HEARING LOSS

J. NICHOLS · 2026 · Case ID: A26025159

MIXED

Summary

The Veteran, a Marine Corps Reserve Veteran who served from October 2008 to March 2009 on active duty and July 2008 to July 2016 in the Reserves, appeals the denial of a compensable initial rating for left ear hearing loss and the denial of service connection for Meniere's syndrome and vertigo. The Board denied the hearing loss claim, finding the evidence did not meet the criteria for a compensable rating, as audiometric data indicated only Level I impairment in both ears, and the Veteran's own statements about worsening symptoms lacked current audiometric support. The Board found the evidence regarding Meniere's syndrome and vertigo to be in approximate balance, ultimately granting service connection. This decision was based on a favorable March 2020 VA opinion linking the conditions to service-related vertigo, corroborated by the Veteran's testimony and fellow service members' observations of dizziness during service. The Board also gave weight to a private neurologist's opinion suggesting a link to service-connected hearing loss and tinnitus. The Veteran's claims for Meniere's syndrome and vertigo were granted service connection due to the approximate balance of evidence.

Rationale

Evidence persuasively weighs against entitlement to a compensable initial rating.; Audiometric data indicated Level I impairment in both ears.; Veteran's assertions of worsening symptoms lacked current audiometric data.

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210323-148646

Full Decision Text

Citation Nr: A26025159
Decision Date: 03/20/26 Archive Date: 03/20/26

DOCKET NO. 210323-148646
DATE: March 20, 2026

ORDER

The appeal for a compensable initial rating for left ear hearing loss is denied.

Service connection for Meniere's syndrome is granted.

Service connection for vertigo is granted.

FINDINGS OF FACT

1. The Veteran's hearing disability was manifested, at worst, by Level I hearing in the right ear and Level I hearing in the left ear.

2. The evidence is at least in approximate balance that the Veteran's Meniere's syndrome and vertigo began during service.

CONCLUSIONS OF LAW

1. The criteria for a compensable initial rating for left ear hearing loss are not met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.85, 4.86.

2. The criteria for service connection for Meniere's syndrome are met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304.

3. The criteria for service connection for vertigo are met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from October 2008 to March 2009 as well as service in the U.S. Marine Corps Reserve from July 2008 to July 2016.

In the March 23, 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on September 18, 2024.

Therefore, the Board may only consider the evidence of record at the time of the June 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 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.

Increased Rating

Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4. The rating schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of, or incident to, military service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. All benefit of the doubt will be resolved in the Veteran's favor. 38 U.S.C. § 5107 (b); Lynch v. McDonough, 21 F.4th 776, 780-81 (Fed. Cir. 2021).

A veteran's entire history is to be considered when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). Where the appeal arises from the original assignment of a disability evaluation following an award of service connection, the severity of the disability at issue is to be considered during the entire period from the initial assignment of the disability rating to the present time. See Fenderson v. West, 12 Vet. App. 119 (1999). Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. Francisco v. Brown, 7 Vet. App. 55, 58 (1994). The Court has held that "staged" ratings are appropriate for an increased rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. Hart v. Mansfield, 21 Vet. App. 505 (2007).

Disability evaluations are determined by the application of the facts presented to VA's Schedule for Rating Disabilities (Rating Schedule) at 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and the residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

Although all the evidence has been reviewed, only the most relevant and salient evidence is discussed below. See Gonzales v. West, 218 F.3d 1378 (Fed. Cir. 2000) (holding that the Board must review the entire record but does not have to discuss each piece of evidence).

Ratings for hearing loss range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of speech discrimination tests combined with the average hearing threshold levels as measured by pure tone audiometry tests in the frequencies 1000, 2000, 3000, and 4000 cycles per second. To rate the degree of disability for service-connected hearing loss, the Rating Schedule has established eleven auditory acuity levels, designated from Level I, for essentially normal acuity, through Level XI, for profound deafness. 38 C.F.R. § 4.85 (h), Table VI.

