MAJOR DEPRESSIVE DISORDER

K. CONNER · 2026 · Case ID: A26028881

DENIED

Summary

The veteran, who served in the U.S. Army from July 1978 to July 1981, with subsequent Army Reserve service until May 1989, appeals the denial of service connection for an acquired psychiatric disability, specifically major depressive disorder with anxiety, and PTSD. The veteran's claim is based on two theories: military sexual trauma (MST) during basic training in October 1978, and the argument that service-connected tinnitus and hearing loss caused or aggravated his psychiatric condition. The Board reviewed evidence including service records, VA examinations from 2001 to 2024, and a private psychiatric opinion. Service treatment records were negative for psychiatric complaints, and the separation examination in 1981 was normal. Post-service, the veteran attributed his symptoms to a 1997 on-the-job injury. While a 2007 VA psychiatric note indicated a positive PTSD screen and diagnosed major depressive disorder secondary to a medical condition, subsequent examinations and the veteran's own reports often linked symptom onset to the 1997 injury. A private psychiatrist in November 2023 opined that the veteran's insomnia and depression were at least as likely as not related to tinnitus, but the Board found this opinion minimally probative due to lack of specific factual support and failure to address conflicting evidence. The Board placed greater weight on a December 2024 VA psychiatric opinion, which found the major depressive disorder not related to service or service-connected conditions, noting the lack of in-service markers for assault and the veteran's consistent attribution of symptoms to the 1997 injury. The Board concluded that the evidence persuasively weighed against a nexus to service and that the negative evidence outweighed the evidence suggestive of a nexus. The benefit of the doubt doctrine was found inapplicable as the evidence was not in equipoise. Service connection for the acquired psychiatric disability was denied.

Rationale

Service treatment records negative for psychiatric disability.; Separation examination normal; denied psychiatric symptoms.; Post-service onset attributed to 1997 on-the-job injury.; Conflicting reports regarding symptom onset and cause.; VA psychiatric opinions found no nexus to service or service-connected conditions.; Private opinion found minimally probative; lacked specific factual support.; Board assigned greater weight to December 2024 VA opinion.; Evidence persuasively against nexus and in-service onset.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250403-531046

Full Decision Text

Citation Nr: A26028881
Decision Date: 03/31/26 Archive Date: 03/31/26

DOCKET NO. 250403-531046
DATE: March 31, 2026

ORDER

Entitlement to service connection for an acquired psychiatric disability is denied.

FINDING OF FACT

The appellant's current psychiatric disability, diagnosed as major depressive disorder, did not have its inception during active duty and is not otherwise etiologically related to an in-service injury or disease or caused or aggravated by a service-connected disability.

CONCLUSION OF LAW

The criteria for service connection for an acquired psychiatric disability have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The appellant served on active duty in the United States Army from July 1978 to July 1981. He was a member of the Army Reserve from March 1984 to May 1989.

This matter comes before the Board of Veterans' Appeals (Board) from a March 2025 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO), the Agency of Original Jurisdiction (AOJ), which, in pertinent part, denied service connection for major depressive disorder with anxiety, also claimed as PTSD and insomnia. The AOJ issued the rating decision to the appellant with a notification letter on March 5, 2025.

Received on April 3, 2025, was a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), upon which the appellant identified the March 2025 AOJ decision, the issue as "Service connection for major depressive disorder with anxiety and insomnia secondary to service connected tinnitus (not addressed)," and elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the March 5, 2025, AOJ decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the appellant would like VA to consider any evidence that was submitted that the Board could not consider, he 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.

In December 2025, the Board sent the appellant a letter inquiring whether he wished to waive the period to change to a different Board review option. Received on January 6, 2026, was the appellant's waiver of his right to select a different Board review option.

In view of the evidence of record and the appellant's contentions, the Board has recharacterized the issue of entitlement to service connection for major depressive disorder with anxiety as entitlement to service connection for an acquired psychiatric disability. See Clemons v. Shinseki, 23 Vet. App. 1, 5-6, 8 (2009) (holding that the scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by a claimant's description of the claim, reported symptoms, and the other information of record).

