HEARING LOSS

Summary

The veteran, who served in January 1991 and again from January 2003 to December 2003, appeals the denial of service connection for three conditions: bilateral hearing loss, a lung nodule, and residuals of isoniazid (INH) therapy. The veteran claimed hearing loss was due to noise exposure as a mechanic, a lung nodule was detected in service and possibly related to PFAS exposure, and INH therapy residuals were from treatment received in service. The Board denied all claims. For hearing loss, the Board found no current disability meeting VA's definition, noting normal hearing on VA examinations despite the veteran's lay statements about acoustic trauma. The VA examiner also provided a negative nexus opinion, finding hearing loss less likely than not service-related due to lack of change between entrance and separation exams. For the lung nodule and INH residuals, the Board denied claims due to the absence of a current diagnosis for either condition, stating that without proof of a present disability, no valid claim exists. The Board noted that while the veteran claimed possible PFAS exposure for the lung nodule and INH therapy, these claims were not substantiated by a current diagnosis. The Board applied the preponderance of the evidence standard, finding the evidence persuasively against service connection for all claims.

Rationale

No current disability meeting VA definition of hearing loss; VA examinations showed hearing within normal limits; VA examiner provided negative nexus opinion (less likely than not service-related)

Full Decision Text

Citation Nr: A26033766
Decision Date: 04/13/26	Archive Date: 04/13/26

DOCKET NO. 260309-635974
DATE: April 13, 2026

ISSUES

Entitlement to service connection for bilateral hearing loss disability.

Entitlement to service connection for a lung nodule.

Entitlement to service connection for residuals of isoniazid (INH) therapy.

ORDER

Entitlement to service connection for bilateral hearing loss disability is denied.

Entitlement to service connection for a lung nodule is denied.

Entitlement to service connection for residuals of INH therapy is denied.

FINDINGS OF FACT

1. A current bilateral hearing loss disability for VA purposes has not been shown. 

2. A lung nodule disability was not manifest during active service, or until many years after service, and is not shown to be causally or etiologically related to an in-service event, injury, or disease. 

3. Residuals of INH therapy were not manifest during active service, or until many years after service, and is not shown to be causally or etiologically related to an in-service event, injury, or disease. 

CONCLUSIONS OF LAW

1. A bilateral hearing loss disability was not incurred in or aggravated by service, and such incurrence may not be presumed. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385.

2. The criteria for service connection for a lung nodule disability have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309.

3. The criteria for service connection for residuals of INH therapy have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from January 1991 to July 1991, and again from January 2003 to December 2003.

This matter comes before the Board of Veterans' Appeals (Board) from a January 2026 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) in Phoenix, Arizona, which is the Agency of Original Jurisdiction (AOJ) in this appeal.

In the March 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the August and September 2025 agency of original jurisdiction (AOJ) decisions, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 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. 

Under 38 C.F.R. § 20.202(c)(2), an appellant has the right to request to switch Board review options (i.e., Direct, Evidence Submission, or Hearing dockets) by filing a new VA Form 10182 before the later of one year from the date the Agency of Original Jurisdiction mailed the decision on appeal, or 60 days from the date the Board received the original VA Form 10182. On June 21, 2024, the CAVC held in Williams v. McDonough that the Board may not issue a decision before the period to change AMA dockets under 38 C.F.R. § 20.202(c)(2) has elapsed. 37 Vet. App.
 38 C.F.R. § 20.202(c)(2), an appellant has the right to request to switch Board review options (i.e., Direct, Evidence Submission, or Hearing dockets) by filing a new VA Form 10182 before the later of one year from the date the Agency of Original Jurisdiction mailed the decision on appeal, or 60 days from the date the Board received the original VA Form 10182. On June 21, 2024, the CAVC held in Williams v. McDonough that the Board may not issue a decision before the period to change AMA dockets under 38 C.F.R. § 20.202(c)(2) has elapsed. 37 Vet. App. 305 (2024). However, as the Veteran has already submitted evidence as described in 38 C.F.R. §§ 20.302 and 20.303, this would preclude a docket switch pursuant to 38 C.F.R. § 20.202(c)(2), and thus the Board will proceed with the adjudication.

