FOOT IMPAIRMENT OF

Summary

The veteran, who served in the United States Army Reserves from September 5, 1985, to December 12, 1985, appeals the denial of service connection for multiple conditions, including bilateral feet, bilateral heels, a psychiatric disorder, stomach issues, GERD, obstructive sleep apnea, and tinnitus. The Board reviewed the evidence of record at the time of the agency of original jurisdiction's March 2025 decision. For the left foot disability, the Board acknowledged a current diagnosis of gout from a private record but found no in-service event or injury related to the left foot. The service treatment records were negative for foot complaints, and a denial of foot trouble in a 1989 Reserve duty report, made years after active duty, was given more weight than the veteran's later contention of service-related issues. The Board also found no competent medical nexus for the left foot disability. For the right foot, bilateral heel, psychiatric disorder, stomach issues, GERD, and obstructive sleep apnea claims, the Board found the evidence persuasively weighed against a current disability or an in-service nexus. While the AOJ found a current bilateral foot disability, the Board corrected this, noting private records only showed left foot swelling. Private records for GERD showed no current symptoms. The Board concluded that the evidence did not support a current disability or a nexus to service for these conditions. For tinnitus, the Board acknowledged a current diagnosis and found evidence of in-service noise exposure due to the veteran's MOS as a Combat Engineer. However, a January 2025 VA examination found no nexus, citing the veteran's denial of ear trouble in 1989 and a reported onset of tinnitus nearly 40 years post-service. The Board found the VA examiner's opinion, based on the veteran's reported history and medical literature, to be persuasive against service connection. All claims were denied.

Rationale

No in-service injury or disease related to left foot; STRs negative for left foot complaints/treatment; Contemporaneous denial of foot trouble given more weight than later claim

Full Decision Text

Citation Nr: A26029800
Decision Date: 04/01/26	Archive Date: 04/01/26

DOCKET NO. 250702-560587
DATE:  April 1, 2026

ORDER

1. Entitlement to service connection for a left foot disability is denied.

2. Entitlement to service connection for a right foot disability is denied.

3. Entitlement to service connection for a bilateral heel disability is denied.

4. Entitlement to service connection for a psychiatric disorder is denied.

5. Entitlement to service connection for a stomach disability is denied.

6. Entitlement to service connection for gastroesophageal reflux disease (GERD) is denied.

7. Entitlement to service connection for obstructive sleep apnea is denied.

8. Entitlement to service connection for tinnitus is denied.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that the Veteran's left foot disability had its onset in service, manifested within one year of service discharge, or is otherwise related to service. 

2. The evidence of record persuasively weighs against finding that the Veteran has had a right foot disability at any time during or approximate to the pendency of the claim, to include symptoms that cause functional impairment of earning capacity. 

3. The evidence of record persuasively weighs against finding that the Veteran has had a bilateral heel disability at any time during or approximate to the pendency of the claim, to include symptoms that cause functional impairment of earning capacity. 

4. The evidence of record persuasively weighs against finding that the Veteran has had a psychiatric disorder at any time during or approximate to the pendency of the claim. 

5. The evidence of record persuasively weighs against finding that the Veteran has had a stomach disability at any time during or approximate to the pendency of the claim, to include symptoms that cause functional impairment of earning capacity. 

6. The evidence of record persuasively weighs against finding that the Veteran has had GERD at any time during or approximate to the pendency of the claim, to include symptoms that cause functional impairment of earning capacity. 

7. The evidence of record persuasively weighs against finding that the Veteran's obstructive sleep apnea was incurred in or otherwise related to service. 

8. Tinnitus did not have its onset in service, was not manifested within one year of service discharge, and is not otherwise related to service. 

CONCLUSIONS OF LAW

1. The criteria for service connection for a left foot disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 

2. The criteria for service connection for a right foot disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 

3. The criteria for service connection for a bilateral heel disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 

4. The criteria for service connection for a psychiatric disorder have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 4.125. 

5. The criteria for service connection for a stomach disability have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 

6. The criteria for service connection for GERD have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 

7. The criteria for service connection for obstructive sleep apnea have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 

8. The criteria for service connection for tinnitus have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309(a). 

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The
 The criteria for service connection for obstructive sleep apnea have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 

8. The criteria for service connection for tinnitus have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309(a). 

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army Reserves from September 5, 1985 to December 12, 1985, with additional periods of Reserve duty.