Service Connection

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 for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f).

1. Entitlement to service
) 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).

1. Entitlement to service connection for an acquired psychiatric disability.

For the reasons that follow, the Board finds that service connection is not warranted for an acquired psychiatric disability.

In the March 2025 rating decision, the AOJ made favorable findings:

You have been diagnosed with a disability. The VA PTSD Examination from July 2021 provides a diagnosis of major depressive disorder with anxiety.

The claimed primary disability is service-connected. You are service connected for hearing loss and tinnitus.

Favorable findings of the AOJ are binding on the Board, absent clear and unmistakable error.

The appellant and his attorney have offered two theories of entitlement: first, that the appellant experienced military sexual trauma (MST) during basic training, and second, that service-connected tinnitus and hearing loss caused or aggravated his acquired psychiatric disability.

On an April 2020 VA Form 21-0781a, Statement in Support of Claim for Service Connection for PTSD Secondary to Personal Assault, the appellant reported that, in October 1978, he was stationed at Fort Benning, Georgia, and:

While sleeping in the barracks a blanket was thrown over me (in the evening) was physically assaulted and raped. This incident happened while in basic training. . . .

In Ft. Campbell Kentucky I spoke to a chaplain to ask if I could quit the Army and the chaplain told me I had to finish at which point I did not further discuss my situation.

The appellant's service personnel records indicate that he was at Fort Benning, Georgia, beginning October 11, 1978. Beginning November 22, 1978, he was en route to Fort Campbell, Kentucky.

Service treatment records are negative for complaints or findings of a psychiatric disability. The appellant's July 1981 separation examination was within normal limits, including psychiatric. On the accompanying Report of Medical History, the appellant denied having, or having had, frequent trouble sleeping, depression or excessive worry, or nervous trouble of any sort.

As part of the appellant's membership in the Army Reserve, he underwent a medical examination in November 1984 at which psychiatric evaluation was again normal. On the accompanying Report of Medical History, the appellant reported that he was in good health and not taking any medications. He endorsed sinusitis, but again denied having, or having had, frequent trouble sleeping, depression or excessive worry, or nervous trouble of any sort.

The post-service record on appeal includes an August 2001 VA mental health note which states that the appellant had not worked for the past three years, since falling down a flight of stairs at work as a firefighter and injuring his neck and back. He recently had his disability payments discontinued by the fire department, but had a union lawyer fighting his case. The appellant denied experiencing traumatic events in adulthood, other than his fall on the job.

A September 2001 VA pain management/medical psychology note states that the appellant

fell during an emergency fire response. This incident resulted in a spinal injury, as well as a blow to the head, causing a concussion. [The appellant] has experienced severe back pain since this accident . . . Looking back, [the appellant] reported that the accident "changed my whole life." Whereas before he reported being very outgoing, including playing many sports, he now frequently stays at home and avoids having contact with others.

A March 2007 VA psychiatric note states that the appellant had a positive PTSD screen. It was noted that, in 1997, the appellant was working as a fireman. He incurred a fall and landed on his head. He experienced neck trauma leading to a herniated disc. Since that time, he had experienced chronic pain and depression, and an inability to work. The appellant was noted to have

Dysthymic mood and affect. Sleeping approximately 2-3 hrs/night with nightmares regarding his past job as a fireman. He experiences frequent [awakenings]. Suffers from low motivation, feeling tired all the time. Has experienced suicidal ideation and . . . experiences crying spells.

The patient is not experiencing suicidal or homicidal ideation. The patient reports difficulties concentrating but is oriented to time, place and person
1997, the appellant was working as a fireman. He incurred a fall and landed on his head. He experienced neck trauma leading to a herniated disc. Since that time, he had experienced chronic pain and depression, and an inability to work. The appellant was noted to have

The patient is not experiencing suicidal or homicidal ideation. The patient reports difficulties concentrating but is oriented to time, place and person and cognitive functions are adequate throughout the interview.