Veterans Claims Assistance Act of 2000 (VCAA)

The Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a). 

The Veteran in this case has not referred to any deficiencies in either the duties to notify or assist; therefore, the Board may proceed to the merits of the claim. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015, cert. denied, U.S.C. Oct. 3, 2016) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board....to search the record and address procedural arguments when the [appellant] fails to raise them before the Board"); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to an appellant's failure to raise a duty to assist argument before the Board).

The Board has reviewed all of the evidence in the Veteran's claims file. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the Veteran or obtained on his behalf be discussed in detail. Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the claims file shows, or fails to show, with respect to the claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-130 (2000).

Service Connection 

Legal Criteria for Service Connection

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish entitlement to service-connected compensation benefits, 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-the so-called "nexus" requirement." Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). 

Service connection may also be granted for disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). 

The Veteran has not claimed and the record does not indicate that the Veteran is eligible for any possible presumptive methods of service connection pursuant to herbicide agent exposure or any other presumptive possibility for service connection based on the record, timing, and location of his active service. The Board thus need not discuss that possibility here. See 38 U.S.C. § 1116; 38 C.F.R. § 3.309(e).

The United States Court of Appeals for Veterans Claims held that "when audiometric test results at a veteran's separation from service do not meet the regulatory requirements for establishing a
 to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). 

The Veteran has not claimed and the record does not indicate that the Veteran is eligible for any possible presumptive methods of service connection pursuant to herbicide agent exposure or any other presumptive possibility for service connection based on the record, timing, and location of his active service. The Board thus need not discuss that possibility here. See 38 U.S.C. § 1116; 38 C.F.R. § 3.309(e).

The United States Court of Appeals for Veterans Claims held that "when audiometric test results at a veteran's separation from service do not meet the regulatory requirements for establishing a 'disability' at that time, he or she may nevertheless establish service connection for a current hearing disability by submitting evidence that the current disability is causally related to service." In evaluating claims of service connection for hearing loss, it is observed that the threshold for normal hearing is from zero to 20 decibels, with higher threshold levels indicating some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 160 (1993). To make this determination, the Board must consider all the evidence of record and make appropriate determinations of competence, credibility, and weight. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005).

Service connection may also be established for a current disability on the basis of a presumption that certain chronic diseases, to include organic diseases of the nervous system such as sensorineural hearing loss, manifesting themselves to a certain degree within a certain time after service must have had their onset in service. 38 U.S.C. §§ 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309(a). For hypertension, the disease must have manifested to a degree of 10 percent or more within one year of service. 38 C.F.R. § 3.307(a)(3).

Service connection for certain chronic diseases can also be established through continuity of symptomatology. Walker v. Shinseki, 708 F.3d 1331 (2013); 38 C.F.R. §§ 3.303(b), 3.309. For chronic diseases shown as such in service or within the applicable presumptive period, subsequent manifestations of the same chronic disease at any later date are service-connected unless attributable to an intercurrent cause. 38 C.F.R. § 3.303(b). For a chronic disease to be considered to have been "shown in service," there must be a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings. Id. When the condition noted in service or within the presumptive period is not a chronic disease, a showing of continuity of symptomatology after discharge is required. Id.

VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154(a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). 

Lay evidence cannot be determined to be not credible merely because it is unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). However, the lack of contemporaneous medical evidence can be considered and weighed against a Veteran's lay statements. Id. Further, a negative inference may be drawn from the absence of complaints or treatment for an extended period. Maxson v. West, 12 Vet. App. 453, 459 (1999), aff'd sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000).

Proof of a current disability is a threshold to establishing service-connection for any claimed disability. In the absence of proof of a present disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). To be present as a current disability, there must be evidence of the condition at some time during the appeals period. Gilpin v. West, 155 F.3d 1353 (Fed.
 West, 12 Vet. App. 453, 459 (1999), aff'd sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000).

Proof of a current disability is a threshold to establishing service-connection for any claimed disability. In the absence of proof of a present disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). To be present as a current disability, there must be evidence of the condition at some time during the appeals period. Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998).

