HEARING LOSS

M. MILLS · 2026 · Case ID: A26028620

DENIED

Summary

The Veteran, who served in the United States Army from March 1996 to May 1996, appeals the denial of service connection for bilateral hearing loss, tinnitus, and Meniere's disease. The Veteran claims these conditions are due to noise exposure during service and, alternatively, that Meniere's disease is secondary to service-connected PTSD. The Board reviewed the evidence, including the Veteran's testimony and various medical records. While the Veteran claimed onset of symptoms during basic training due to noise exposure, service records were negative for any complaints related to hearing or balance. Post-service records showed the earliest complaints in 2009, with diagnoses of tinnitus and Meniere's disease in 2013. The Board found the Veteran's reports of symptom onset and continuity to be inconsistent and not credible, particularly given the significant gap between claimed in-service onset and first medical treatment. VA examinations in September 2020 found hearing within normal limits and no evidence of permanent auditory damage or a nexus to service for tinnitus and Meniere's disease. The Board also noted the lack of competent medical opinions linking the conditions to service. The claim for Meniere's disease secondary to PTSD also lacked competent evidence. Consequently, the Board denied service connection for all claimed conditions.

Rationale

No current hearing loss disability established per 38 CFR § 3.385; November 2015 audiogram too old to establish current disability; September 2020 VA audiological exam showed normal hearing; June 2023 private audiogram showed normal hearing; Lay statements insufficient to establish objective hearing loss

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210311-145871

Full Decision Text

Citation Nr: A26028620
Decision Date: 03/30/26 Archive Date: 03/30/26

DOCKET NO. 210311-145871
DATE: March 30, 2026

ORDER

The claim for service connection for a bilateral hearing loss disability is denied.

The claim for service connection for tinnitus is denied.

The claim for service connection for a vestibular disability currently diagnosed as Meniere's disease, to include as secondary to service connected posttraumatic stress disorder (PTSD), is denied.

FINDINGS OF FACT

1. In an April 2019 rating decision, the AOJ made a favorable finding that a current right ear hearing loss disability was present. This finding constitutes clear and unmistakable error (CUE) and is overturned.

2. The Veteran does not have a bilateral hearing loss disability for VA purposes.

3. A causal relationship does not exist between the Veteran's tinnitus and an in-service disease or injury.

4. A causal relationship does not exist between the Veteran's vestibular disability, currently diagnosed as Meniere's disease, and an in-service disease or injury or a service-connected disability.

CONCLUSIONS OF LAW

1. The criteria for service connection for a bilateral hearing loss disability are not met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.385.

2. The criteria for service connection for tinnitus are not met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.307, 3.309.

3. The criteria for establishing service connection for a vestibular disability, currently diagnosed as Meniere's disease, are not met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty with the United States Army from March 1996 to May 1996. This case comes before the Board of Veterans' Appeals (Board) on appeal from an October 2020 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO).

The Appeals Modernization Act (AMA) automatically applies to all claims for which VA issues notice of an initial decision on or after February 19, 2019. See 38 C.F.R. § 3.2400(a)(1). The October 2020 rating decision issued by VA, agency of original jurisdiction (AOJ), was generated following the Veteran's February 2019 claims for service connection and the Board's April 2020 remand. The October 2020 rating decision constitutes an initial decision, and the AMA applies.

The Board remanded the claims for service connection for a hearing loss disability, tinnitus, and Meniere's disease in April 2020 to correct pre-decisional errors of the duty to assist. The AOJ then issued the October 2020 rating decision on appeal, confirming and continuing the denials of service connection. The Veteran responded with a VA Form 10182 (Decision Review Request: Board Appeal) on March 11, 2021. She elected to place her appeal on the Hearing docket. As a valid and timely VA Form 10182 was received, the appeal is properly before the Board.

The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a virtual hearing in October 2024. A transcript of the hearing is included in the claims file. The Board may only consider the evidence of record at the time of the October 2020 rating decision, as well as any evidence submitted by the appellant at the October 2024 hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a).

In other words, the Board cannot consider (1) evidence submitted during the period after the AOJ issued the October 2020 rating decision, or (2) evidence submitted more than 90 days after the October 2024 Board hearing. 38 C.F.R. § 20.303.

