OSTEOARTHRITIS

ERIC S. LEBOFF · 2026 · Case ID: A26014214

MIXED

Summary

The veteran, who served, appeals the denial of service connection for bilateral hearing loss, tinnitus, and right lower extremity radiculopathy, while service connection for degenerative arthritis of the right knee was granted. The Board found that the evidence was in approximate balance regarding the right knee condition, and applying the benefit of the doubt, granted service connection. The veteran reported right knee pain during service that has continued since, and while a VA examiner issued a negative nexus opinion, the Board found the continuity of symptomatology sufficient to grant service connection, noting arthritis is a chronic disease under 38 C.F.R. § 3.309(a). For bilateral hearing loss, the Board acknowledged a current diagnosis and in-service noise exposure but found the veteran's separation examination and service treatment records silent regarding complaints of hearing loss, which the Board found probative against service connection. A negative nexus opinion from a VA examiner also contributed to the denial. Similarly, for tinnitus, the Board noted the veteran's current diagnosis and a VA examiner's opinion linking it to hearing loss, but since service connection for hearing loss was denied, the tinnitus claim was also denied as not proximately due to or aggravated by a service-connected disability. Finally, for right lower extremity radiculopathy, the Board noted the absence of current medical evidence or diagnosis, and that the veteran, while competent to report symptoms, was not competent to diagnose the condition, leading to denial.

Rationale

Current diagnosis of degenerative arthritis of the right knee.; Reported onset of right knee pain during service with continued symptoms.; Continuity of symptomatology established for chronic disease.; Evidence in approximate balance; benefit of doubt applied.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

220924-280236

Full Decision Text

Citation Nr: A26014214
Decision Date: 02/17/26 Archive Date: 02/17/26

DOCKET NO. 220924-280236
DATE: February 17, 2026

ORDER

Entitlement to service connection for degenerative arthritis of the right knee is granted.

Entitlement to service connection for bilateral hearing loss is denied.

Entitlement to service connection for tinnitus as proximately due to service connected bilateral hearing loss is denied.

Entitlement to service connection for right lower extremity radiculopathy is denied.

FINDINGS OF FACT

1. The evidence is in at least approximate balance as to whether the Veteran has experienced right knee pain due to degenerative arthritis since his period of active service.

2. The weight of the evidence is persuasively against a finding that the Veteran's bilateral hearing loss is the result of an in-service event, injury, or occurrence, to include in-service onset and/or conceded exposure to hazardous noise.

3. The weight of the evidence is persuasively against a finding that the Veteran's tinnitus is proximately due to or aggravated by his service connected hearing loss.

4. The weight of the evidence is persuasively against a finding that the Veteran has a current diagnosis of right lower extremity radiculopathy.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for degenerative arthritis of the right knee are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.309.

2. The criteria for entitlement to service connection for bilateral hearing loss are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.309, 3.385.

3. The criteria for entitlement to service connection for tinnitus, to include as proximately due to or aggravated by a service connected disability, are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. The criteria for entitlement to service connection for right lower extremity radiculopathy are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The rating decision on appeal was issued in October 2021 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the September 2022 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A July 2025 notification advised the Veteran that a hearing was scheduled for November 7, 2025. The Veteran did not appear for the scheduled Board hearing. Therefore, the Board may only consider the evidence of record at the time of the October 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran [or representative] within 90 days following the date of the scheduled hearing. 38?C.F.R. §?20.302(c). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date of the scheduled Board hearing, or (2) more than 90 days following the date of the scheduled hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(c), 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[s], 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 will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and
3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], 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 will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); 38 C.F.R. § 3.303.

Entitlement to service connection may be established on a secondary basis where there is evidence of (1) a current, non-service-connected disability, (2) a current service-connected disability, and (3) evidence that the non-service-connected disability is either (i) proximately due to or the result of a service-connected disability or (ii) aggravated (increased in severity) beyond its natural progression by a service-connected disability. 38 U.S.C. § 1110; Allen v. Brown, 7 Vet. App. 439, 446 (1995); 38 C.F.R. § 3.310.

In adjudicating claims for VA benefits, the burden of proof only requires an "approximate balance" of the evidence for and against a claim. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1991). This low standard of proof is "unique" to the VA adjudicatory process, and "the nation, 'in recognition of our debt to our veterans,' has 'taken upon itself the risk of error' in awarding such benefits." Wise v. Shinseki, 26 Vet. App. 517, 531 (2014). In evaluating a claim for disability benefits, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107.

The Board has reviewed all of the evidence in the record, with an emphasis on the evidence relevant to this appeal. Although there is an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). Hence, the Board will summarize the relevant evidence as deemed appropriate and the analysis will focus specifically on what the evidence shows, or fails to show, as to the claim.

1. Entitlement to service connection for degenerative arthritis of the right knee

The Veteran has a current diagnosis of degenerative arthritis of the right knee. Where there is evidence of a chronic disability in service, but insufficient evidence of chronicity, the nexus element may be satisfied by a showing of a continuity of symptomatology after service. 38 C.F.R. §§ 3.303(b), 3.309(a). Arthritis is among those disabilities for which VA may presume a nexus between an in-service incurrence or event and a current disability provided there is a showing of continuity of symptomatology. See Walker v. Shinseki, 708 F.3d 1331, 1338-39 (Fed. Cir. 2013); 38 C.F.R. §§ 3.303(b), 3.309(a).