After the evidence is assembled, it is the Board's responsibility to evaluate the entire record. See 38 U.S.C. § 7104(a). When there is an approximate balance of evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each issue shall be given to the claimant. See 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 4.3. 

If the evidence for and against a claim is in approximate balance, the claim will be granted. 38 C.F.R. § 4.3. A claim will be denied only if the approximate balance of the evidence is persuasively against the claim. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). 

Evidence and Analysis - Bilateral Hearing Loss Disability

The Veteran contends that exposure to loud noises during his periods of active service as a mechanic for military vehicles led to his current hearing loss disability. He originally filed a claim for service connection for bilateral hearing loss in September 2004 within a year of his last active duty service, and was denied in a June 2005 rating decision. The Veteran then filed a supplemental claim in July 2025 but was denied again in an August 2025 rating decision. After a request for a higher level review in September 2025, the Veteran was again denied service connection for bilateral hearing loss in a January 2026 rating decision, which is the decision on appeal here.

As the Veteran lacks a current diagnosis of hearing loss in either ear, and though VA concedes an in-service injury in the form of acoustic trauma, the approximate balance of the evidence persuasively weighs against a finding that the Veteran has a claimed hearing loss disability in either ear that is related to the acoustic trauma sustained in service. For this reason, the claim for service connection for bilateral hearing loss is denied.

A claim for service connection requires medical evidence showing that the veteran currently has the claimed disability. See Degmetich v. Brown, 104 F.3d 1328 (Fed. Cir. 1997); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992); Gilpin v. Brown, 155 F.3d 1353 (Fed. Cir. 1998) [service connection may not be granted unless a current disability exists]. Under 38 U.S.C. § 1110, it is essential that there be a current disability in order to establish service connection. See Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998). Absent proof of a current disability, there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 144 (1992). 

First, the evidence of record does not demonstrate that the Veteran has a current bilateral hearing loss disability that comports with VA's definition of disability resulting from hearing impairment. For purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies of 500, 1000, 2000, 3000, or 4000 Hertz (Hz) is 40 decibels (dB) or greater; or when the auditory thresholds for at least three of the frequencies of 500, 1000, 2000, 3000, or 4000 Hz are 26 dB or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. 

The Veteran has received a VA audiological examination that evaluated his hearing loss in September 2025. For the examination,
, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies of 500, 1000, 2000, 3000, or 4000 Hertz (Hz) is 40 decibels (dB) or greater; or when the auditory thresholds for at least three of the frequencies of 500, 1000, 2000, 3000, or 4000 Hz are 26 dB or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. 

The Veteran has received a VA audiological examination that evaluated his hearing loss in September 2025. For the examination, none of the tested frequencies in either ear exceeded 26 dB; the average was 20 dB in the right ear and 21 dB in the left ear. The Maryland CNC test was 100 percent in the right ear and 96 percent in the left ear. The examiner noted all frequencies and measurements pursuant to 38 C.F.R. § 3.385 were tested, and acoustic immittance was considered normal in each the right ear and the left ear. Sensorineural hearing loss in the frequency range of 6000 Hz or higher was noted for each the right ear and left ear, but no sensorineural hearing loss was noted in the frequency range of 500 to 4000 Hz range for either ear.  

This September 2025 examiner also provided a negative nexus opinion for service connection, saying it was less likely than not, less than 50 percent probability, that any hearing loss was caused by or a result of an event in military service for each ear. The examiner's rationale was that the Veteran's hearing exhibited no change when comparing the entrance examination with the separation examination. The examiner also noted the Veteran's lay statements about his exposure to acoustic trauma as a field mechanic, but that he still had hearing considered within normal limits.

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

The record establishes the Veteran has no current hearing loss considered disabling for VA purposes. The Board has conceded hazardous noise exposure while in service. However, the preponderance of the evidence is against the Veteran's claim of service connection for hearing loss. The Veteran's lay statements contrast with a finding of normal hearing from VA in December 2004 and again in September 2025. The Board notes there is no additional evidence in the Veteran's favor, beyond his own statements. In the absence of proof of a current disability, there is no valid claim. Brammer v. Derwinski, 3 Vet. App. 223 (1992).

