MAJOR DEPRESSIVE DISORDER

E. I. VELEZ · 2026 · Case ID: A26033978

GRANTED

Summary

The Veteran, who served honorably in the U.S. Marine Corps from February 1994 to August 1994, appeals the denial of service connection for a psychiatric disability, specifically unspecified depressive disorder and depressive disorder with anxious distress, claimed as secondary to his service-connected tinnitus. The Veteran asserts that the constant ringing in his ears disrupts his sleep, leading to irritability, mood swings, and anger, which has strained his relationships and caused social isolation. He also reports heightened anxiety and fear due to his tinnitus. Lay statements from friends corroborate his increased irritability and lack of sleep. While the Board found the lay evidence probative for observable symptoms, it noted the lack of medical expertise in these statements. The Veteran submitted two private medical opinions; the August 2023 opinion linked his psychiatric disability to service and tinnitus, though without strong rationale, and the November 2024 opinion summarized literature associating tinnitus with depression and anxiety. The Board found the evidence in approximate balance and resolved reasonable doubt in the Veteran's favor, concluding that the sleeplessness caused by tinnitus likely led to his depression. Consequently, service connection for a psychiatric disability secondary to tinnitus was granted.

Rationale

Service-connected tinnitus; Lay evidence of sleeplessness and irritability; Private medical opinions noting association between tinnitus and depression/anxiety; Resolution of reasonable doubt in Veteran's favor

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250519-545703

Full Decision Text

Citation Nr: A26033978
Decision Date: 04/14/26 Archive Date: 04/14/26

DOCKET NO. 250519-545703
DATE: April 14, 2026

ORDER

Entitlement to service connection for a psychiatric disability, to include unspecified depressive disorder and depressive disorder with anxious distress, as secondary to service-connected tinnitus, is granted.

FINDING OF FACT

Resolving any reasonable doubt in favor of the Veteran, his psychiatric disability is proximately due to his service-connected tinnitus.

CONCLUSION OF LAW

The criteria for entitlement to service connection for a psychiatric disability, to include unspecified depressive disorder and depressive disorder with anxious distress, as secondary to service-connected tinnitus, have been met. 38 U.S.C. §§ 1110, 5107 (2024); 38 C.F.R. §§ 3.102, 3.310 (2025).

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served honorably in the U.S. Marine Corps from February 1994 to August 1994.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2025 rating decision by the agency of original jurisdiction (AOJ).

In the May 2025 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 April 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, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

The Board notes that there is conflicting evidence in the record regarding the Veteran's diagnosis. See August 2023 & November 2024 Private Medical Opinions. Therefore, the Board will broadly construe the Veteran's claim as a claim for service connection for a psychiatric disability, to include unspecified depressive disorder and depressive disorder with anxious distress.? Clemons v. Shinseki, 23?Vet. App.?1, 6 (2009) (holding that the Board must consider any disability that "may be reasonably encompassed by" the description of the claim).? The issue has been recharacterized accordingly.

Entitlement to service connection for a psychiatric disability, as secondary to service-connected tinnitus.

The Veteran contends that he should be granted service connection for a psychiatric disability that he asserts was caused by his service-connected tinnitus. See September 2023 Statement in Support of Claim. For the following reasons, the Board finds that secondary service connection is warranted.

Secondary service connection may be granted for a disability that is proximately due to, or the result of, a service-connected disease or injury.? 38 C.F.R. § 3.310(a). The evidence must show that a current disability exists and that the current disability was either caused by or aggravated by a service-connected disability. 38 C.F.R. § 3.310(a); see also Allen v. Brown, 7 Vet. App. 439 (1995). Secondary service connection is not limited to a "single cause and effect" but also applies to conditions that "would have been less severe were it not for the service-connected disability." Spicer v. McDonough, 61 F.4th 1360, 1364 (Fed. Cir. 2023).

When, after careful consideration of all the evidence, there is a reasonable doubt regarding service connection, such doubt will be resolved in favor of the veteran.? 38?U.S.C. §?5107(b); 38?C.F.R. §?3.102.? The phrase "reasonable doubt" means there is an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim.? Id.? The evidence is not in approximate balance when the evidence "persuasively favors one side or the other."? Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021).

In the April
. Cir. 2023).