This appeal comes to the Board of Veterans' Appeals (Board) from a March 2025 rating decision by the agency of original jurisdiction (AOJ), which denied service connection for a bilateral feet disability, a bilateral heel disability, a psychiatric disorder, a stomach disability, GERD, obstructive sleep apnea, and tinnitus. The Veteran appealed the decision to the Board by submitting a July 2025 VA Form 10182, Notice of Disagreement, and electing the Direct Review docket.

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

Service Connection

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a veteran must show: (1) the existence of a present disability; (2) 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. 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).

Additionally, where a veteran served 90 days or more of active service, and certain chronic diseases, such as tinnitus, which is an organic disease of the nervous systems, become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). 

1. Entitlement to service connection for a left foot disability

The Board has carefully reviewed the evidence of record and finds that the evidence persuasively weighs against the award of service connection for a left foot disability. The reasons follow.

The Veteran has been diagnosed with a left foot disability, and thus there is evidence of a current disability. For example, in a December 2023 private medical record, the examiner diagnosed the Veteran with acute gout involving toe of the left foot, with notations of redness and swelling. In the March 2025 rating decision, based on this record, the AOJ found that there is evidence of a current disability of a left foot disability. The Board is bound by this favorable finding. See 38 C.F.R. § 3.104(c). Thus, the facts establish that the first element of a service-connection claim is met.

However, as to an in-service disease or injury, the evidence does not support a finding of a disease or injury in service indicative of a left foot disability. The service treatment records (STRs) do not support complaints, symptoms, evaluation, diagnosis, or treatment indicative of a left foot disability
 gout involving toe of the left foot, with notations of redness and swelling. In the March 2025 rating decision, based on this record, the AOJ found that there is evidence of a current disability of a left foot disability. The Board is bound by this favorable finding. See 38 C.F.R. § 3.104(c). Thus, the facts establish that the first element of a service-connection claim is met.

However, as to an in-service disease or injury, the evidence does not support a finding of a disease or injury in service indicative of a left foot disability. The service treatment records (STRs) do not support complaints, symptoms, evaluation, diagnosis, or treatment indicative of a left foot disability. In an April 1989 Report of Medical Examination, the Veteran was found to have a clinically normal evaluation of his feet and in an April 1989 Report of Medical History, the Veteran denied a history of foot trouble. The Board notes that these records are during the Veteran's period of Reserve duty; however, the examination and history were completed more than three years after his period of active duty ended in 1985. 

In an August 2024 VA Form 21-526EZ, Fully Developed Claim, the Veteran contended that his foot disability was due to the requirement of wearing boots during service. However, the Board affords more probative value to the Veteran's April 1989 denial of a history of foot trouble than to the contention made almost 40 years later. The 1989 record was created contemporaneously with his reserve service, and the Board has no reason to doubt the veracity of the Veteran's own denial of foot symptoms, particularly when it was coupled with a clinically normal evaluation of his feet, both of which were several years after separation from active service. Thus, the Board finds that the Veteran's August 2024 contention is not credible.

Accordingly, for these reasons, the Board finds the evidence persuasively weighs against a finding of disease or injury related to a left foot disease or injury during service, and the in-service disease or injury element is not met. 

Additionally, the evidence persuasively weighs against a nexus between a left foot disability and service. For example, in a December 2023 private treatment record, the Veteran was first diagnosed with a left foot disability, which is more than 35 years after service, and does not lend to a finding that a left foot disability had its onset in service. 

Prior to this time, private treatment records show that the Veteran underwent reviews of systems in January 2015, April 2018, and July 2018, which were negative for gout pain. At the time of his December 2023 diagnosis of gout, he reported that his symptoms had their onset on the day of the examination. This is affirmative evidence against ongoing left foot disability symptoms in the years following service discharge. 

While the Veteran alleges that the left foot disability is related to service, he is not competent to attribute the left foot disability to service, as medical expertise is required. In this regard, the question of causation involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. As such, the question of etiology in this case may not be competently addressed by lay evidence, and the Veteran's opinion is nonprobative evidence. At the present time, there is no competent and probative evidence of a nexus between the left foot disability and service, and the nexus element of a service-connection claim is not met.

VA did not provide the Veteran with a VA examination or medical opinion in connection with this claim. VA must provide a medical examination and/or medical opinion when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service, or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) there is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006). 

Here, for the reasons described above, the Board finds both that the evidence does not support an event, injury, or disease that occurred in service, or that a left foot disability manifested during the one-year period following service discharge. The evidence also does not establish a left foot disability may be associated with the Veteran's service. For a VA examination and/or medical opinion to be warranted, all the McLendon criteria have to be met, and at least one of the criteria is not met. Therefore, entitlement to a VA examination and/or medical opinion is not warranted for
 is insufficient competent medical evidence on file for the Secretary to make a decision on the claim. McLendon v. Nicholson, 20 Vet. App. 79 (2006). 

