HEARING LOSS

Summary

The veteran, who served in the U.S. Army from September 1974 to June 1975, appeals the denial of service connection for bilateral hearing loss and tinnitus, and the remand of his claim for a low back disability. The Board found that the evidence persuasively weighed against service connection for bilateral hearing loss and tinnitus. The veteran's service treatment records were silent regarding complaints or diagnoses of hearing loss or tinnitus, and his separation examination in May 1975 indicated normal hearing. A March 2011 VA treatment record also noted normal hearing. While the veteran claimed hearing loss and tinnitus since service, his assertions lacked credibility given his denials of ear trouble in 1975 and normal hearing findings in 2011. The Board found the June 2021 VA examiner's opinion, which stated the conditions were less likely than not related to service, to be highly probative and adequate. Conversely, a February 2025 private medical opinion was deemed conclusory and of limited value as it did not adequately address the lack of in-service complaints or the normal hearing findings. For the low back disability, the Board remanded the claim because the June 2021 VA examiner's opinion was inadequate. The examiner failed to address a June 1975 service treatment record noting a complaint of back pain, rendering the opinion less probative. The Board also noted the need to obtain outstanding non-VA treatment records from 2005 related to the back condition. Service connection for bilateral hearing loss and tinnitus was denied, while the low back disability claim was remanded for further development.

Rationale

Service treatment records silent for hearing loss complaints.; Separation examination in May 1975 indicated normal hearing.; March 2011 VA treatment record noted normal hearing.; Private opinion lacked sufficient explanation and addressed Veteran's denials.; VA examiner's opinion was adequate and probative.

Full Decision Text

Citation Nr: A26035833
Decision Date: 04/16/26	Archive Date: 04/16/26

DOCKET NO. 210722-173801
DATE: April 16, 2026

ORDER

Entitlement to service connection for bilateral hearing loss is denied.

Entitlement to service connection for tinnitus is denied.

REMANDED

Entitlement to service connection for a low back disability is remanded.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding the Veteran's bilateral hearing loss had its onset during active service, manifested in the first post-service year, or is otherwise etiologically related to his service.

2. The evidence of record persuasively weighs against finding the Veteran's tinnitus had its onset during active service, manifested in the first post-service year, or is otherwise etiologically related to his service.

CONCLUSIONS OF LAW

1. The criteria for service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385.

2. The criteria for service connection for tinnitus have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from September 1974 to June 1975. 

The rating decision on appeal was issued in June 2021 by a Department of Veterans Affairs (VA) Regional Office, which serves as the Agency of Original Jurisdiction (AOJ). The rating decision readjudicated and denied service connection for bilateral hearing loss, tinnitus, and a low back disability.

In the July 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. On December 2, 2024, the Veteran withdrew the hearing request.

Therefore, the Board may only consider the evidence of record at the time of the June 2021 decision on appeal, as well as any evidence submitted by the Veteran or representative within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 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. However, because the Board is remanding the claim of entitlement to service connection for low back disability, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

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

In order to establish service connection for the claimed disability, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical, or in certain circumstances, lay evidence of a nexus between the claimed in-service disease or injury and the current disability. See 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

Where a Veteran served 90 days or more during a period of war or during pe
. § 3.303(d).

In order to establish service connection for the claimed disability, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical, or in certain circumstances, lay evidence of a nexus between the claimed in-service disease or injury and the current disability. See 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

Where a Veteran served 90 days or more during a period of war or during peacetime service after December 31, 1946, and a chronic disease, including hearing loss and tinnitus, becomes manifest to a degree of 10 percent or more within one year from the date of termination of such service, such disease shall be presumed to have been incurred in or aggravated by service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. If a condition listed as a chronic disease in § 3.309(a) is noted during service, but is either shown not to be chronic or the diagnosis could be legitimately questioned, then a showing of continuity of related symptomatology after discharge is required to support the claim. 38 C.F.R. § 3.303(b); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) (holding that the continuity of symptomatology provisions of 38 C.F.R. § 3.303(b) only apply to a chronic disease listed in § 3.309(a)). 

When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. When a veteran seeks benefits and the evidence is in relative equipoise, the veteran prevails. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The benefit-of-the-doubt rule does not apply when the evidence persuasively favors one side or the other. Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021).

1. Entitlement to service connection for bilateral hearing loss.

The Veteran asserts he has bilateral hearing loss resulting from exposure to hazardous noise levels during military service.

The June 2021 rating decision favorably found the Veteran has bilateral hearing loss and that a qualifying event, injury, or disease had its onset during the Veteran's service.

These favorable findings are binding on the Board unless rebutted by evidence that identifies a clear and unmistakable error. After reviewing the evidence, the Board finds the favorable findings have not been rebutted.

Therefore, the remaining question before the Board is whether the hearing loss is etiologically related to the Veteran's service.

As will be explained below, the Board finds evidence of record persuasively weighs against finding the Veteran's bilateral hearing loss had its onset during active service, manifested in the first post-service year, or is otherwise etiologically related to his service.

