HEARING LOSS

B. D. WATSON · 2026 · Case ID: A26027288

DENIED

Summary

The Veteran served from May 1960 to June 1962 and received an honorable discharge. He appeals the denial of service connection for hearing loss, left leg blood clots, right leg blood clots, and dementia. The Board denied service connection for hearing loss because the Veteran failed to attend a scheduled VA examination and there was no evidence of a current hearing loss disability. The Board found the evidence persuasively against service connection for hearing loss, rendering the benefit of the doubt doctrine inapplicable. For the bilateral leg blood clots, the Board denied service connection, stating the first element of a current disability was not met as no medical records documented the condition. The Board noted it was not obligated to provide an examination when no supporting nexus evidence existed. For dementia, the Board acknowledged a current diagnosis but found the second element of service connection (in-service injury) was not met. The Veteran's service treatment records and personnel records did not indicate a head injury, dementia symptoms, or toxic exposure risk activity (TERA). A TERA memorandum also stated the Veteran had not participated in any TERA. The Board found the evidence persuasively against a causal relationship to service and deemed the benefit of the doubt doctrine inapplicable. Consequently, all claims were denied.

Rationale

No evidence of current hearing loss disability; Veteran failed to report for VA hearing loss examination; Benefit of the doubt doctrine inapplicable as evidence weighs against claim

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250514-546099

Full Decision Text

Citation Nr: A26027288
Decision Date: 03/26/26 Archive Date: 03/26/26

DOCKET NO. 250514-546099
DATE: March 26, 2026

ORDER

Entitlement to service connection for hearing loss is denied.

Entitlement to service connection for left leg blood clots is denied.

Entitlement to service connection for right leg blood clots is denied.

Entitlement to service connection for dementia is denied.

FINDINGS OF FACT

1. The record does not have evidence of a hearing loss diagnosis and the Veteran failed to report to a VA hearing loss examination.

2. The record does not have evidence of a bilateral leg blood clot diagnosis.

3. The persuasive weight of the evidence weighs against a finding that the Veteran's dementia was causally related to his active-duty service.

CONCLUSIONS OF LAW

1. The criteria for service connection for hearing loss have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for left leg blood clots have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for right leg blood clots have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for dementia have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from May 1960 until June 1962. He was honorably discharged.

This matter comes before the Board of Veterans' Appeals (Board) from a March 2025 rating decision issued by a Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ), which denied service connection for hearing loss, bilateral leg blood clots and dementia. In May 2025, the Veteran filed a timely VA Form 10182, Notice of Disagreement (NOD) requesting the direct review docket with review by a Veterans Law Judge. Accordingly, the Board may only consider the evidence of record at the time of the AOJ decision on appeal. 38 C.F.R. § 20.301.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

This appeal has been advanced on the docket pursuant to 38 C.F.R. § 20.902(c).

1. Entitlement to service connection for hearing loss is denied.

Generally, to establish a right to compensation for a present disability, 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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). All three elements must be established by competent and credible evidence to find service connection.

Service connection may be established for any disease after discharge, when the evidence establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Moreover, where a veteran served continuously for 90 days or more, certain chronic disabilities, such as organic diseases of the nervous system, to include sensorineural hearing loss, are presumed to have been incurred in service, if manifested to a compensable degree within one year of separation from service, even though there is no evidence of such disease during the period of service. See, Fountain v. McDonald, 27 Vet. App. 258 (2015) (sensorineural hearing loss is an organic disease of the nervous system and the presumption of 38 C.F.R. § 303(b) and 38 C.F.R. § 3.309(a) applies). This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S
served continuously for 90 days or more, certain chronic disabilities, such as organic diseases of the nervous system, to include sensorineural hearing loss, are presumed to have been incurred in service, if manifested to a compensable degree within one year of separation from service, even though there is no evidence of such disease during the period of service. See, Fountain v. McDonald, 27 Vet. App. 258 (2015) (sensorineural hearing loss is an organic disease of the nervous system and the presumption of 38 C.F.R. § 303(b) and 38 C.F.R. § 3.309(a) applies). This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 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). However, 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) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

