on a flight line. The examiner did not determine whether hearing protection was used during these exposures. After service, the Veteran was exposed to noise as a forklift operator for 12 years, although he used hearing protection as required by his job.

In his October 2024 request for Higher Level Review, the Veteran stated that during his service, he was exposed to loud noise while flying aboard a C-141 Starlifter aircraft. When he got off the aircraft, his ears were ringing so loudly, it was like they were screaming.

During a February 2025 VA examination, the Veteran reported in-service noise exposure from firing weapons and serving in or around aircraft. He used hearing protection. After service, the Veteran operated a forklift with hearing protection. He denied recreational noise exposure.

During the October 2025 Board hearing, the Veteran testified that he worked in close proximity to noise from a flightline during his service. He was not issued hearing protection. The Veteran did not have significant noise exposure after service. The Veteran explained that his work as a forklift operator was intermittent and involved a quiet electric forklift that did not generate much noise.

The Veteran is competent to report events that happened to him. These accounts are credible because they are consistent with one another and the circumstances of the Veteran's service. The Board assigns them high weight, and finds that the Veteran was exposed to noise in service.

The February 2024 VA examiner concluded that the Veteran's BHL was not at least as likely as not caused by or the result of an event in military service. The examiner noted that the Veteran's military occupational specialty (MOS) of personal affairs technician was not conceded for noise exposure. The Veteran's service treatment records, which were blank or incomplete, did not support a finding of a threshold shift. The Veteran's hearing was normal during in-service examinations in February 1978 and February 1982. No evidence of noise injury during service was identified. The Veteran had not reported hearing problems until decades after his service. The Veteran also reported 12 years of post-service noise exposure as a forklift operator, although he used hearing protection and underwent regular hearing tests. The Veteran's hearing loss was more likely related to post-service noise exposure and aging.

The February 2024 VA examiner is competent to form the opinion provided. The opinion's probative value suffers from the fact that it relies upon incomplete service treatment records as affirmative evidence that the Veteran did not experience acoustic injury in service. The opinion also did not address the fact that any post-service noise exposure was diminished by the use of hearing protection. The Board assigns low weight to the opinion.

The February 2025 VA examiner concluded that the Veteran's BHL was not at least as likely as not caused by or the result of an event, injury, or disease incurred during military service. The examiner noted that the Veteran's MOS had a low risk of hazardous noise exposure. No hearing threshold shift could be ascertained from his service treatment records. The Veteran did not report hearing loss until nearly 40 years after service. He also had occupational noise exposure post-service. There was therefore no nexus.

The February 2025 VA examiner is competent to
injury in service. The opinion also did not address the fact that any post-service noise exposure was diminished by the use of hearing protection. The Board assigns low weight to the opinion.

The February 2025 VA examiner is competent to form the opinion provided. The opinion probative value is undermined by the same defects which afflict the February 2024 VA opinion. The Board assigns low weight to the opinion.

In October 2025, the Veteran submitted a private medical opinion authored by Dr. C.A. Dr. C.A. noted the Veteran's in-service exposure to flightline noise and his lack of post-service noise exposure. Exposure to aircraft in close proximity had been shown to result in the development of BHL. Dr. C.A. therefore concluded that the Veteran's BHL was caused by in-service hazardous noise exposure.

Dr. C.A. is competent to form the opinion provided. The opinion is credible because it addresses noise exposure associated with the Veteran's actual duties in the military, not his MOS, and correctly notes that the Veteran's post-service noise exposure was minimal. The opinion addresses the impact of military noise exposure on the Veteran's later development of BHL. The Board assigns high weight to the opinion.

Because the most credible medical opinion of record establishes that military noise exposure caused the Veteran's BHL, service connection is granted.

2. Entitlement to service connection for tinnitus

The Veteran contends that his tinnitus was caused by military noise exposure.

Certain chronic diseases, including tinnitus, will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38C.F.R. §§3.303 (b), 3.307, 3.309(a).

During the February 2024 VA examination, the Veteran reported that his tinnitus had its onset in 2014. He began hearing ringing that occurred two to three times per month. It affected both ears, and lasted between 15 and 35 minutes.

During a February 2025 VA examination, the Veteran reported that his tinnitus had its onset in 1980. He experienced bilateral ringing that occurred every other day or twice per week, and lasted between 15 and 20 minutes. The Veteran reported in-service noise exposure from firing weapons and serving in or around aircraft. He used hearing protection. After service, the Veteran operated a forklift with hearing protection. He denied recreational noise exposure.

During the October 2025 Board hearing, the Veteran testified that he noticed ringing in his ears during service. After working near the flightline, he noticed ringing in his ears. It would last a day or two, and then go away until the next episode. The Veteran noticed that the ringing was a permanent problem sometime around 1983.