In an October 14, 2024 brief to the Board, the Veteran's representative argued that the Veteran's claimed Meniere's disease was etiologically related to service connected PTSD. In support of this contention, the representative cited to a medical journal article and stated that a copy of the article (as well as a "few" others) were attached to the brief. The actual articles were not attached to the brief, associated with private treatment records submitted later in October 2024, or otherwise submitted to the Board. Thus, the representative's October 2024 brief references content that is not otherwise part of the record on appeal; it was therefore not accessed nor considered as part of the record before the Board. See Bowey v. West, 11 Vet. App. 106, 108-09 (1998) (holding that the mere reference to non-VA documents is insufficient to incorporate them into the record); see also Nici v. Brown, 9 Vet. App. 494, 497-98 (1996) (medical treatises appended to appellant's brief were not part of record on appeal and could not be considered); Obert v. Brown, 5 Vet. App. 30, 32 (1993) (excerpt from medical treatise not before Board could not be considered by the Court of Appeals for Veterans Claims (Court) on appeal).

As a final matter, the Board also finds that remanding the claim for service connection for a hearing loss disability for an additional VA examination is not appropriate. During the October 2024 hearing, the Veteran testified that her hearing has worsened since the September 2020 VA audiological examination. In the October 2024 brief to the Board, the Veteran's representative argued that a new VA examination was warranted under Caffrey v. Brown, 6 Vet. App. 377, 381 (1994) based on the Veteran's reported worsening of her claimed disability.

Under the AMA, the Board looks for "pre-decisional" duty to assist errors-meaning that the error must have occurred prior to the AOJ decision on appeal. In this case, the Board is limited to looking for pre-decisional duty to assist errors prior to the October 2020 rating decision on appeal. Thus, any alleged worsening of the Veteran's condition after the October 2020 rating decision would not be a basis for a pre-decisional duty to assist error. The Veteran's testimony at the October 2024 hearing cannot serve as the basis for a remand of the claim for service connection for a bilateral hearing loss disability and the Board will continue with a decision on this issue.

Service Connection Claims

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 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).

Service connection is also provided for a disability that is proximately due to, the result of, or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310; Allen v. Brown, 7 Vet. App. 439 (1995).

1. Entitlement to service connection for a bilateral hearing loss disability.

The Veteran contends that service connection is warranted for a bilateral hearing loss disability as it was incurred due to noise exposure during active service.

Hearing loss is considered a ratable disability for VA disability compensation purposes when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 hertz (Hz) is 40 decibels or greater; or when the auditory thresholds for at least three of these frequencies 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. In evaluating claims of service connection for hearing loss, the threshold for normal hearing is from 0 to 20 decibels, and higher threshold levels indicating some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993).

It is not required that a Veteran have sufficient hearing loss during service, or even within a year of discharge, to satisfy the threshold minimum
(Hz) is 40 decibels or greater; or when the auditory thresholds for at least three of these frequencies 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. In evaluating claims of service connection for hearing loss, the threshold for normal hearing is from 0 to 20 decibels, and higher threshold levels indicating some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993).

It is not required that a Veteran have sufficient hearing loss during service, or even within a year of discharge, to satisfy the threshold minimum requirements of § 3.385 to be considered a ratable disability. The record must establish, however, that a current hearing loss disability exists (that is, at least at some point since the filing of their claim) to satisfy the requirements of this VA regulation and, in turn, that the disability is ratable, so long as there is evidence linking this current hearing loss to his service as opposed to other ("intercurrent") causes. See Hensley, supra. See also Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992).

The Court has stated that the 38 C.F.R. § 3.385 "prescribes the level at which a hearing loss becomes a disability for purposes of entitlement to VA compensation.... [N]ot every change in hearing should be service connected." See Palczewski v. Nicholson, 21 Vet. App. 174 (2007).

The April 2019 and October 2020 rating decisions include favorable findings relevant to the claim on appeal. First, the AOJ determined in the October 2020 rating decision that new and relevant evidence had been received to readjudicate the claim for service connection for a hearing loss disability. Next, the October 2020 rating decision includes a favorable finding in the hearing loss disability section that the Veteran has been "diagnosed with a disability." However, the identified disability is "tinnitus," and appears to be a typographical error as tinnitus is discussed later in the rating decision. Furthermore, in the analysis portion of the October 2020 decision, it is clear the AOJ denied service connection for a bilateral hearing loss disability based on the absence of a hearing loss disability for VA purposes. Thus, the Board concludes that the October 2020 rating decision does not include a favorable finding that the Veteran has a hearing loss disability. The Board will therefore not disturb the findings of the October 2020 rating decision. See 38 C.F.R. § 3.104(c). (The Board is bound by the RO's favorable findings, absent CUE).