For the purposes of applying the law administered by VA, impaired hearing is considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz (specified frequencies) is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. "[W]hen audiometric test results at a veteran's separation from service do not meet the regulatory requirements for establishing a 'disability' at that time, the Veteran may nevertheless establish service connection for a current hearing disability by submitting evidence that the current disability is causally related to service." Hensley v. Brown, 5 Vet. App. 155, 160 (1993). A veteran does not need to show 38?C.F.R. §?3.385 hearing loss at any time in service, including on the service separation examination. See 3.303(d) (Service connection may be granted for any disease diagnosed after discharge that was incurred in service); Hensley v. Brown, 5 Vet. App. 155, 159 (1993); Godfrey v. Derwinski, 2 Vet. App. 352, 356 (1992) (holding that a veteran may establish the required nexus between current hearing loss disability and the term of military service if he can show that the hearing loss disability resulted from acoustic trauma).

The VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154(a). Lay testimony is competent to prove that a claimant exhibited certain lay-observable symptoms and the time those symptoms appeared. Layno v. Brown, 6 Vet. App. 465, 470 (1994).

Lay assertions may serve to support a claim for service connection by establishing the occurrence of observable events or the presence of disability or symptoms of disability that are subject to lay observation. 38 U.S.C. § 1153 (a); 38 C.F.R. § 3.303 (a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F. 3d 1331, 1336 (Fed. Cir. 2006) (addressing lay evidence as potentially competent to support presence of disability even where not corroborated by contemporaneous medical evidence). Lay testimony is not competent to determine the extent or etiology of hearing loss, as such matters require medical testing and expertise to determine. See Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007); Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011).

The Veteran has the responsibility to present and support a claim
Buchanan v. Nicholson, 451 F. 3d 1331, 1336 (Fed. Cir. 2006) (addressing lay evidence as potentially competent to support presence of disability even where not corroborated by contemporaneous medical evidence). Lay testimony is not competent to determine the extent or etiology of hearing loss, as such matters require medical testing and expertise to determine. See Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007); Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011).

The Veteran has the responsibility to present and support a claim for benefits. 38 U.S.C. § 5107(a). The VA shall consider all information, including lay and medical evidence of record. VA is responsible for determining whether the evidence persuasively favors one side or another. 38 C.F.R. § 4.3. When there is an approximate or nearly equal balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the Veteran and the claim will be granted on the merits. 38 U.S.C. § 5107(b). When the evidence persuasively favors against the claims of the Veteran, the benefit of the doubt doctrine is inapplicable, and the claim will be denied on its merits. 38 U.S.C. § 5107; Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021).

The first element of service connection is a current disability. The evidence of record does not reflect the Veteran has a current hearing loss disability. The March 2025 rating decision noted that the Veteran failed to report for a hearing loss examination. In March 2025, the VA attempted to contact the Veteran about his failure to report to his hearing loss examination but was unable to reach anyone at either number previously provided by the Veteran. An Informal Hearing Presentation (IHP) also noted the Veteran did not attend his VA hearing loss examination and noted that the Veteran should have an examination. The IHP offered no additional information regarding the Veteran's failure to report for his hearing loss examination, including whether there was good cause for such failure to report. As there was no evidence of a current hearing loss disability, the first element of service connection has not been satisfied.

As the first element of service connection is not satisfied, there is no need to discuss the remaining elements of service connection. As the three elements of service connection have not been met, the persuasive weight of the evidence weighs against the finding of service connection for hearing loss.