The February 2024 VA examiner concluded that it was less likely than not that the Veteran's tinnitus was the result of military noise exposure. The Veteran did not report the onset of his tinnitus during service. The examiner stated that it was widely accepted that tinnitus occurs at the time of noise exposure, and does not develop years later. The examiner cited a study from the Institute of Medicine (IOM) that stated that as the time between noise exposure and tinnitus onset increased, it was more likely that intervening factors were to blame for the onset. Many factors could contribute to t
consistent with one another and the circumstances of the Veteran's service. The Board assigns them high weight, and finds that the Veteran experienced tinnitus in service.

The February 2024 VA examiner concluded that it was less likely than not that the Veteran's tinnitus was the result of military noise exposure. The Veteran did not report the onset of his tinnitus during service. The examiner stated that it was widely accepted that tinnitus occurs at the time of noise exposure, and does not develop years later. The examiner cited a study from the Institute of Medicine (IOM) that stated that as the time between noise exposure and tinnitus onset increased, it was more likely that intervening factors were to blame for the onset. Many factors could contribute to tinnitus, including recreational, occupational, and environmental noise exposure, as well as aging. Because the Veteran reported tinnitus decades after service, it was more likely caused by post-service noise exposure.

The February 2025 VA examiner concluded that the Veteran's tinnitus was not at least as likely as not caused by or a result of military noise exposure. The Veteran's MOS had a low risk for noise exposure. The Veteran's report of the onset of tinnitus was at odds with his February 2024 report that his tinnitus had its onset in 2013 or 2014. The February 2025 examiner cited the same evidence as the February 2024 VA examiner to contradict the idea that tinnitus could have its onset many years after noise exposure.

Both the February 2024 and February 2025 VA examiners are competent to offer their opinions. Their probative value is undermined by their reliance on an IOM study that the United States Court of Appeals for Veterans Claims explicitly questioned in McCray v. Wilkie.?31?Vet. App.?243?(2019). The opinions also did not address the Veteran's report of ringing in his ears after noise exposures in service. The Board assigns low weight to the VA opinions of record.

In October 2025, the Veteran submitted a private medical opinion authored by Dr. C.A. Dr. C.A. noted the Veteran's in-service exposure to flightline noise and his lack of post-service noise exposure. Exposure to aircraft in close proximity had been shown to result in the development of tinnitus. Dr. C.A. therefore concluded that the Veteran's tinnitus was caused by in-service hazardous noise exposure.

Dr. C.A. is competent to form the opinion provided. The opinion is credible because it addresses noise exposure associated with the Veteran's actual duties in the military, not his MOS, and correctly notes that the Veteran's post-service noise exposure was minimal. The opinion addresses the impact of military noise exposure on the Veteran's development of tinnitus. The Board assigns high weight to the opinion.

Finally, when a claim involves a diagnosis based on purely subjective complaints, like tinnitus, the Board is within its province to weigh the Veteran's testimony and determine whether it supports a finding of service incurrence and continued symptoms since service. Barr v. Nicholson, 21 Vet. App. 303, 305 (2007). Here, the Board finds the Veteran's lay statements clarifying the onset and continuation of his tinnitus symptoms to be competent and credible. The Board finds the Veteran's statements to be competent, as well as consistent with his service, and therefore the lay evidence persuasively weighs in favor of finding a relationship between his currently diagnosed tinnitus disability and his in-service military noise exposure. As such, a grant of service connection for tinnitus is warranted. See 38 C.F.R. § 3.303 (b); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990).

3. Entitlement to service connection for glaucoma

The Veteran contends that his eye condition, to include glaucoma, is related to his service.

Service connection may also be established on a secondary basis for a disability which is proximately due to or the result of a service-connected 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) (en banc).

The May 2025 rating decision conceded a current diagnosis of glaucoma, based on the findings of a February 2025 VA examination. This finding is binding on the Board. 38?C.F.R. §?3.104(c).

The Veteran is currently service-connected for diabetes mellitus.

In November 2024, a VA examiner offered the opinion that the Veteran's gl
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) (en banc).

The May 2025 rating decision conceded a current diagnosis of glaucoma, based on the findings of a February 2025 VA examination. This finding is binding on the Board. 38?C.F.R. §?3.104(c).

The Veteran is currently service-connected for diabetes mellitus.

In November 2024, a VA examiner offered the opinion that the Veteran's glaucoma was at least as likely as not caused by TERA, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERA of the Veteran. The examiner noted that the Veteran was diagnosed with diabetes mellitus, which was presumptively caused by exposure to herbicide agents. Diabetes mellitus was known to contribute to an increased risk for the development of glaucoma. Therefore, it was at least as likely as not that the Veteran's service contributed to his development of diabetes, which in turn contributed to the development of glaucoma.