Here, for the reasons described above, the Board finds both that the evidence does not support an event, injury, or disease that occurred in service, or that a left foot disability manifested during the one-year period following service discharge. The evidence also does not establish a left foot disability may be associated with the Veteran's service. For a VA examination and/or medical opinion to be warranted, all the McLendon criteria have to be met, and at least one of the criteria is not met. Therefore, entitlement to a VA examination and/or medical opinion is not warranted for this claim, and there was no pre-decisional duty to assist error in the AOJ not providing a VA medical examination or medical opinion.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether entitlement to service connection for a left foot disability is warranted. Rather, the evidence persuasively weighs against service connection. The benefit of the doubt doctrine, see 38?U.S.C. §?5107(b), is therefore not for application. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

2. Entitlement to service connection for a right foot disability

3. Entitlement to service connection for a bilateral heel disability

4. Entitlement to service connection for a psychiatric disorder

5. Entitlement to service connection for a stomach disability

6. Entitlement to service connection for GERD

The Board has carefully reviewed the evidence of record and finds that the evidence persuasively weighs against the award of service connection for a right foot disability, a bilateral heel disability, a psychiatric disorder, GERD, and a stomach disability. The reasons follow.

The question before the Board as to these claims is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease or is caused or aggravated by a service-connected disability. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.310. For service connection to be established, there needs to be competent evidence of a current disability. However, here the Board finds that the evidence persuasively weighs against a finding that the Veteran has a current a right foot disability, a bilateral heel disability, a psychiatric disorder, GERD, and/or a stomach disability, and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 

In the March 2025 rating decision currently on appeal, the AOJ made a favorable finding that the Veteran has a current bilateral foot disability, based on findings of foot swelling in the Veteran's private treatment records. However, these records document only swelling in the left foot, and not the right foot. As such, the Board finds that the AOJ committed a clear and unmistakable error with respect to finding that there was a current right foot disability, and therefore such finding is not binding upon the Board. 

Private treatment records from October 2018, December 2018, and January 2020 show that the Veteran reported previous GERD-like symptoms, but that he had no current symptoms. This evidence does not support a finding of a current disability manifested by GERD-like symptoms. 

The evidence does not support complaints, symptoms, evaluation, diagnosis, or treatment for a right foot disability, a bilateral heel disability, a psychiatric disorder, GERD, or a stomach disability during the appeal period. The Board concludes that the evidence persuasively weighs against a finding that the Veteran has current a right foot disability, a bilateral heel disability, a psychiatric disorder, GERD, and/or a stomach disability, to include symptoms that cause functional impairment that affects earning capacity, and has not had any such disability or disabilities at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b), 38 C.F.R. § 3.303(a), (d). For example, of record are medical records from 2006 to 2024, and the evidence during this time period does not support a current a right foot disability, a bilateral heel disability, a psychiatric disorder, a GERD, or a stomach disability, to include symptoms that cause functional impairment that affects earning capacity. These records cover an 18-year period, and the lack of documentation of such disabilities, to include pain, is evidence against the claim for service connection for a right foot disability
 the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b), 38 C.F.R. § 3.303(a), (d). For example, of record are medical records from 2006 to 2024, and the evidence during this time period does not support a current a right foot disability, a bilateral heel disability, a psychiatric disorder, a GERD, or a stomach disability, to include symptoms that cause functional impairment that affects earning capacity. These records cover an 18-year period, and the lack of documentation of such disabilities, to include pain, is evidence against the claim for service connection for a right foot disability, a bilateral heel disability, a psychiatric disorder, GERD, or a stomach disability.

While the Veteran believes he has a current a right foot disability, a bilateral heel disability, a psychiatric disorder, GERD, and/or a stomach disability, he is not competent to provide evidence of a current disability for any of these issues in this case. The issues are medically complex, as they require specialized medical education. Consequently, the Board gives more probative weight to the competent evidence, which does not support that the Veteran experiences symptoms of these disabilities.

VA did not provide the Veteran with a VA examination or opinion in connection with these claims. The Board has laid out the requirements for entitlement to a VA examination and/or medical opinion above. Here, as explained above, the Board finds that the evidence does not establish competent evidence of a current disability or persistent or recurrent symptoms of a disability for these issues. For a VA examination and/or medical opinion to be warranted, all the McLendon criteria have to be met, and at least one of the criteria is not met in each of these claims. Therefore, entitlement to a VA examination and/or medical opinion is not warranted for these claims, and there was no pre-decisional duty to assist error in the AOJ not providing VA examinations or medical opinions.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether entitlement to service connection for a right foot disability, a bilateral heel disability, a psychiatric disorder, a stomach disability, and/or GERD, is warranted. Rather, the evidence persuasively weighs against service connection. The benefit of the doubt doctrine, see 38?U.S.C. §?5107(b), is therefore not for application. Lynch, 21 F.4th 776.

