HEARING LOSS

Summary

The Veteran, an Army veteran who served from February 1991 to February 1995, appeals the denial of service connection for bilateral hearing loss, tinnitus, and vertigo. The Veteran's military records indicate service as a cannon crew member, consistent with noise exposure, and a history of motion sickness noted on separation examination. The Board considered evidence submitted up to the January 2021 agency of original jurisdiction decision and evidence presented at the May 2025 Board hearing. The Veteran submitted two private medical opinions. An October 2020 audiological opinion found it more likely than not that the hearing loss and tinnitus were caused by military service, citing noise exposure as a cannon crew member and lack of post-service noise exposure or family history. A March 2025 opinion from a physician found it at least as likely as not that the vertigo, hearing loss, and tinnitus were related to service. This opinion linked vertigo to motion sickness and acoustic trauma from cannon exposure, noted significant shifts in audio evaluations in service records for hearing loss, and cited medical literature correlating acoustic trauma with tinnitus. While VA examinations in 2020 and 2021 found no hearing loss or vertigo, and some opinions were unfavorable, the Board found the private opinions more probative due to their thorough rationales, consideration of the Veteran's history, and correlation with medical literature. The Board applied the benefit of the doubt doctrine, granting service connection for all three conditions.

Rationale

Private audiological opinion found hearing loss more likely than not caused by military service.; Private physician opinion found hearing loss at least as likely as not related to service.; Physician noted Veteran's occupation as cannon crew member resulted in acoustic trauma.; Physician noted significant shifts in audio evaluations during service.; Physician rationalized post-service occupation as barber had no recreational noise exposure.; VA examinations found no hearing loss, but private audiological exam met requirements for hearing loss.

Full Decision Text

Citation Nr: A26031182
Decision Date: 04/06/26	Archive Date: 04/06/26

DOCKET NO. 210406-151691
DATE: April 6, 2026

ORDER

Entitlement to service connection for bilateral hearing loss is granted.

Entitlement to service connection for tinnitus is granted. 

Entitlement to service connection for a vertigo disability is granted. 

FINDING OF FACT

The persuasive evidence of record is in approximate balance that the Veteran currently suffers from hearing loss, tinnitus, and a vertigo disability that are related to his active duty service. 

CONCLUSIONS OF LAW

1. The criteria for service connection for bilateral hearing loss have been met.  38?U.S.C. §§?101, 1131, 1132, 1153, 5107; 38?C.F.R. §§?3.102, 3.303, 3.304, 3.385.

2. The criteria for service connection for tinnitus have been met.  38?U.S.C. §§?1131, 5107; 38?C.F.R. §§?3.303, 3.304, 3.307, 3.309

3. The criteria for service connection for a vertigo disability have been met.  38?U.S.C. §§?1131, 5107; 38?C.F.R. §§?3.303, 3.304.

REASONS AND BASES FOR FINDING AND CONCLUSIONS

The Veteran served on active duty in the United States Army from February 1991 to February 1995. 

In?April 2021, the Veteran filed a?VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement)?and?elected the Hearing docket.? A Board hearing was held on?May 20, 2025.? Therefore, the Board may only consider the evidence of record at the time of the?January 2021?agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence?submitted?by the Veteran, or?his?representative,?at the hearing or within 90 days following the hearing.? 38 C.F.R. §?20.302(a).? If evidence was?submitted?either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision.  38 C.F.R. §§?20.300, 20.302(a), 20.801.? 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and?submit?or?identify?this evidence.? 38 C.F.R. §?3.2501.?If the evidence is new and relevant, VA will issue another decision on the claims, 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 will be granted if the evidence?demonstrates?that a current disability resulted from an injury or disease incurred in or aggravated by active service.??38?U.S.C. §?1110; 38?C.F.R. §?3.303(a).  In order to establish service connection, the record must show competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability.??Holton v. Shinseki, 557 F.3d, 1362, 1366 (Fed. Cir. 2009).??? 