The assignment of disability ratings for hearing impairment is derived by a mechanical application of the Rating Schedule to the numeric designations assigned after audiometric evaluations are rendered. See Lendenman v. Principi, 3 Vet. App. 345 (1992).

The rating criteria for hearing impairment use controlled speech discrimination tests (Maryland CNC) together with the results of pure tone audiometry tests. These results are then charted on Table VI, or Table VIA in exceptional cases as described in 38 C.F.R. § 4.86, and Table VII, as set out in the Rating Schedule. 38 C.F.R. § 4.85. An exceptional pattern of hearing loss occurs when the pure tone threshold at 1000, 2000, 3000, and 4000 Hertz is 55 decibels or more, or when the pure tone threshold is 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz. 38 C.F.R. § 4.86. Specifically, when the pure tone threshold is 30 decibels or less at 1000 Hertz and 70 decibels or more at 2000 Hertz, the Roman numeral designation for hearing impairment is determined from either Table VI or Table VIA, whichever results in the higher numerical. 38 C.F.R. § 4.86 (b). That numeral will then be elevated to the next higher Roman numeral. Each ear will be evaluated separately. Id.

In Martinak v. Nicholson, 21 Vet. App. 447, 455 (2007), the United States Court of Appeals for Veterans Claims (Court) held that relevant to VA audiological examinations, in addition to dictating objective test results, a VA audiologist must fully describe the functional effects caused by a hearing disability in his or her final report. Id.

In this case,
els or more at 2000 Hertz, the Roman numeral designation for hearing impairment is determined from either Table VI or Table VIA, whichever results in the higher numerical. 38 C.F.R. § 4.86 (b). That numeral will then be elevated to the next higher Roman numeral. Each ear will be evaluated separately. Id.

In this case, service connection for left ear hearing loss was established by a January 2020 rating decision, and assigned a noncompensable rating. The Veteran filed a supplemental claim in February 2020. The AOJ continued the noncompensable rating in a June 2020 rating decision. The present appeal arises from disagreement with the June 2020 rating decision. As the Veteran continuously pursued a higher rating since the initial rating was assigned, the initial rating is on appeal.

The Veteran's left ear hearing disability has been rated pursuant to 38 C.F.R. § 4.86, Diagnostic Code 6100.

Entitlement to a compensable initial rating for left ear hearing loss.

The Veteran submitted a private audiogram dated in July 2019. At that time, the Veteran reported difficulty hearing in noisy environments. The Veteran had pure tone thresholds in the left ear as follows: 5, 15, 25, and 65 at the frequencies of 1000, 2000, 3000, and 4000 Hz, respectively. The Veteran had puretone thresholds in the right ear as follows: 10, 15, 15, and 10 at the frequencies of 1000, 2000, 3000, and 4000 Hz, respectively. His puretone average was 27.5 in the left ear and 12.5 in the right ear. Speech discrimination scores were recorded but it is unclear whether the Maryland CNC speech discrimination test was used for the private evaluation.

Applying Table Via (using pure tone thresholds only), the July 2019 findings of puretone threshold averages of 27.5 in the left ear and 12.5 in the right ear results in Level I in each ear.

The Veteran was provided with a VA examination in October 2019. At that time, the Veteran reported that he had difficulty hearing on his job as a corrections officer, in noisy environments, and while watching television. The Veteran had puretone thresholds in the left ear as follows: 10, 15, 25, and 60 at the frequencies of 1000, 2000, 3000, and 4000 Hz, respectively. He had puretone thresholds in the right ear as follows: 10, 0, 10, and 5 at the frequencies of 1000, 2000, 3000, and 4000 Hz, respectively. His puretone average was 27.5 in the left ear and 6.25 in the right ear. Speech discrimination testing was 100 percent in the left ear and 96 percent in the right ear.