7. Entitlement to service connection for obstructive sleep apnea

The Board has carefully reviewed the evidence of record and finds that the evidence persuasively weighs against the award of service connection for obstructive sleep apnea. The reasons follow.

The Veteran has been diagnosed with obstructive sleep apnea, and thus there is evidence of a current disability. For example, in a June 2018 private medical record the Veteran was diagnosed with obstructive sleep apnea. In the March 2025 rating decision, the AOJ found that there is evidence of a current disability of obstructive sleep apnea. The Board is bound by this favorable finding. See 38 C.F.R. § 3.104(c). Thus, the facts establish that the first element of a service-connection claim is met.

However, as to an in-service disease or injury, the evidence does not support a finding of a disease or injury in service indicative of obstructive sleep apnea. The STRs do not support complaints, symptoms, evaluation, diagnosis, or treatment indicative of obstructive sleep apnea. Additionally, the Veteran has not alleged experiencing obstructive sleep apnea symptoms in service or that there was in-service incident that resulted in his developing obstructive sleep apnea. The Board notes that in an August 2024 VA Form 21-526EZ, Fully Developed Claim, the Veteran contended that his obstructive sleep apnea began in 2016 and was due to irregular sleep patterns. This contention is unclear, and does not support a finding of an injury or disease during service indicative of obstructive sleep apnea. Accordingly, for these reasons, the Board finds the evidence persuasively weighs against a finding of disease or injury related to obstructive sleep apnea during service, and the in-service disease or injury element is not met. 

Additionally, the evidence persuasively weighs against a nexus between obstructive sleep apnea and service. For example, in an April 2018 treatment record, the Veteran was first assessed to have obstructive sleep apnea, which is more than 30 years after service, and does not lend to a finding that obstructive sleep apnea had its onset in service. Shortly before the Veteran's diagnosis of obstructive sleep apnea, also in April 2018, it was documented that the Veteran had not previously been evaluated for sleep apnea. This is affirmative evidence against ongoing obstructive sleep apnea
 a finding of disease or injury related to obstructive sleep apnea during service, and the in-service disease or injury element is not met. 

Additionally, the evidence persuasively weighs against a nexus between obstructive sleep apnea and service. For example, in an April 2018 treatment record, the Veteran was first assessed to have obstructive sleep apnea, which is more than 30 years after service, and does not lend to a finding that obstructive sleep apnea had its onset in service. Shortly before the Veteran's diagnosis of obstructive sleep apnea, also in April 2018, it was documented that the Veteran had not previously been evaluated for sleep apnea. This is affirmative evidence against ongoing obstructive sleep apnea symptoms in the years following service discharge. 

While the Veteran alleges that obstructive sleep apnea is related to service, he is not competent to attribute obstructive sleep apnea to service, as medical expertise is required. In this regard, the question of causation involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. As such, the question of etiology in this case may not be competently addressed by lay evidence, and the Veteran's opinion is nonprobative evidence. At the present time, there is no competent and probative evidence of a nexus between the obstructive sleep apnea and service, and the nexus element of a service-connection claim is not met.

VA did not provide the Veteran with a VA examination or opinion in connection with this claim. The Board has laid out the requirements for entitlement to a VA examination and/or medical opinion above. Here, as explained above, the Board finds that the evidence does not establish that an event, injury, or disease occurred in service, or that a obstructive sleep apnea may be associated with the Veteran's service. For a VA examination and/or medical opinion to be warranted, all the McLendon criteria have to be met, and at least one of the criteria is not met. Therefore, entitlement to a VA examination and/or medical opinion is not warranted for this claim, and there was no pre-decisional duty to assist error in the AOJ not providing a VA medical examination or medical opinion.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether entitlement to service connection for obstructive sleep apnea is warranted. Rather, the evidence persuasively weighs against service connection. The benefit of the doubt doctrine, see 38?U.S.C. §?5107(b), is therefore not for application. Lynch, 21 F.4th 776.

8. Entitlement to service connection for tinnitus

The Board has carefully reviewed the evidence of record and finds that the evidence persuasively weighs against the award of service connection for tinnitus. The reasons follow.