The assessment was:

Post Traumatic Stress Disorder delayed chronic and severe Major Depressive Disorder without Psychotic features (secondary to a medical condition)

A May 2007 VA preventive medicine education note states that MST (military sexual trauma) screening was performed. The appellant expressly denied experiencing MST.

A February 2018 VA psychology note states that the appellant "seemed more anxious than our previous session, describing a significant increase in hyperarousal symptoms and intrusive thoughts. He shared MST experience, and said that post-hurricane Maria stressors triggered many memories."

presents with symptoms consistent with Major Depressive Disorder of moderate severity and Posttraumatic Stress Disorder related to MST. Symptoms seem to have begun after traumatic fall while working as a fireman, which led him to suffer chronic medical conditions. As a main concern, he will be taking care of his mother who has a dementing illness.

A March 2019 VA psychology note states that the appellant was thinking about his in-service MST due to seeing news reports regarding child sexual abuse by clergy. After a very vivid nightmare regarding his MST, the appellant finally told his wife about the incident.

The appellant's service connection claim for, inter alia, depression, anxiety, insomnia, and PTSD, due to MST was received in February 2020.

In April 2021, the Veteran was afforded a VA audiology examination in connection with a claim of service connection for hearing loss and tinnitus. He reported that the date of onset of his tinnitus was in 1980 and that it had worsened since that time. The examiner concluded that it was at least as likely as not that the Veteran's tinnitus originated during his period of active service or is otherwise etiologically related to his active service. The Veteran indicated that he was frustrated with his communication abilities due to his hearing loss and tinnitus but reported no other complications or symptoms such as insomnia or psychological impacts.

The appellant was afforded a VA PTSD examination in July 2021. Following examination of the appellant and review of the claims file, the examiner diagnosed the appellant as having major depressive disorder, chronic, with anxiety. The examiner determined that the appellant did not meet the diagnostic criteria for a diagnosis of PTSD. The appellant's chronic pain was relevant to the understanding or management of his diagnosed mental health disorder.

Regarding traumatic military event he states, "while at Fort Benning, a blanket party was thrown over me while I was sleeping at the barracks and I was raped" "everything was very fast". "I didn't mention to anybody until I told to a chaplain while in Kentucky and asked him if I could leave the Army and he recommended to finished it" "then I didn't talk about it anymore".

The VA psychiatrist provided a negative etiological opinion. The psychiatrist noted that there was no evidence of psychiatric complaints, findings, or treatment during service and explained that there was "not consistent circumstantial marker evidence found that support a link between any MST stressor event and veteran's mental disorder." The psychiatrist found it significant that the appellant denied any symptoms at separation and three years later in 1984, and that examination was normal in 1981 at separation and again three years later. The psychiatrist noted that medical records consistently noted that symptom onset was at the time of the on-the-job injury working as a fireman.

A January 2022 VA psychology note states that the appellant presented severe symptoms of depression and moderate symptoms of anxiety in the context of physical conditions and the pandemic.

Received on November 8, 2023, was a Mental Disorders Disability Benefits Questionnaire (DBQ), completed by Pedro Oyola Nieves, M.D., a private psychiatrist who indicated that he examined the appellant in person and that the appellant was regularly seen as a patient in his clinic. Major depressive disorder and insomnia were diagnosed, both as secondary to tinnitus. Dr. Oyola Nieves indicated that "psichiatric [sic] notes" were the records reviewed, but provided no further detail. Dr. Oyola Nieves stated that the appellant initiated psychiatric treatment because
2 VA psychology note states that the appellant presented severe symptoms of depression and moderate symptoms of anxiety in the context of physical conditions and the pandemic.