The November 2024 VA examiner is competent to form the opinion provided. The opinion is credible because it is based upon a review of medical literature regarding the relationship between diabetes mellitus and glaucoma. The Board assigns high weight to the opinion.

The November 2024 VA opinion is the sole medical opinion which addresses the relationship between the Veteran's glaucoma and diabetes mellitus. Because this credible opinion establishes that the Veteran's glaucoma was caused by his service-connected diabetes mellitus, service connection for glaucoma is granted.

4. Entitlement to service connection for pseudophakia

The Veteran contends that his eye condition, to include pseudophakia, is related to his service.

The May 2025 rating decision conceded a current diagnosis of pseudophakia, based on the findings of a February 2025 VA examination. This finding is binding on the Board. 38?C.F.R. §?3.104(c).

The Veteran is currently service-connected for diabetes mellitus.

The April 2025 VA examination reflects bilateral postoperative cataracts with a replacement intraocular lens, or pseudophakia.

In November 2024, a VA examiner offered the opinion that the Veteran's glaucoma was at least as likely as not caused by TERA, after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERA of the Veteran. The examiner noted that the Veteran was diagnosed with diabetes mellitus, which was presumptively caused by exposure to herbicide agents. Diabetes mellitus was known to contribute to the development of cataracts. Therefore, it was at least as likely as not that the Veteran's service contributed to his development of diabetes, which in turn contributed to the development of cataracts, and therefore his need for cataract surgery in both eyes.

The November 2024 VA examiner is competent to form the opinion provided. The opinion is credible because it is based upon a review of medical literature regarding the relationship between diabetes mellitus and pseudophakia. The Board assigns high weight to the opinion.

Because this credible opinion establishes that the Veteran's pseudophakia was caused by his service-connected diabetes mellitus, service connection for pseudophakia is granted.

REASONS FOR REMAND

1. Entitlement to service connection for COPD is remanded.

2. Entitlement to service connection for asthma is remanded.

The Veteran contends that his currently diagnosed COPD and asthma are related to toxic exposure risk activities (TERA) during his military service.

An October 2024 TERA memorandum conceded exposure to herbicide agents, motor fuels/exhaust, lubricants, hydraulic fluid, cleaning chemicals, aircraft exhaust, and dust.

The Veteran's service treatment records reflect numerous complaints of chest pain, congestion, and cough between June 1971 and July 1982.

In July 2024, VA obtained an opinion. The VA examiner opined that it was less likely than not that the Veteran's COPD was incurred in or caused by an in-service injury, event, or illness. The examiner stated that the Veteran's service treatment records were silent for complaints of COPD. The Veteran reported symptoms beginning in approximately 1996. Chronicity could not be established due to the length of time between service and diagnosis.

The July 2024 VA examiner also opined that it was less likely than not that the Veteran's asthma was incurred in or caused by an in-service injury, event, or illness
complaints of chest pain, congestion, and cough between June 1971 and July 1982.

The July 2024 VA examiner also opined that it was less likely than not that the Veteran's asthma was incurred in or caused by an in-service injury, event, or illness. The examiner stated that the Veteran's service treatment records were silent for complaints of asthma. The Veteran reported symptoms beginning in approximately 1996. Chronicity could not be established due to the length of time between service and diagnosis.

The July 2024 VA examination did not address in-service treatment notes related to respiratory complaints. It is therefore unclear whether these complaints represented the onset of a respiratory condition while the Veteran was in the military. Failure to address these reports renders the July 2024 opinion regarding both COPD and asthma inadequate.

In April 2025, VA obtained an opinion regarding whether the Veteran's asthma was related to TERA. The examiner gave a grammatically confusing rationale that the Board is unable to evaluate. This renders the April 2025 VA TERA opinion regarding asthma inadequate.

Once VA obtains an opinion, it must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Accordingly, the failure to provide adequate opinions as to whether a nexus exists between the Veteran's COPD and asthma and his military service, as well as between the Veteran's asthma and his TERA, constitutes a pre-decisional duty to assist error. Remand is necessary to obtain an addendum opinion to remedy these errors.

3. Entitlement to service connection for retinal detachment repair is remanded.

The Veteran contends that his currently diagnosed retinal detachment repair is related to TERA or his service-connected diabetes.

Service treatment records reflect that the Veteran had inflammation in his right eye in May 1974.

In May 2024, VA obtained an opinion regarding the Veteran's retinal detachment repair. The examiner concluded that it was less likely than not that the Veteran's retinal detachment repair was incurred in or caused by an in-service injury, event, or illness. The examiner noted that the Veteran's service treatment records did not reflect an eye injury. Risk factors for retinal detachment included history of eye surgery.