The Veteran has been diagnosed with tinnitus, and thus there is evidence of a current disability. For example, in a January 2025 VA examination report the Veteran was diagnosed with tinnitus. In the March 2025 rating decision, the AOJ found that there is evidence of a current disability of tinnitus. The Board is bound by this favorable finding. See 38 C.F.R. § 3.104(c). Thus, the facts establish that the first element of a service-connection claim is met.

Additionally, as to an in-service disease or injury, the evidence supports a finding of a disease or injury in service indicative of tinnitus. In the March 2025 rating decision, the AOJ made a favorable finding that the evidence shows that a qualifying event, injury, or disease had its onset during the Veteran's service. The Veteran's DD Form 214 noted that his military occupational specialty (MOS) as a Combat Engineer had a high probability of noise exposure. Accordingly, the Board finds the evidence supports a finding of disease or injury related to tinnitus during service, and the in-service disease or injury element is met. 

However, the evidence persuasively weighs against a nexus between the post-service diagnosis of tinnitus and service. For example, the July 1989 Report of Medical Examination from the Veteran's Reserve duty shows the Veteran was found to have a clinically normal evaluation of his ears. In a concurrent July 1989 Report of Medical History, the Veteran denied a history of ear, nose, or throat trouble and hearing loss. Thus, more than three years following service discharge, the Veteran was not experiencing ear trouble or hearing loss, and his ears were found to be clinically normal.

In the January 2025 VA examination report, the Veteran reported that his tinnitus began approximately one to two years ago, which was almost 40 years after separation from service, and does not lend to a finding that tinnitus had its onset in service. The Veteran's statement is also affirmative evidence against ongoing tinnitus symptoms in the years following service discharge. 

The January 
 the Veteran was found to have a clinically normal evaluation of his ears. In a concurrent July 1989 Report of Medical History, the Veteran denied a history of ear, nose, or throat trouble and hearing loss. Thus, more than three years following service discharge, the Veteran was not experiencing ear trouble or hearing loss, and his ears were found to be clinically normal.

In the January 2025 VA examination report, the Veteran reported that his tinnitus began approximately one to two years ago, which was almost 40 years after separation from service, and does not lend to a finding that tinnitus had its onset in service. The Veteran's statement is also affirmative evidence against ongoing tinnitus symptoms in the years following service discharge. 

The January 2025 VA examiner opined that the Veteran's tinnitus was not incurred in or otherwise related to service. The examiner explained that the onset of tinnitus was reported by the Veteran to be post-separation. The examiner stated that there is no report of tinnitus in the service treatment records, at separation or in the medical records until the time of the claim. The examiner explained that current literature does not support late onset noise-induced tinnitus.

The examiner reviewed the evidence and provided an opinion with a rationale that was based on the specific facts of the case and medical principles. In light of the VA examiner's consideration of medical literature in application to the Veteran's medical history, the Board affords this opinion probative value and finds that it is evidence against a finding that tinnitus had its onset in service and is otherwise related to service. The facts upon which the examiner based the opinion are the same facts that the Board finds are the most accurate facts, which is that the Veteran did not report experiencing ear trouble or hearing loss more than three years following service and reported the onset of his tinnitus as occurring one to two years prior to the VA examination. Thus, the VA examiner's medical opinion is based on an accurate set of facts.

As to presumptive service connection for a chronic disease, the Board finds that the Veteran did not incur an event, injury, or disease related to his current tinnitus in service and that his tinnitus did not manifest during service or within one year of separation from service. Furthermore, the evidence of record does not demonstrate that the Veteran's symptoms have been continuous since separation from service. See 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). There were no complaints, diagnosis, or treatment for this disability for almost 40 years following service discharge until the Veteran first reported experiencing tinnitus in the approximately 2023 to 2024 timeframe. This is evidence that refutes continuity of symptomatology following service discharge. 

While the Veteran alleges that the tinnitus is related to service, he is not competent to attribute the tinnitus to service, as medical expertise is required. In this regard, the question of causation involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. As such, the question of etiology in this case may not be competently addressed by lay evidence, and the Veteran's opinion is nonprobative evidence. At the present time, there is no competent and probative evidence of a nexus between the tinnitus and service to weigh against the January 2025 VA medical opinion, and the nexus element of a service-connection claim is not met.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether entitlement to service connection for tinnitus is warranted. Rather, the evidence persuasively weighs against service connection. The benefit of the doubt doctrine, see 38?U.S.C. §?5107(b), is therefore not for application. Lynch, 21 F.4th 776.

 

 

A. P. SIMPSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Husain, Rahat

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. 


.1303.