In the April 2025 rating decision, the AOJ made the following favorable findings: (1) the Veteran has a current disability in the form of a diagnosis of depressive disorder with anxious distress and (2) the Veteran is service connected for tinnitus. Under the Appeals Modernization Act, the Board is bound by the favorable findings of the AOJ in the absence of clear and unmistakable error. 38 C.F.R. § 3.104. The Board finds no clear and unmistakable error in this instance. Therefore, the only issue before the Board is whether the Veteran's psychiatric disability is caused or aggravated by his service-connected tinnitus.

The Veteran reports that the ringing in his ears causes him to be unable to sleep and makes him extremely irritable with friends, family members, and coworkers. See September 2023 Statement in Support of Claim. Because of his irritability and quick temper, the Veteran has become isolated from his family, friends, and coworkers. He reports that "no one wants to talk to [him] because [he] always starts an argument." The Veteran experiences "unbearable anxiety, mood swings, and . . . rages of anger" and reports feeling fearful that he will not hear an intruder because of his tinnitus. He therefore checks the locks on doors and windows multiple times and sleeps with a weapon by his side.

The Veteran submitted two lay statements from long time friends in support of his claim. See September 2023 Lay Statements. Both friends report having witnessed the Veteran's increased irritability and anger since his diagnosis with tinnitus. In addition, one of the friends notes that the Veteran has complained of being unable to sleep due to the ringing in his ears and feeling as though his anger and irritability are a result of his lack of sleep.

The Veteran and his friends are not competent to prove a matter requiring medical expertise, such as the cause of his psychiatric disability. However, they are competent to describe items capable of lay observation, including the nature of the Veteran's symptoms, such as lack of sleep, irritability, and anger. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). The Board therefore finds that the three lay statements have significant probative value to the extent they describe the Veteran's lay observable symptoms.

VA did not obtain a medical opinion in connection with the Veteran's claim. However, the Veteran submitted two private medical opinions in support of his claim. See August 2023 & November 2024 Private Medical Opinions. The August 2023 opinion notes that the Veteran reports having constant ringing in both ears which negatively impacts his sleep. As a result of his poor sleep, the Veteran is moody, impatient, irritable, and quick to anger, which has strained his familial and social relationships and resulted in his social isolation. The November 2024 opinion similarly describes the Veteran's symptoms and includes a summary of medical studies discussing tinnitus and psychiatric disabilities. According to these medical studies, "a substantial proportion of patients with tinnitus have depression;" "tinnitus may be associated with . . . reduced emotional wellbeing, particularly anxiety and depression;" and the "likelihood of positive depression and anxiety screens [is] elevated for those with tinnitus."

Neither of the private medical opinions provide a particularly strong medical rationale for finding a relationship between the Veteran's tinnitus and his psychiatric disability. The November 2024 opinion summarizes medical literature that finds an association or correlation between tinnitus and depression, but this literature does not discuss causation. The August 2023 opinion states that the Veteran's psychiatric disability is at least as likely as not "incurred in or caused by [active duty] service, aggravated by the Veteran's service connected conditions of tinnitus and hearing loss." Thus, not only is it unclear whether the opinion is stating that the Veteran's psychiatric disability is directly related to his service or aggravated by his tinnitus, the opinion does not provide any rationale for the Board to analyze. Nevertheless, the Board affords the two private opinions some prob
relationship between the Veteran's tinnitus and his psychiatric disability. The November 2024 opinion summarizes medical literature that finds an association or correlation between tinnitus and depression, but this literature does not discuss causation. The August 2023 opinion states that the Veteran's psychiatric disability is at least as likely as not "incurred in or caused by [active duty] service, aggravated by the Veteran's service connected conditions of tinnitus and hearing loss." Thus, not only is it unclear whether the opinion is stating that the Veteran's psychiatric disability is directly related to his service or aggravated by his tinnitus, the opinion does not provide any rationale for the Board to analyze. Nevertheless, the Board affords the two private opinions some probative weight to the extent that they describe the Veteran's symptoms and the state of current medical literature regarding tinnitus and depression.

The Board finds that the evidence is in approximate balance and will therefore resolve any reasonable doubt in the Veteran's favor. The Veteran has credibly described how the constant ringing in his ears disrupts his sleep which in turn makes him irritable, impatient, and quick to anger. It is therefore reasonable to conclude that the sleeplessness resulting from the constant ringing in the Veteran's ears is more likely than not to have caused his depression. Accordingly, service connection for a psychiatric disability, as secondary to service-connected tinnitus, is granted.

E. I. VELEZ

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Zimmerman, K.

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.

Analyze in VA Law Explorer