Received on November 8, 2023, was a Mental Disorders Disability Benefits Questionnaire (DBQ), completed by Pedro Oyola Nieves, M.D., a private psychiatrist who indicated that he examined the appellant in person and that the appellant was regularly seen as a patient in his clinic. Major depressive disorder and insomnia were diagnosed, both as secondary to tinnitus. Dr. Oyola Nieves indicated that "psichiatric [sic] notes" were the records reviewed, but provided no further detail. Dr. Oyola Nieves stated that the appellant initiated psychiatric treatment because he suffered insomnia and depression due to ringing in his ears. The appellant had been receiving psychiatric treatment from Dr. Oyola Nieves since September 2022 for chronic sleep impairment and depression. Prozac and Remeron had been prescribed.

Dr. Oyola Nieves provided a positive opinion:

It is my clinical/medical judgement that this Veteran['s] insomnia and depression disorder are at least as likely as not etiologicaly [sic] caused by his service-connected condition of tinnitus. According with a research study conducted on the Henry Ford Hospital by Dr. Yaremchunk and Dr. Miguel; there is a significant association between tinnitus and insomnia. "Tinnitus involves congnitive [sic], emotional and psych-physiological processes which can results in [sic] an increase in a patient['s] distress", say Dr. Yaremchuk (Chairman of Department of Otolaringology [sic] - Head and Neck Surgery). Chronic tinnitus patients present a chalinging [sic] clinical picture that may include: anxiety, depression, anoyance [sic] or self-reported emotional distress, which is my patient['s] case also. Therefore, based on a scientific finding and my medical expertise, I conclude: that my patient['s] conditions (insomnia and depression) are more likely than not related to his tinnitus disorder.

The appellant was afforded a VA PTSD examination in December 2024. The claims file was reviewed. Following examination of the appellant and review of the claims file, major depressive disorder was diagnosed. The appellant's symptoms did not meet the diagnostic criteria for PTSD. The appellant denied any mental history regarding his military service. The only stressor reported during the examination was "1979-1981, Germany." The examiner noted that such was not adequate to support a diagnosis of PTSD, such was not related to a fear of hostile military or terrorist activity, and that such was not related to personal assault.

The December 2024 VA psychiatrist opined that the appellant's major depressive disorder was "not related to, nor aggravated by, nor secondary to his active military service[,] nor service[-]connected condition." The psychiatrist found it significant that the appellant's first mental evaluation, diagnosis, and treatment was in 1997, at which time the appellant attributed his symptoms to a 1997 injury while working as a fireman, in which he fell, landed on his head, and had neck trauma. There was no evidence provided during the examination which indicated a connection with the appellant's military service or a service-connected disability. The psychiatrist also found none on review of the record.

On the April 3, 2025, VA Form 10182, it was contended that service connection as secondary to tinnitus was not considered.

Applying the facts to the criteria set forth above, the Board finds that service connection is not warranted for an acquired psychiatric disability.

With respect to the first element necessary to establish service connection, a current disability, the Board finds the evidence persuasively against a finding that the appellant currently has PTSD or has had PTSD during the pendency of the claim. The evidence of record reflects that the appellant has been examined by multiple medical professionals since filing the claim and they consistently concluded that he does not meet the criteria for a diagnosis of PTSD. Rather, all of the appellant's psychiatric symptoms have been attributed to major depressive disorder.

While the record includes DSM-IV diagnoses of PTSD from March 2007 and February 2018, the appellant has not been diagnosed as having PTSD since that time, including since filing his February 2020 claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007) (holding that a current disability means one that is present or has been seen recent to the filing of the claim for service connection). Moreover, the March 2007 and February 2018 diagnoses were rendered in the context of treatment, without being based on a corroborated stressor. Thus, the Board finds that the competent evidence is persuasively against a finding that the appellant met the criteria for a diagnosis of PTSD under DSM-IV or DSM-5 criteria for any portion of the period under review. Rather, the record reflects that the Veteran's current psychiatric disability has consistently been diagnosed as major depressive disorder. Thus, the Board finds that the first element of service connection is met.