Applying Table VI, the October 2019 findings of 100 percent speech discrimination score and pure tone threshold average of 27.50, results in Level I in the left ear. Applying the same table to the right ear average speech discrimination score of 96 percent and pure tone threshold of 6.25 results in Level I in the right ear.

Applying Table VII to Level I in the right ear and Level I in the left ear, results in a noncompensable rating under Table VII. 38 C.F.R. § 4.85, Table VII.

VA and private treatment records do not demonstrate worse findings than those noted during the July 2019 private audiogram and October 2019 VA examination.

The Board has considered the Veteran's functional impairment associated with hearing loss. Notably, when the October 2019 VA examiner asked the Veteran to describe his functional impairment due to hearing loss, the Veteran reported that he experiences difficulty hearing at his job and in noisy environments as well as difficulty hearing his television. Similarly, the July 2019 private clinician also noted the Veteran's reports of difficulty hearing in noisy environments.

The Board acknowledges that the Veteran asserts that his left ear hearing loss should warrant a higher rating, particularly given his young age and the suggestion that he inquire about hearing aids at VA. Transcript page 4. However, the Board observes that, while the Veteran is competent to report symptoms such as difficulty hearing or understanding speech, he is not competent to report that his hearing
functional impairment associated with hearing loss. Notably, when the October 2019 VA examiner asked the Veteran to describe his functional impairment due to hearing loss, the Veteran reported that he experiences difficulty hearing at his job and in noisy environments as well as difficulty hearing his television. Similarly, the July 2019 private clinician also noted the Veteran's reports of difficulty hearing in noisy environments.

The Board acknowledges that the Veteran asserts that his left ear hearing loss should warrant a higher rating, particularly given his young age and the suggestion that he inquire about hearing aids at VA. Transcript page 4. However, the Board observes that, while the Veteran is competent to report symptoms such as difficulty hearing or understanding speech, he is not competent to report that his hearing acuity is of sufficient severity to warrant a particular evaluation under VA's tables for rating hearing loss disabilities because such an opinion requires medical expertise (training in evaluating hearing impairment), which he has not been shown to have. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006); Charles v. Principi, 16 Vet. App. 370 (2002); Woehlaert v. Nicholson, 21 Vet. App. 456 (2007).

The Board has also considered the Veteran's sworn testimony that his hearing loss had worsened over the past couple of years (prior to the 2024 Board hearing). The Board observes that the most recent audiogram data was obtained in 2019. As the present appeal arises from the June 2020 rating decision, there is no duty to assist error by failing to obtain a more recent audiogram. The Board is not able to apply the rating tables to the Veteran's statement that his hearing loss has worsened without audiogram data. The Veteran is welcome to file a supplemental claim following this decision.

The Board has also considered whether referral for an extraschedular rating is warranted. The Court has held that the schedular criteria for rating hearing loss, contemplate the functional effects of difficulty hearing and understanding speech. Doucette v. Shulkin, 28 Vet. App. at 371. These would include any difficulty hearing or understanding speech. Again, the Veteran has not reported any additional functional impairment other than Meniere's syndrome and vertigo, for which the Board is granting service connection herein. Thus, the Board finds the schedular criteria here adequately address the functional impact of the Veteran's left ear hearing loss.

Because the evidence persuasively weighs against entitlement to a compensable initial rating for left ear hearing loss, the benefit of the doubt doctrine is not for application as to this claim. See 38 U.S.C. § 5107 (b); Lynch, 21 F.4th at 780-81. Accordingly, the appeal for a compensable initial rating is denied.

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d).

Direct service connection may not be granted without evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disease or injury. 38 U.S.C. § 1112; 38 C.F.R. § 3.304. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Additionally, for Veterans who served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities are presumed to have been incurred in service if manifest to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309.

Alternatively, when a disease at 38 C.F.R. § 3.309 (a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service. See 38 C.F.R. § 3.303 (b). The use of continuity of symptoms to establish service connection is limited only to those diseases listed
after December 31, 1946, certain chronic disabilities are presumed to have been incurred in service if manifest to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309.