When considering such a claim for service connection, the Board must consider on a case-by-case basis, the competence and sufficiency of lay evidence offered to?support a finding of service connection.??See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009) (quoting?Jandreau v. Nicholson, 492 F.3d 1372, 1377 Fed. Cir. 2007)).??The mere conclusory or generalized lay statements that a service?event or illness caused a current disability are insufficient.??Waters v. Shinseki, 601 F.3d 1274, 1278 (2010).??? 

1. Entitlement to Service Connection: Bil
 must consider on a case-by-case basis, the competence and sufficiency of lay evidence offered to?support a finding of service connection.??See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009) (quoting?Jandreau v. Nicholson, 492 F.3d 1372, 1377 Fed. Cir. 2007)).??The mere conclusory or generalized lay statements that a service?event or illness caused a current disability are insufficient.??Waters v. Shinseki, 601 F.3d 1274, 1278 (2010).??? 

1. Entitlement to Service Connection: Bilateral Hearing Loss

2. Entitlement to Service Connection: Tinnitus

3. Entitlement to Service Connection: Vertigo

The Veteran contends that he currently suffers from bilateral hearing loss, tinnitus, and vertigo that are related to his active-duty service. 

As?an initial?matter, the Board acknowledges that the Veteran has been diagnosed with?bilateral hearing loss, tinnitus, and vertigo.  The Veteran's military records confirm he was a cannon crew member during service, and therefore exposure to noise is consistent with his military duties.? Additionally, the Veteran checked "yes" for motion sickness on his separation Report of Medical History.  Thus, the issue turns upon whether there is evidence of a nexus between the said in-service event or injury?and the present diagnosed disabilities.??See?38?C.F.R. §?3.303;?Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).??The Board finds there is.? 

In October 2020, the Veteran submitted a private opinion.  The audiologist opined it was more likely than not that that the Veteran's hearing loss and tinnitus symptoms were caused by his military service.  The audiologist rationalized that the Veteran was exposed to noise in service as a cannon crew member.  The audiologist further explained that the Veteran's occupation as a barber post service did not expose him to noise, and he does not have recreational noise exposure and has no known family history of noise exposure.  

In May 2025, the Veteran submitted another private opinion dated March 2025.  The physician opined it was at least as likely as not that the Veteran's vertigo, hearing loss, and tinnitus are related to his active duty service.  For the Veteran's vertigo, the physician noted the Veteran had been diagnosed with benign paroxysmal positional vertigo (BPPV).  The physician rationalized that the Veteran had an occurrence of motion sickness in 1994 during his service.  The physician explained that while the etiology of motion sickness and vertigo differ, the symptoms can overlap.  The physician further rationalized the Veteran has a history of acoustic trauma in service, and data shows that exposure to extremely intense sounds, such as those that would come from a cannon, may increase one's likelihood of vertigo.  The physician explained it is likely the Veteran has both motion sickness and vertigo, which includes symptoms while in moving vehicles and correlate with sudden head movements that can trigger vertigo.  The physician lastly noted again that data shows a clear correlation between vertigo and acoustic trauma.  The physician cited to multiple medical literature articles. 

For the Veteran's bilateral hearing loss, the physician rationalized that the Veteran's service treatment records document a significant shift in audio evaluations performed in 1994 compared to the Veteran's 1991 evaluation.  The physician explained that the Veteran was exposed to hazardous noise daily during service as he was required to stay in close proximity to cannons without use of auditory protection, which resulted in acoustic trauma.  The physician further rationalized that the Veteran's post service occupation was as a barber, which had no recreational noise exposure and no known exposure to ototoxic medications.   Lastly, for the Veteran's tinnitus, the physician provided that the Veteran has reported ringing and buzzing in his ears that began since service.  The physician explained that medical literature studies show that veterans are twice as likely to have tinnitus compared to non-veterans.  The physician additionally provided that studies document that acoustic trauma signs and symptoms include tinnitus, and noise generally affects thresholds from 3000 to 6000 Hertz. 