The Board notes that the September 2025 VA audiologist opined that any hearing loss was less likely than not due to the Veteran's active military service. The finding for service connection requires proof of a current disability, and the Veteran's examination for right ear and left ear hearing loss does not reach the threshold of hearing loss for VA purposes. Thus, the approximate balance of the evidence is persuasively against a finding of current hearing loss disability for VA purposes, and therefore service connection for bilateral hearing loss disability is not warranted. 38 C.F.R. §§ 3.303, 3.385. Since the approximate balance of the evidence is against the claim, the benefit of the doubt rule is not applicable. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 5557 (1990); 38 C.F.R. § 3.102. For these reasons, the claim is denied.

Evidence and Analysis - Lung Nodule

The Veteran originally claimed service connection in July 2025 for a nodule on his lung, detected during medical treatment in 2003 during a period of the Veteran's active service. The Veteran contended in a July 2025 statement with his claim that the spot on his lung was monitored closely to see it if develops into a malignancy. The Veteran noted that he had possible exposure to PFAS chemicals in the course of his military duties as a mechanic.

VA provided a respiratory conditions examination in August 2025 for his lung nodule claim. The examiner noted the Veteran does not have a current diagnosis associated with his claimed lung nodule condition, and therefore it was less likely than not incurred in or caused by the claimed in-service injury, event, or illness.

2. Entitlement to service connection for a lung nodule is denied.

In the absence of a current diagnosis of any lung disability for which VA service connection is possible, service connection for a lung nodule disability is not warranted. 38 C.F.R. § 3.303. The
 develops into a malignancy. The Veteran noted that he had possible exposure to PFAS chemicals in the course of his military duties as a mechanic.

VA provided a respiratory conditions examination in August 2025 for his lung nodule claim. The examiner noted the Veteran does not have a current diagnosis associated with his claimed lung nodule condition, and therefore it was less likely than not incurred in or caused by the claimed in-service injury, event, or illness.

2. Entitlement to service connection for a lung nodule is denied.

In the absence of a current diagnosis of any lung disability for which VA service connection is possible, service connection for a lung nodule disability is not warranted. 38 C.F.R. § 3.303. The Board notes there is no additional evidence in the Veteran's favor, beyond his own statements. In the absence of proof of a current disability, there is no valid claim. Brammer v. Derwinski, 3 Vet. App. 223 (1992). Under these circumstances, the Veteran has failed to state a claim of entitlement to service connection for a lung nodule disability upon which relief could be granted. As such, the claim lacks legal merit and must be denied. Sabonis v. Brown, 6 Vet. App. 426 (1994).

Evidence and Analysis - INH Therapy Residuals

The Veteran originally claimed service connection in July 2025 for residuals of INH therapy during a period of the Veteran's active service. The Veteran contended in a July 2025 statement with his claim that he had received the narrow spectrum antibiotic isoniazid (INH) in May 2003 after a skin PPD test that was considered a false positive later after the course of treatment. 

VA provided a respiratory conditions examination in August 2025 for his INH therapy residuals claim. The examiner noted the Veteran does not have a current diagnosis associated with his claimed INH therapy residuals, and therefore it was less likely than not incurred in or caused by the claimed in-service injury, event, or illness.

3. Entitlement to service connection for residuals of INH therapy is denied.

In the absence of a current diagnosis of any INH therapy disability for which VA service connection is possible, service connection for residuals of INH therapy is not warranted. 38 C.F.R. § 3.303. The Board notes there is no additional evidence in the Veteran's favor, beyond his own statements. In the absence of proof of a current disability, there is no valid claim. Brammer v. Derwinski, 3 Vet. App. 223 (1992). Under these circumstances, the Veteran has failed to state a claim of entitlement to service connection for residuals of INH therapy upon which relief could be granted. As such, the claim lacks legal merit and must be denied. Sabonis v. Brown, 6 Vet. App. 426 (1994).

 

 

MICHAEL A. PAPPAS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J. Setter, 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.