The May 2024 VA examiner is competent to form the opinion provided. However, the opinion incorrectly states that the Veteran's service treatment records were silent for eye injury. This renders the opinion inadequate. Remand is therefore necessary to obtain an adequate opinion regarding whether the Veteran's retinal detachment repair is directly related to complaints of eye inflammation in May 1974.

The May 2024 examiner identified eye surgery as a risk factor for retinal detachment. In the instant decision, the Board is granting service connection for pseudophakia, a condition associated with postoperative cataracts. Remand is necessary to determine whether the Veteran's service-connected pseudophakia caused or aggravated his retinal detachment.

The Board has also granted service connection for glaucoma, and on remand the RO will consider whether this disability caused or aggravated the Veteran's retinal detachment.

The November 2024 VA opinions did not specifically address retinal detachment repair.

A March 2024 opinion simply stated that there was no evidence in the Veteran's medical records linking the retinal detachment to his service records or TERA. This opinion is also inadequate due to its lack of rationale. On remand, an adequate opinion will be obtained regarding whether the Veteran's retinal detachment is related to in-service TERA.

Finally, the Veteran has argued that his retinal detachment repair is related to his service-connected diabetes mellitus. The Board has granted service connection for two other eye disabilities which are secondary to diabetes mellitus. It is therefore possible that his retinal detachment repair was caused or aggravated by diabetes mellitus. No opinion has been obtained regarding this linkage. In order to fulfill the duty to assist, VA will obtain such an opinion on remand. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006).

The matters are REMANDED for the following action:

1. Obtain an addendum opinion regarding the Veteran's COPD and asthma. The opinion should address the following questions:

(a.) Is it at least as likely as not that the Veteran's currently diagnosed COPD incurred during service, or is otherwise directly related to service?

(b.) Is it at least as likely as not
secondary to diabetes mellitus. It is therefore possible that his retinal detachment repair was caused or aggravated by diabetes mellitus. No opinion has been obtained regarding this linkage. In order to fulfill the duty to assist, VA will obtain such an opinion on remand. See McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006).

The matters are REMANDED for the following action:

1. Obtain an addendum opinion regarding the Veteran's COPD and asthma. The opinion should address the following questions:

(a.) Is it at least as likely as not that the Veteran's currently diagnosed COPD incurred during service, or is otherwise directly related to service?

(b.) Is it at least as likely as not that the Veteran's currently diagnosed asthma incurred during service, or is otherwise directly related to service?

(c.) The examiner is directed to address service treatment notations of respiratory complaints between June 1971 and July 1982, and explain whether these complaints represent the onset of COPD or asthma during the Veteran's active service.

(d.) Is it at least as likely as not that the Veteran's currently diagnosed COPD was caused by toxic exposure risk activities, after considering the total potential exposure through all applicable military deployments of the veteran and the synergistic, combined effect of all toxic exposure risk activities of the veteran?

(e.) Is it at least as likely as not that the Veteran's currently diagnosed asthma was caused by toxic exposure risk activities, after considering the total potential exposure through all applicable military deployments of the veteran and the synergistic, combined effect of all toxic exposure risk activities of the veteran?

2. Obtain an addendum opinion regarding the Veteran's retinal detachment repair. The opinion should address the following questions:

(a.) Is it at least as likely as not that the Veteran's currently diagnosed retinal detachment repair incurred during service, or is otherwise directly related to service?

(b.) The examiner is directed to address reports of right eye inflammation found in service treatment records from May 1974.

(c.) Is it at least as likely as not that the Veteran's currently diagnosed retinal detachment repair was proximately caused by another service-connected condition, including diabetes mellitus, glaucoma, and pseudophakia?

(d.) Is it at least as likely as not that the Veteran's currently diagnosed retinal detachment repair was aggravated by another service-connected condition, including diabetes mellitus, glaucoma, and pseudophakia? Note that aggravation in this context means any incremental increase in the non-service-connected disability (i.e., any additional impairment of earning capacity)?caused by the service-connected disability.

(e.) Is it at least as likely as not that the Veteran's currently diagnosed retinal detachment repair was caused by toxic exposure risk activities, after considering the total potential exposure through all applicable military deployments of the veteran and the synergistic, combined effect of all toxic exposure risk activities of the veteran?

Note?that the?lack?of documented treatment in service, or a long period after, while probative, cannot serve as the sole basis for a negative finding. The Veteran's lay contentions must be considered and weighed in making the determination.

The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached. The examiner is reminded that the term "as likely as not" does not mean "within the?realm?of medical possibility," but rather that the likelihood is at least approximately balanced or nearly equal, if not higher.

Bethany L. Buck

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Gibbons, Douglas K.

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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