The Board, however, finds that the evidence persuasively establishes that the Veteran's current psychiatric disability did not have its onset in service nor is it causally related to an in-service disease or injury or caused or aggravated by a service-connected disability.

As discussed above, the appellant's service treatment records contain no indication of a psychiatric disability, to include major depressive disorder. Rather, the Board finds that this evidence persuasively establishes that the current psychiatric disability did not have its inception during active duty. Again, the appellant underwent an examination at service separation which showed that his psychiatric system was normal and he denied having, or ever having had, psychiatric symptoms at discharge. Moreover, in post-service clinical settings prior to filing this claim, the Veteran dated the onset of his psychiatric symptoms to an on-the-job injury he sustained in 1997. The Board finds that this contemporaneous evidence outweighs the recent contradictory statements of the onset of psychiatric symptoms in service, made in the context of a claim for monetary benefits.

The Board further finds that the evidence of record persuasively weighs against finding that a nexus exists between the appellant's current psychiatric disability and an in-service injury or disease or a service-connected disability. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. §§ 3.303, 3.310.

Here, the Board notes that the July 2021 VA medical opinion was found to be inadequate by the Board in November 2024 because "the examiner failed to address the Veteran's statements regarding the assault he experienced in basic training when supporting the opinion." Although the July 2021 VA examiner did not expressly detail the appellant's lay statements in the rationale, the examination report reflects that she did detail the appellant's assertions in the Disability Benefits Questionnaire (DBQ), reflecting that she considered them. Moreover, the examiner also indicated that she had conducted a review of the service treatment and personnel records and concluded that there were no markers or indications of an in-service personal assault in the claims file. She indicted that "[a]fter careful review of all the longitudinal medical evidence of e-file and medical records," the examiner concluded that a link between the appellant's "neuropsychiatric established depressive condition and in-service marker evidence cannot be made."

Nonetheless, in light of the Board's finding, the appellant was thereafter scheduled for another VA psychiatric examination. As set forth above, however, during examinations conducted since the July 2021 VA examination, the appellant consistently attributed his symptoms to an alternative cause and not a claimed in-service assault. The November 2023 private medical opinion states that the appellant began treatment in September 2022 because of insomnia and depression due to ringing in his ears. The November 2023 private clinician made no mention of any alleged in-service assault or MST. Likewise, the appellant did not report any in-service assault or MST to the clinician who conducted the December 2024 VA medical opinion. Given these facts, the Board finds that the AOJ complied with the Board's remand instructions to the extent possible and the duty to assist has been satisfied.

The Board finds that the competent medical evidence demonstrating the absence of nexus between the claimed disability and the appellant's active service outweighs the evidence suggestive of a nexus. The Board additionally finds that the evidence persuasively establishes that the appellant's diagnosed major depressive disorder with anxiety is not caused or aggravated by his service-connected disabilities to include hearing loss or tinnitus. In particular, the December 2024 medical opinions were based on a thorough review of the record, including the appellant's statements, and analysis of his medical history and the pertinent medical literature. The Board therefore places significant weight on the cumulative findings set forth by the examiners who provided the December 2024 medical opinions. See Nieves-Rodriguez, 22 Vet. App. at 295 (the probative value of a medical opinion comes from when it is the factually accurate, fully articulated, and sound reasoning for the conclusion); see also Bloom v. West, 12 Vet. App. 185, 187 (1999) (the probative value of a physician's statement is dependent, in part, upon the extent to which it reflects "clinical data or other rationale to support his opinion").

Significantly, in the December 2024 medical opinion, the clinician considered the appellant's medical history including his self-report of military and life stressors, as well as the progression of his psychological symptomatology, as recorded in the contemporaneous evidence of record. Given the appellant's conflicting reports in the context of this claim for monetary benefits, the Board assigns greater probative weight to the appellant's reports in contemporaneous settings. The Board finds the December 2024 medical opinion probative as it is consistent with those contemporaneous reports.