Although the October 2020 rating decision did not establish the presence of a hearing loss disability, in an earlier April 2019 rating decision, the AOJ did specifically find that a right ear hearing loss disability was present. This finding was made based on the results of a November 2015 private audiogram. The Board concludes that the AOJ's favorable finding was CUE and must be overturned.

In the April 2019 rating decision, the AOJ found that a November 2015 audiogram established a right ear hearing loss disability in accordance with 38 C.F.R. § 3.385. Review of the audiogram report indicates the presence of a right ear puretone hearing threshold of 60 decibels (dB) at 4000 Hertz (Hz). This finding is generally adequate to establish a hearing loss disability under 38 C.F.R. § 3.385, which defines a hearing disability as "the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater..." However, the Board finds that the November 2015 audiogram cannot establish a current hearing loss disability as it was performed years before receipt of the Veteran's initial claim in February 2019.

The requirement of a current disability is met by evidence of symptomatology at the time of filing or at any point during the pendency of the claim. McClain v. Nicholson, 21 Vet. App. 319, 323 (2007); Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013) (finding that the Board must address pre-claim evidence in assessing whether a current disability existed, for purposes of service connection, at the time the claim was filed or during its pendency). Thus, while the November 2015 private audiogram indicates the presence of a puretone threshold at one frequency that may meet the requirements of a hearing loss disability, it cannot serve

Additionally, none of the competent medical evidence dated during the relevant rating period establishes a hearing loss disability for VA purposes. The Veteran was provided a VA audiological examination in September 2020, but the examiner found that the Veteran's puretone hearing thresholds and word recognition scores did not establish the presence of a hearing loss disability. The examiner specifically found that the Veteran had hearing "within normal limits" in both ears. A private audiogram submitted by the Veteran and dated in June 2023 also indicates normal hearing bilaterally. The Board also notes that audiograms performed in connection with the Veteran's employment in August 2014 and December 2017 also demonstrated normal bilateral hearing, in contrast to the single finding at the November 2015 private audiogram.

Based on the date of the November 2015 private audiogram, as well as the consistent agreement among every other audiogram in the record (including the September 2020 VA examination) regarding the Veteran's normal hearing, the Board finds that the April 2019 favorable finding of a right ear hearing loss disability constitutes CUE. It is therefore overturned.

As discussed above, the Board finds that the competent medical evidence of record establishes that the Veteran does not have a hearing loss disability for VA purposes. See 38 C.F.R. § 3.385. Although the Veteran generally contends that she experiences hearing loss, her reports of hearing loss are not accompanied by any timely clinical findings. The Board therefore finds that the Veteran's contentions are outweighed by the objective evidence documenting the Veteran does not have hearing loss of the severity contemplated by 38 C.F.R. § 3.385.

Similarly, the Board has also considered the Veteran's general contentions that she incurred a hearing loss disability due to noise exposure during active duty. Lay statements can establish the presence of observable symptomatology and "may provide sufficient support for a claim of service connection" in certain circumstances. Layno v. Brown, 6 Vet. App. 465 (1994). However, determining whether a Veteran meets the threshold minimum requirements of 38 C.F.R. § 3.385 is based on the results of objective testing (namely, an audiogram and Maryland CNC speech discrimination). The Veteran's statements alone are therefore not sufficient to establish the presence of a hearing loss disability in accordance with 38 C.F.R. § 3.385.

This determination of whether lay, versus medical, evidence is required is fact specific, so on a case-by-case basis and entirely dependent on the type of condition being claimed. See King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). Under VA regulations, a hearing loss disability must be established with objective audiogram testing indicating hearing loss at certain quantitative levels. The Board therefore finds that the Veteran is not competent to diagnose herself with a ratable hearing loss disability for VA compensation purposes and a chronic disability is not established.

The competent and probative medical evidence does not establish the presence of a hearing loss disability for VA purposes. Absent proof of the existence of the disability being claimed, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223 (1992). Accordingly, the Board must conclude that the evidence significantly and substantially weighs against the claim, the benefit-of-the-doubt rule does not apply, and the claim for service connection for a hearing loss disability must be denied.

2. Entitlement to service connection for tinnitus.

3. Entitlement to service connection for a vestibular disability currently diagnosed as Meniere's disease, to include as secondary to service connected PTSD.