The Board recognizes that April 2013, July 2020, and January 2021 VA examinations documented the Veteran as not having hearing loss for VA purposes.  However, an October 2020 private audiological examination documented the Veteran as having a speech recognition score of 92 percent in the right ear and 80 percent in the left ear using the Maryland CNC, which meets the requirements of 38?C.F.R. §?
  The physician explained that medical literature studies show that veterans are twice as likely to have tinnitus compared to non-veterans.  The physician additionally provided that studies document that acoustic trauma signs and symptoms include tinnitus, and noise generally affects thresholds from 3000 to 6000 Hertz. 

The Board recognizes that April 2013, July 2020, and January 2021 VA examinations documented the Veteran as not having hearing loss for VA purposes.  However, an October 2020 private audiological examination documented the Veteran as having a speech recognition score of 92 percent in the right ear and 80 percent in the left ear using the Maryland CNC, which meets the requirements of 38?C.F.R. §?3.385 for hearing loss.  The Board additionally recognizes a July 2020 examiner found the Veteran had no diagnosis of vertigo.  But, as mentioned above, a private physician diagnosed the Veteran with BPPV.  The Board understands July 2020 and June 2021 examiners opined the Veteran's tinnitus was not related to his service.  However, both examiners based their opinions, in part, on a certain section of an IOM report finding insufficient evidence of late-onset permanent noise-induced hearing loss in animals or humans.? The Board observes that while a?portion?of the IOM report found there is no evidence of delayed onset hearing loss due to noise exposure, another?portion?of the same IOM report found that "an individual's awareness of the effects of noise on hearing may be delayed considerably after the noise exposure."? (IOM report at 203-04).? A medical text's qualifying or contradictory opinions may affect the probative value of any medical opinion that relies upon the text, whether agreeing with the medical text and using it as supportive or distinguishing from it.??See McCray v.?Wilkie, 31?Vet. App.?243.? Finally, tinnitus is, by definition, "a noise in the ears, such as ringing, buzzing, roaring, or clicking. It is usually subjective in type."  Dorland's Illustrated Medical Dictionary, 1914 (30th ed. 2003).  As such, tinnitus is "subjective," as its existence is generally determined by whether or not the Veteran claims to experience it. For VA purposes, tinnitus has been specifically found to be a disorder with symptoms that can be identified through lay observation alone.  See Charles v. Principi, 16?Vet. App.?370 (2002).  If a veteran reports ringing in his or her ears, then a diagnosis of tinnitus is generally applied without further examination. Consequently, for the reasons discussed, the Board does not put probative value to the VA opinions.  

Therefore, the Board finds?the?October 2020 and March 2025 private opinions to be of significant probative value in?determining?the Veteran's?bilateral hearing loss, tinnitus, and vertigo are related to his active-duty service.? The Board notes that the probative value of medical opinion evidence is based on the medical experts' personal examination of the patient, their knowledge, and skill in analyzing the data, and their medical conclusion.? As is true with any piece of evidence, the credibility and weight to be attached to these opinions are within the province of the adjudicator.??Guerrieri?v. Brown, 4?Vet. App.?467, 470-71 (1993).? Here, the physicians showed knowledge of the Veteran's background and based the opinions on the Veteran's lay contentions, their medical knowledge,?review of the record, and examination of the Veteran.? Additionally,?complete and thorough rationales were?provided for the opinions?rendered?and?are?consistent with the medical evidence of record.??See?Guerrieri?v. Brown,?4?Vet. App.?467, 470-71 (1993).? 

Accordingly, the Board concludes that the evidence of record is persuasively in favor of the claims, and the benefit of the doubt doctrine has been applied.??See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).? 

 

 

JENNIFER HWA

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J. Negron, 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.