The Veteran has reported the onset of right knee pain during his period of active service. 07/26/2021, C&P Exam. He has indicated that such symptoms have continued since that time. Laypeople are competent to report symptoms and experiences observable by their senses, such as pain. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). No other evidence of record contradicts the Veteran's assertions.

The Board finds that the evidence is in at least approximate balance as to whether the Veteran has experienced right knee pain due to degenerative arthritis since his period of active service.

It is acknowledged that a negative nexus opinion was issued in July
active service. 07/26/2021, C&P Exam. He has indicated that such symptoms have continued since that time. Laypeople are competent to report symptoms and experiences observable by their senses, such as pain. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). No other evidence of record contradicts the Veteran's assertions.

The Board finds that the evidence is in at least approximate balance as to whether the Veteran has experienced right knee pain due to degenerative arthritis since his period of active service.

It is acknowledged that a negative nexus opinion was issued in July 2021. In this regard, as arthritis is a chronic disease under 38 C.F.R. § 3.309(a), an award solely based on continuity of symptomatology is permissible. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Given the above, the criteria for entitlement to service connection for degenerative arthritis of the right knee are met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.309.

2. Entitlement to service connection for bilateral hearing loss is denied.

The October 2021 rating decision on appeal reflects the favorable findings that the Veteran has a current diagnosis of bilateral hearing loss; and that the Veteran was exposed to hazardous noise during his period of active service.

However, in September 2021 a VA examiner opined that it was less likely than not that the Veteran's bilateral hearing loss had its onset during active service or was otherwise the result of an in-service event, injury, or occurrence, to include in-service hazardous noise exposure.

The Veteran's separation examination does not reflect any diagnosed hearing loss disability. 09/28/2014, STR - Medical at 3-7. Similarly, neither the Veteran's service treatment records (STRs) nor his separation examination reflect any complaints of hearing loss.

As a general matter, the absence of evidence is not substantive negative evidence. Horn v. Shinseki, 25 Vet. App. 231, 239 n.7 (U.S. 2012); see also Barr v. Nicholson, 21 Vet. App. 303, 310 (U.S. 2007) (the Board may not reject as not credible any uncorroborated statements merely because the contemporaneous medical evidence is silent as to complaints or treatment for the relevant condition or symptoms). While this is not an absolute rule, there must be "a proper foundation... to demonstrate that such silence has a tendency to prove or disprove a relevant fact." Horn at 239 n. 7.

Here, the Veteran's STRs and separation examination reflect a variety of other reports by the Veteran concerning his perceived state of health at that time. The Board thus finds the Veteran's silence as to hearing loss complaints to be probative of the question of whether he was experiencing any such phenomena at the time.

Further, the Board notes that at the September 2021 VA examination the Veteran reported that he first began to notice signs of hearing loss at age 26, approximately 4 years after the end of his period of active service.

In light of the above, the weight of the evidence is persuasively against a finding that the Veteran's bilateral hearing loss is the result of an in-service event, injury, or occurrence, to include in-service onset and/or conceded exposure to hazardous noise. The criteria for entitlement to service connection for bilateral hearing loss are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.309, 3.385.

3. Entitlement to service connection for tinnitus is denied.

The October 2021 rating decision on appeal reflects the favorable finding that the Veteran has a current diagnosis of tinnitus.

Here, the Veteran's STRs and separation examination reflect a variety of other reports by the Veteran concerning his perceived state of health at that time. The Board thus finds the Veteran's silence as to tinnitus-related complaints to be probative of the question of whether he was experiencing any such phenomena at the time.

The weight of the evidence is persuasively against a finding that the Veteran's tinnitus is the result of an in-service event, injury, or occurrence, to include in-service onset.

As noted above, service connection for a disability may be warranted where that disability is proximately due to or aggravated by another service connected disability.

In September 2021 a VA examiner opined that the Veteran's tinnitus is proximately due to his bilateral hearing loss. As discussed above, service connection is not in effect for bilateral hearing loss.

The weight of the evidence is persuasively against a finding that the Veteran's tinnitus is proximately due to or aggravated by his service connected hearing loss. There is no evidence to suggest, nor has the Veteran contended, that his tinnitus is proximately due to any disability other than his bilateral hearing loss.

Based on the foregoing, the criteria for entitlement to service connection for tinnitus, to include as proximately due to or aggravated by a service connected disability, are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

4. Entitlement to service connection for right lower extremity radiculopathy is denied.

In the absence of proof of a present disability due to disease or injury, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992)

The Veteran was afforded a VA examination in October 2020. The October 2021 VA examiner stated that there is no evidence of right lower extremity radiculopathy. A second VA examiner in July 2021 indicated no right lower extremity radiculopathy. No clinical records or other evidence demonstrates right lower extremity radiculopathy.

The Veteran may believe that he has radiculopathy of the right lower extremity. While he is competent to report observable symptoms such as numbness, he is not competent to diagnosis a chronic disability. The issue is medically complex, requiring knowledge of the interaction between multiple organ systems in the body and the anatomical relationships, pathology, and interpretation of complicated diagnostic medical testing. 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); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011)

In light of the above, the weight of the evidence is persuasively against a finding that the Veteran has a current diagnosis of right lower extremity radiculopathy. The criteria for entitlement to service connection for right lower extremity radiculopathy are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Sametshaw, Eric C.

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.

lower extremity radiculopathy. The criteria for entitlement to service connection for right lower extremity radiculopathy are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.310.

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Sametshaw, Eric C.

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