The Veteran contends that service connection is warranted for tinnitus and a vestibular disability as they were incurred due to noise exposure during active duty service. Specifically, the Veteran testified at the October 2024 Board hearing that she experienced the onset of tinnitus and balance problems during basic training while participating in weapons exercises. In the alternative, the Veteran contends that her diagnosed
that the evidence significantly and substantially weighs against the claim, the benefit-of-the-doubt rule does not apply, and the claim for service connection for a hearing loss disability must be denied.

2. Entitlement to service connection for tinnitus.

3. Entitlement to service connection for a vestibular disability currently diagnosed as Meniere's disease, to include as secondary to service connected PTSD.

The Veteran contends that service connection is warranted for tinnitus and a vestibular disability as they were incurred due to noise exposure during active duty service. Specifically, the Veteran testified at the October 2024 Board hearing that she experienced the onset of tinnitus and balance problems during basic training while participating in weapons exercises. In the alternative, the Veteran contends that her diagnosed Meniere's disease was also incurred secondary to service connected PTSD.

The Board finds that while current disabilities and in-service injuries are present, the substantial weight of the evidence is against a conclusion that the Veteran's disabilities began during service or are otherwise related to an in-service injury or service-connected disability. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d).

The October 2020 rating decision contains some favorable findings relevant to the claims. First, the AOJ found that new and relevant evidence was received sufficient to readjudicate the claims for service connection. Next, the AOJ found that current disabilities were established as VA examinations in September 2020 confirmed the presence of tinnitus and a vestibular disorder diagnosed as Meniere's disease. Finally, the AOJ found that tinnitus is a chronic disease that may be presumptively associated with active duty service under 38 C.F.R. §§ 3.307 and 3.309. The Board sees no reason to disturb these favorable findings. See 38 C.F.R. § 3.104(c).

The favorable findings of the AOJ in the October 2020 rating decision establish the first element of service connection. The Board also finds that that an in-service injury (the second element of service connection) is demonstrated.

During the October 2024 hearing, the Veteran testified that she was exposed to loud noises during her basic training while performing military exercises with live weapons. She also testified that she experienced episodes of tinnitus and dizziness during basic training following her exposure to loud noise. The Board finds that the Veteran is competent to report events that occurred during service and finds her testimony credible for the limited purpose of determining whether an in-service injury occurred. Although service records are negative for any complaints pertaining to the Veteran's ears or balance, the Board will resolve any doubt in favor of the Veteran and finds that in-service injuries are present.

The Board must now determine whether the third element of service connection-a causal link between the current disabilities and in-service injuries-is present.

Service records do not indicate such a link. There are no complaints of, treatment for, or diagnoses of tinnitus or balance problems in the service records. The Board notes that the Veteran served approximately two months of active duty for "initial active duty for training" as part of her service with the Army Reserve. In May 1996, she was separated from active service due to disability associated with preexisting pes planus (flat feet). She waived the right to an examination with the Physical Evaluation Board (PEB) in April 1996, and a separation examination was therefore not performed prior to her discharge in May 1996. Thus, service records do not document any problems with the Veteran's hearing or balance, despite showing treatment for other conditions including pes planus.

The post-service evidence also does not support the claims. The earliest medical evidence of tinnitus or a vestibular disorder dates from September 2009, when the Veteran was seen at a private emergency department (ED) with complaints of lightheadedness, dizziness, and nausea. She reported the gradual onset of the symptoms one and a half months earlier. She was diagnosed with acute vertigo and otitis externa. Thereafter, the Veteran continued to receive treatment for various episodes of sinusitis, and in November 2013, was treated by a private ear, nose, and throat (ENT) provider for Meniere's disease with associated balance problems and vertigo. A steroid perfusion of the inner ear was performed to treat the Veteran's diagnosed Meniere's disease, ostalgia, Eustachian tube dysfunction, and allergic rhinitis. A tube was also placed in the Veteran's right ear by the same provider in November or December 2013. The Veteran continued to receive treatment for various ear symptoms, including feelings of "fullness," fungal infections, drainage and debris in the ear canals,
vertigo and otitis externa. Thereafter, the Veteran continued to receive treatment for various episodes of sinusitis, and in November 2013, was treated by a private ear, nose, and throat (ENT) provider for Meniere's disease with associated balance problems and vertigo. A steroid perfusion of the inner ear was performed to treat the Veteran's diagnosed Meniere's disease, ostalgia, Eustachian tube dysfunction, and allergic rhinitis. A tube was also placed in the Veteran's right ear by the same provider in November or December 2013. The Veteran continued to receive treatment for various ear symptoms, including feelings of "fullness," fungal infections, drainage and debris in the ear canals, and various sinus infections associated with sinusitis. A balloon sinuplasty was performed by a private provider in August 2016