Alternatively, when a disease at 38 C.F.R. § 3.309 (a) is not shown to be chronic during service or the one-year presumptive period, service connection may also be established by showing continuity of symptomatology after service. See 38 C.F.R. § 3.303 (b). The use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309 (a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

In addition to the regulations cited above, service connection is warranted for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury. 38 C.F.R. § 3.310. Any additional impairment of earning capacity resulting from an already service-connected condition, regardless of whether or not the additional impairment is itself a separate disease or injury caused by the service-connected condition, should also be compensated. Allen v. Brown, 7 Vet. App. 439 (1995). When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. Id.

The determination as to whether the requirements for service connection are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. 38 U.S.C. § 7104 (a); see 38 C.F.R. § 3.303 (a).

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.

1. Entitlement to service connection for Meniere's syndrome.

2. Entitlement to service connection for vertigo.

In this case, there is no dispute that the Veteran has current diagnoses of Meniere's syndrome and vertigo. See June 2020 rating decision. The Veteran asserts that his Meniere's syndrome and vertigo are related to service or his service-connected left ear hearing loss and tinnitus. See Transcript page 8.

There is no dispute that the Veteran was exposed to significant noise during service. In this regard, service connection is already in effect for left ear hearing loss and tinnitus due to noise exposure during service.

The Veteran provided private treatment records that indicated that his Meniere's syndrome and vertigo were related to service-connected hearing loss and tinnitus. In this regard, in a November 2019 private disability benefits questionnaire, a private clinician interviewed the Veteran and reviewed the Veteran's treatment records from an ear, nose, and throat (ENT) specialist, and determined that the Veteran had a diagnosis of Meniere's syndrome. The clinician noted the Veteran's reports that he had progressively worsening tinnitus during the five years prior to the evaluation. The examiner also noted the Veteran's report that he had severe tinnitus during service and that the Veteran had severe left ear hearing loss. The examiner noted that the Veteran's Meniere's syndrome episodes lasted from a few minutes to 4-6 hours. The examiner also noted the Veteran's reports of bilateral ear fullness and severe dizziness when that almost completely resolves between episodes. The examiner noted the Veteran's reports that he constantly felt dizzy with quick head movements. The examiner noted that the Veteran's symptoms of Meniere's syndrome included the following: hearing impairment with vertigo, hearing impairment with attacks of vertigo and cerebellar gait, tinnitus, vertigo, and hearing loss.

A VA medical opinion was obtained in January 2020. The VA examiner determined that it was less likely than not that the Veteran's disorders were related to service. The examiner reasoned that there was no evidence of Meniere's disease in service or within one year of service separation. The examiner noted that the Veteran's diagnosis was in 2019 with symptoms having begun in the year prior to the diagnosis. The examiner also opined that it was less likely than not that the Veteran's disorders were a result of service-connected disorder. The examiner explained that the hearing loss and Meniere's disease are not medically related. The examiner noted that Meniere's disease is a separate entity entirely from hearing loss, tinnitus, noise exposure and unrelated to it. The examiner noted that medical literature did not support a medical relationship and that the cause of Meniere's disease is unknown. The examine also
disorders were related to service. The examiner reasoned that there was no evidence of Meniere's disease in service or within one year of service separation. The examiner noted that the Veteran's diagnosis was in 2019 with symptoms having begun in the year prior to the diagnosis. The examiner also opined that it was less likely than not that the Veteran's disorders were a result of service-connected disorder. The examiner explained that the hearing loss and Meniere's disease are not medically related. The examiner noted that Meniere's disease is a separate entity entirely from hearing loss, tinnitus, noise exposure and unrelated to it. The examiner noted that medical literature did not support a medical relationship and that the cause of Meniere's disease is unknown. The examine also noted that symptoms of Meniere's disease appeared to be a result of an abnormal amount of fluid in the inner ear but that it was not clear what caused that to happen. The examiner noted that factors that affect the fluid and might contribute to Meniere's disease generally included improper fluid drainage, abnormal immune response, viral infection, and genetic predisposition. The examiner cited a medical journal article indicating that because no single cause has been identified, it is likely that Meniere's disease results form a combination of factors.