While the appellant contended on his April 3, 2025, VA Form 10182 that service connection as secondary to tinnitus had not been considered, again, the December 2024 VA examiner explained there was no evidence provided during the examination, or elsewhere in the record, which indicated any connection between the appellant's current acquired psychiatric disability and a service-connected disability. Again, prior to contending that his psychiatric disability was the result of his service-connected hearing loss and tinnitus for purposes of seeking service connection, the appellant consistently dated the onset of his symptoms to other unrelated causes.

The Board has carefully considered the contentions of the appellant that he suffers from a diagnosed psychiatric disability, which was incurred during his military service and/or as secondary to or aggravated by his service-connected disabilities. To this end, the Board recognizes that lay witnesses are competent to opine as to some matters of diagnosis and etiology, and the Board must determine on a case by case basis whether a veteran's particular disability is the type of disability for which lay evidence is competent. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Kahana v. Shinseki, 24 Vet. App. 428, 433, n. 4 (2011). In this case, the appellant's assertions as to etiology concern an internal medical process, which extends beyond an immediately observable cause-and-effect relationship that is of the type that the courts have found to be beyond the competence of lay witnesses. Cf. Jandreau, 492 F.3d at 1376 (lay witness capable of diagnosing dislocated shoulder); Barr v. Nicholson, 21 Vet. App. 303, 308-9 (2007); Falzone v. Brown, 8 Vet. App. 398, 403 (1995) (lay person competent to testify to pain and visible flatness of his feet); with Clemons v. Shinseki, 23 Vet. App. 1, 6 (2009) ("It is generally the province of medical professionals to diagnose or label a mental condition, not the claimant"); Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007) (unlike varicose veins or a dislocated shoulder, rheumatic fever is not a condition capable of lay diagnosis); Jandreau, 492 F.3d at 1377, n. 4 ("sometimes the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer"). See also Colantonio v. Shinseki, 606 F.3d 137
6 (2009) ("It is generally the province of medical professionals to diagnose or label a mental condition, not the claimant"); Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007) (unlike varicose veins or a dislocated shoulder, rheumatic fever is not a condition capable of lay diagnosis); Jandreau, 492 F.3d at 1377, n. 4 ("sometimes the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer"). See also Colantonio v. Shinseki, 606 F.3d 1378, 1382 (Fed. Cir. 2010) (recognizing that in some cases lay testimony "falls short" in proving an issue that requires expert medical knowledge).

The Board has assigned more probative weight to the opinions offered by the December 2024 clinician on the question of nexus. This opinion was based on a review of the record and was provided by an individual with the expertise to opine on the etiology of the appellant's disability. Additionally, the clinician provided a rationale for the conclusions rendered which is consistent with the contemporaneous evidence of record. Thus, the Board finds the specific, reasoned opinion of the trained health care provider to be of greater probative weight than the more general lay assertions of the appellant.

The Board also finds that the December 2024 medical opinion is entitled to greater probative weight than the November 2023 private medical opinion. The November 2023 private medical opinion of Dr. Oyola Nieves is minimally probative, at best. The rationale is based on research studies showing associations, not causation. Additionally, the research studies are general and not based on the specific facts of the appellant's history. Moreover, Dr. Oyola Nieves failed to address the conflicting evidence of record, such as the evidence showing that in clinical settings prior to seeking secondary service connection, the appellant attributed his psychiatric symptoms to causes other than his service-connected hearing loss and tinnitus.

The Board is charged with weighing the positive and negative evidence; resolving reasonable doubt in the appellant's favor when the evidence is in equipoise. Considering the overall evidence, the Board finds that the negative evidence is more persuasive and of greater evidentiary weight. In conclusion, as the evidence is not in approximate balance and is more persuasively against the appellant's claim, the benefit of the doubt rule is inapplicable. See 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

K. Conner

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board R. Behlen, 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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