In January 2018, the Veteran first complained of ear and balance problems at the VA Medical Center (VAMC). At that time, she provided a history of dizziness, bilateral tinnitus, and aural fullness since 2013. She also reported a past diagnosis of Meniere's disease. The VAMC audiologist noted that the Veteran's reports of symptoms were not entirely consistent with Meniere's disease, but could have a benign paroxysmal positional vertigo component. In February 2018, the Veteran reported that she wished to establish care with the VAMC ENT department, and in March 2018 she reported to a VA otolaryngologist the onset of chronic dizziness in 2013 with constant bilateral aural fullness sometimes associated with dizziness. Additional clinical records from the VA and private doctors document continued treatment for various ear and sinus complaints, as well as the Veteran's reports that her condition began in 2013.

Post-service treatment records therefore document the onset of the Veteran's symptoms in 2009-almost 15 years after her discharge from active duty-and diagnoses of tinnitus and dizziness in 2013.

Service connection is possible for certain disabilities, to include organic diseases of the nervous system, on a presumptive basis as a chronic disease in accordance with 38 C.F.R. §§ 3.307 and 3.309. However, based on the lack of competent evidence of tinnitus or a vestibular condition for years after service, the Board cannot conclude that the disabilities were present to a compensable degree within one year from the date of separation. The Board further notes that the Veteran has provided conflicting reports regarding the onset of her disabilities, as discussed in more detail below. The Board therefore finds that service connection is not possible on a presumptive basis for the claimed disabilities. See 38 C.F.R. §§ 3.307 and 3.309.

There are also no medical opinions in support of the claims for service connection. No physician or other healthcare provider has linked the Veteran's tinnitus or Meniere's disease to service.

Additionally, in September 2020 medical opinion reports, VA clinicians provided medical opinions weighing against service connection for the claimed tinnitus and Meniere's disease. After reviewing the complete claims file, the VA clinicians found the Veteran's disabilities were not related to active duty service. Regarding the claimed vestibular disorder, the VA clinician reviewed the symptoms, physical mechanics, and suspected risk factors of Meniere's disease (including constrictions in blood vessels, allergic infections, and genetic variations). The clinician also acknowledged the absence of objective evidence of the condition during service and the Veteran's own reports that her symptoms began in 2009. Similarly, the September 2020 VA audiologist noted there was no evidence of a significant shift in hearing thresholds during service, as well as the lack of evidence of permanent auditory damage. As such, there was no nexus of auditory damage on active duty to relate the current reports of tinnitus to military noise exposure. The September 2020 VA medical opinions are accompanied by fully explained rationales and weigh significantly against the claims. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008).

The Board has also considered the Veteran's contentions regarding a nexus between service and her current disabilities, but notes that as a lay person, she is not competent to opine as to medical etiology or render medical opinions in that respect. Barr v. Nicholson, 21 Vet. App. 303 (2007); see Grover v. West, 12 Vet. App. 109, 112 (1999). The Board acknowledges that the Veteran is competent to report observable symptoms but finds that her opinion as to the cause of these symptoms simply cannot be accepted as competent evidence. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d
Veteran's contentions regarding a nexus between service and her current disabilities, but notes that as a lay person, she is not competent to opine as to medical etiology or render medical opinions in that respect. Barr v. Nicholson, 21 Vet. App. 303 (2007); see Grover v. West, 12 Vet. App. 109, 112 (1999). The Board acknowledges that the Veteran is competent to report observable symptoms but finds that her opinion as to the cause of these symptoms simply cannot be accepted as competent evidence. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1131, 1336 (Fed. Cir. 2006).

Service connection is also possible for certain chronic disabilities under 38 C.F.R. § 3.303(b) based on a continuity of symptomatology. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). As noted above, organic diseases of the nervous system are chronic disabilities under 38 C.F.R. § 3.309(a).

The Veteran has reported a continuity of symptoms since service. During her October 2024 hearing before the Board, the Veteran testified that she experienced the onset of tinnitus and dizziness during active duty in 1996 following live weapons exercises. The Veteran also testified that these symptoms have been present ever since 1996, though she did not seek medical treatment until 2009. The Veteran's representative, in a separate October 2024 statement, reiterated Veteran's contentions that her disabilities began in service. The Boad finds that any reported continuity of symptoms is not credible for the purposes of granting service connection given the Veteran's own inconsistent reports of the history of her disabilities.