The Board has considered the benefit of the doubt doctrine and determined it is not applicable. As the evidence is persuasively against the Veteran's claim for service connection for hearing loss, the evidence is not in approximate balance, and the benefit of the doubt rule does not apply. Therefore, the claim must be denied. See 38 U.S.C. § 5107(b); 38 CFR § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

2. Entitlement to service connection for left leg blood clots is denied.

3. Entitlement to service connection for right leg blood clots is denied.

As noted above, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Disorders diagnosed after discharge will still be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

The claimant has the responsibility to present and support a claim for benefits. 38 U.S.C. § 5107(a). The VA shall consider all information, including lay and medical evidence of record. VA is responsible for determining whether the evidence persuasively favors one side or another. 38 C.F.R. § 4.3. When there is an approximate or nearly equal balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter,
Cir. 2004). Disorders diagnosed after discharge will still be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

The claimant has the responsibility to present and support a claim for benefits. 38 U.S.C. § 5107(a). The VA shall consider all information, including lay and medical evidence of record. VA is responsible for determining whether the evidence persuasively favors one side or another. 38 C.F.R. § 4.3. When there is an approximate or nearly equal balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the Veteran and the claim will be granted on the merits. 38 U.S.C. § 5107(b). When the evidence persuasively favors against the claims of the Veteran, the benefit of the doubt doctrine is inapplicable, and the claim will be denied on its merits. 38 U.S.C. § 5107; Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021).

The first element of service connection is a current disability. The Veteran submitted some medical records, none of which documented that the Veteran had bilateral leg blood clots. Accordingly, there is no evidence of a current blood clot disability. As there is no evidence of a current disability, the first element of service connection has not been satisfied.

As the first element of service connection was not satisfied, there is no need to discuss the remaining elements of service connection. As the three elements of service connection have not been met, the persuasive weight of the evidence weighs against the finding of service connection for bilateral leg blood clots.

The Board is aware that the Veteran did not have a VA examination to address blood clots. The VA is not obligated to provide an examination for a medical nexus opinion where there is no supporting nexus evidence in the record. 38 U.S.C. § 38 C.F.R. § 5103A(d)(2)A and B; McLendon v. Nicholson, 20 Vet. App. 79 (2006); Duenas v. Principi, 18 Vet. App. 512, 519 (2004).

The Board has considered the benefit of the doubt doctrine and determined it is not applicable. As the evidence is persuasively against the Veteran's claim for service connection for bilateral leg blood clots, the evidence is not in approximate balance, and the benefit of the doubt rule does not apply. Therefore, the claim must be denied. See 38 U.S.C. § 5107(b); 38 CFR § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

4. Entitlement to service connection for dementia is denied.

The first element of service connection is a current disability. The March 2025 medical records submitted by the Veteran confirmed he was diagnosed with dementia. Accordingly, the first element of service connection, a current dementia disability, is satisfied.

The second element of service connection is an inservice injury. The Veteran's service treatment records did not contain any evidence of a head injury, dementia type symptoms, or toxic exposure risk activity (TERA). The Veteran's military personnel records reflected the Veteran worked in a warehouse and at the time of discharge had been working in food services at an Air Force hospital. His May 1960 to August 1961 evaluation report noted that he was responsible for ordering food supplies for issuance to dining halls and also worked in a hospital subsistence warehouse room. The March 2025 TERA memorandum stated the Veteran had not participated in any TERA. Accordingly, there is no evidence to support a finding that the Veteran incurred dementia in service or as a result of an event in service which may later have precipitated dementia. Thus, the second element of service connection has not been satisfied.

As the three elements of service connection have not been satisfied, the persuasive weight of the evidence weighs against a finding that the Veteran's dementia is causally related to service.

The Board is aware that the Veteran did not have a VA examination to address his dementia. The VA is not obligated to provide an examination for a medical nexus opinion where there is no supporting nexus evidence in the record. 38 U.S.C. § 38 C.F.R. § 5103A(d)(2)A and B; McLendon v. Nicholson, 20 Vet. App. 79 (2006); Duenas v. Principi, 18 Vet. App. 512, 519 (2004).

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The Board
of service connection have not been satisfied, the persuasive weight of the evidence weighs against a finding that the Veteran's dementia is causally related to service.

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The Board has considered the benefit of the doubt doctrine and determined it is not applicable. As the evidence is persuasively against the Veteran's claim for service connection for dementia, the evidence is not in approximate balance, and the benefit of the doubt rule does not apply. Therefore, the claim must be denied. See 38 U.S.C. § 5107(b); 38 CFR § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

B. D. WATSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board W. Polk

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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