Another VA opinion was obtained in March 2020. At that time, the examiner addressed a private treatment record dated in September 2019 which noted that the Veteran's symptoms of motion sickness, dizziness, balance issues were related to Meniere's syndrome. The examiner also opined that given the Veteran's records, medical history, symptoms and treatments, it was at least as likely as not that Meniere's syndrome was incurred in or caused by the vertigo during service.

The Veteran submitted a statement from a fellow service member dated in March 2021. The service member reported that during boot camp, he remembered the Veteran complaining of dizzy spells and that the Veteran would sit out of training and say he felt dizzy and off balance.

Another statement from a different fellow service member, C.M., noted that he served with the Veteran for three years in the same platoon. C.M. reported that he remembered the Veteran periodically complaining of feeling lightheaded and drunk when he had not been drinking.

An August 2024 private opinion from Dr. R.S., neurologist, opined that the Veteran's Meniere's syndrome was highly likely a direct result of service. Dr. R.S. noted that he had been the regular treating neurologist for the Veteran since September 2019. Dr. R.S. also explained that the Veteran had no other known risk factors that may have precipitated the Veteran's Meniere's syndrome.

In September 2024 letter, Dr. J.F. opined that the Veteran's Meniere's disease was caused by prolonged and repeated acoustic trauma while in service.

During the September 2024 hearing before the Board, the Veteran reported that before he separated from service, he was given a hearing test and told that his hearing had gotten significantly worse. The Veteran reported that every so often he would get attacks where he would feel extremely dizzy. He described feeling like his body was being pulled into a certain direction. He reported seeking medical attention from a neurologist and mentioning the symptoms to his chain of command. Transcript page 8. The Veteran reported that his Meniere's symptoms began in 2009. He reported that he started mentioning the symptoms when he first got into the Reserve and it got progressively worse. He reported that he currently has attacks two to four times per week. Transcript page 8. The Veteran reported that following a magnetic resonance imaging (MRI) of the brain, he was sent to an ENT where he was given another hearing examination. The Veteran reported that the physician asked the Veteran his branch of service and told the Veteran that he had Meniere's disease and not a disorder affecting his brain. He reported that the physician explained to him that lots of Veterans get hearing loss and develop tinnitus and sometimes, rarely, it escalates to the point where the patients develop Meniere's. The physician indicated to the Veteran that the Meniere's was due to his prolonged exposure to acoustic trauma.

Based on the foregoing, the Board finds that the evidence is at least in approximate balance as to whether the Veteran's Meniere's syndrome and vertigo are secondary to service- connected disabilities. In this regard, the Board places a high probative value on the September 2024 private opinion because the private clinician offered a detailed explanation for the basis of the opinion that it was likely that the Veteran's Meniere's syndrome (of which vertigo is a symptom) had evolved from the Veteran's hearing loss and tinnitus. The Board also places a high probative value on the March 2020 VA opinion in which the examiner found that it was at least as likely as not that the Veteran's Meniere's syndrome and
acoustic trauma.

The Board also places a high probative value on the Veteran's sworn testimony that his Meniere's symptoms began in 2009, toward the end of his active service. These statements are bolstered by the Veteran's fellow service members who observed the Veteran complaining of symptoms of vertigo and being off balance during service. The Board places a high probative value on the lay statements as the fellow service members are competent to report their observations and the Board has no reason to doubt their credibility.

For these reasons, the Board finds that the evidence is at least in approximate balance that the Veteran's Meniere's syndrome and vertigo began in service. Thus, service connection for Meniere's syndrome and vertigo is warranted.

J. NICHOLS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board D. Ebaugh, 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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