As previously discussed, service records are negative for complaints or treatment related to tinnitus or balance problems. The Veteran was medically discharged for pes planus, but made no comments regarding the onset of the alleged constant tinnitus and dizziness at that time. In fact, there are no complaints related to the ringing in her ears or balance problems until 2009, when the Veteran was seen at a private ED for acute vertigo and otitis externa.

Regarding the gap in time between the Veteran's reported onset of her symptoms in 1996 and the first recorded complaints in 2009, the Veteran provided confusing testimony in October 2024. She initially reported that she experienced constant symptoms of dizziness and ear ringing since 1996, but did not seek treatment until 2009 when her husband encouraged her to have her symptoms looked at. However, she also testified that she did report the symptoms to various providers, but her symptoms were "brushed" off as part of her sinusitis. It is therefore not clear to the Board when the Veteran contends she first sought medical treatment for her tinnitus and vestibular disorder.

In any event, this testimony is clearly inconsistent with the history she provided to her various private and VA health care providers. She did not provide any history of problems with her ears since service; in fact, in 2009 the Veteran specifically reported the gradual onset of symptoms one and a half months earlier. Similarly, the Veteran provided a consistent history of tinnitus and Meniere's disease dating from 2009 or 2013 while receiving treatment with both private and VA providers. In January 2018, when she began treatment for both conditions at the VAMC, she clearly stated that she had been experiencing tinnitus and dizziness since 2013.

The Veteran has also provided other conflicting reports regarding the onset of her claimed conditions. During the September 2020 VA audiological examination, she reported the onset of tinnitus in 1996 during active duty. However, on a second VA examination also in September 2020, she reported experiencing symptoms of Meniere's disease (including ear ringing and fullness) since 2013, with no mention of experiencing dizziness during active duty.

Based on the inconsistencies present in the Veteran's own statements, as well as the contradictions in her reported history, the Board finds that the Veteran's reports of a continuity of symptoms since service are not credible. The Board also notes the clear difference in the Veteran's history when provided in the context of receiving medical treatment versus those provided to support a claim for compensation benefits. The Board therefore finds that the Veteran's reported history of continuous symptoms are clearly outweighed by the competent evidence weighing against service connection.

In sum, the record shows that the first evidence of the Veteran's claimed disabilities was almost 15 years after separation from service. In addition, there is no medical evidence indicating that the Veteran's current tinnitus and Meniere's disease are etiologically related to active duty service. The Veteran is not
, as well as the contradictions in her reported history, the Board finds that the Veteran's reports of a continuity of symptoms since service are not credible. The Board also notes the clear difference in the Veteran's history when provided in the context of receiving medical treatment versus those provided to support a claim for compensation benefits. The Board therefore finds that the Veteran's reported history of continuous symptoms are clearly outweighed by the competent evidence weighing against service connection.

In sum, the record shows that the first evidence of the Veteran's claimed disabilities was almost 15 years after separation from service. In addition, there is no medical evidence indicating that the Veteran's current tinnitus and Meniere's disease are etiologically related to active duty service. The Veteran is not competent to link her disabilities to service, and she has not provided a credible history of a continuity of symptoms since service which would tend to eliminate other intervening causes. The Board therefore concludes that the evidence is substantially against a direct nexus between the claimed disabilities and active military service.

As a final matter, the Board will now turn to the Veteran's contentions regarding service connection on a secondary basis. The Veteran contends that service connection is warranted for Meniere's disease as secondary to service connected PTSD. She has not provided any specific argument in support of the secondary claim, aside from noting in her representative's October 204 brief (without competent support) that veterans with PTSD are more likely to experience vertigo and dizziness.

There is no competent medical or lay evidence in support of the secondary service connection claim. None of the Veteran's treating providers have identified a relationship between any aspect of the Veteran's Meniere's disease and her PTSD. As the record contains no competent lay or medical evidence in support of service connection for the Veteran's Meniere's disease on a secondary basis, the Board must deny the claim.

Accordingly, the Board must conclude that the evidence significantly and substantially weighs against the claims for service connection on both direct and secondary bases, and they are denied. 38 U.S.C. § 5107(b); see also Lynch v. McDonough, 21 F.4t 776 (Fed. Cir. 2021).

M. MILLS

Veterans Law Judge

Board of Veterans' Appeals

M. Riley, Attorney for the Board of Veterans' Appeals

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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