The Veteran's service treatment records are silent for complaints, treatment, or diagnoses related to hearing loss. He denied having hearing loss in May and June 1975, and did not have VA-defined hearing loss on May 1975 separation examination.

A March 2011 VA treatment record notes the Veteran's hearing was normal.

The Veteran filed his first claim of service connection for bilateral hearing loss in May 2015.

The Veteran was provided a VA hearing loss examination in June 2021. The examiner diagnosed bilateral hearing loss and opined it was less likely than not caused by military noise exposure. She explained his May 1975 separation audiogram revealed normal hearing bilaterally.  

In February 2025, the Veteran submitted a February 2025 non-VA medical opinion. The physician opined the Veteran's hearing loss was as likely as not related to service based on the "documented service-connected loud noise exposure with reported onset of tinnitus and hearing loss with continuation." He noted the Veteran filed a claim for service connection for hearing loss in May 2015. 

Initially, the Board finds the Veteran is not entitled to service connection for bilateral hearing loss on a presumptive basis. There is no evidence the bilateral hearing loss manifested in
 diagnosed bilateral hearing loss and opined it was less likely than not caused by military noise exposure. She explained his May 1975 separation audiogram revealed normal hearing bilaterally.  

In February 2025, the Veteran submitted a February 2025 non-VA medical opinion. The physician opined the Veteran's hearing loss was as likely as not related to service based on the "documented service-connected loud noise exposure with reported onset of tinnitus and hearing loss with continuation." He noted the Veteran filed a claim for service connection for hearing loss in May 2015. 

Initially, the Board finds the Veteran is not entitled to service connection for bilateral hearing loss on a presumptive basis. There is no evidence the bilateral hearing loss manifested in the first post-service year. The medical evidence shows the Veteran's hearing was noted to be normal in March 2011 and that the bilateral hearing loss was diagnosed in June 2021, more than 30 years following his discharge from service. The Veteran himself has not asserted hearing loss manifested or was diagnosed within the first post-service year. Therefore, the presumptive provisions based on chronic symptoms in service and continuous symptoms since service do not apply. Walker v. Shinseki, 708 F.3d 1331, 1338-39 (Fed. Cir. 2013); 38 C.F.R. § 3.309(a).

The Board finds the June 2021 VA examiner's opinion adequate for appellate review and highly probative. There is no evidence that the examiner is not competent or credible, and the opinion is based on a full review of the evidence of record, as well as an in-person examination of the Veteran. The examiner reviewed the pertinent evidence and provided a fully articulated opinion supported by the evidence of record. For these reasons, the Board affords the opinion significant probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-05 (2008). 

On the other hand, the Board finds the private February 2025 opinion is of limited value. The examiner opined the Veteran's hearing loss resulted from service, but provided no explanation other than citing the Veteran's conceded exposure to hazardous noise levels in service and reported continuation of hearing loss since service. The examiner did not address the Veteran's denials of experiencing hearing loss in May and June 1975 or indication of normal hearing in March 2011. In other words, the examiner's opinion was conclusory and unaccompanied by a sufficient explanation of rationale. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (holding that to have probative value, a medical examination must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two); see also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions").

The Board has considered the Veteran's general assertion that his bilateral hearing loss is related to service. However, because he is a layperson, he is not competent to opine on the etiology of bilateral hearing loss, which is a medically complex question. See Jandreau v. Nicholson, 492 F. 3d 1372, 1377 (2007). To the extent the Veteran has reported he has experienced hearing loss since service, the Board finds such assertions lack credibility. Significantly, he denied experiencing hearing loss in May and June 1975 and was noted to have normal hearing in March 2011.

Based on the June 2021 VA examiner's probative opinion and the absence of competent evidence linking the Veteran's current hearing loss to service, the Board finds that the evidence of record persuasively weighs against finding the Veteran's bilateral hearing loss had its onset during active service, manifested in the first post-service year, or is otherwise etiologically related to his service. Accordingly, the criteria for service connection for bilateral hearing loss have not been met, and the appeal is denied.

2. Entitlement to service connection for tinnitus.

The Veteran asserts he has tinnitus resulting from exposure to hazardous noise levels during military service.

The June 2021 rating decision favorably found the Veteran has tinnitus and that a qualifying event, injury, or disease had its onset during the Veteran's service.

These favorable findings are binding on the Board unless rebutted by evidence that identifies a clear and unmistakable error. After reviewing the evidence, the Board finds the favorable findings have not been rebutted.

Therefore, the remaining question before the Board is whether the tinnitus is etiologically related to the Veteran's service.

As will be explained below, the Board finds evidence of record persuasively weighs against finding the Veteran's tinnitus had
2. Entitlement to service connection for tinnitus.

The Veteran asserts he has tinnitus resulting from exposure to hazardous noise levels during military service.

The June 2021 rating decision favorably found the Veteran has tinnitus and that a qualifying event, injury, or disease had its onset during the Veteran's service.

These favorable findings are binding on the Board unless rebutted by evidence that identifies a clear and unmistakable error. After reviewing the evidence, the Board finds the favorable findings have not been rebutted.

Therefore, the remaining question before the Board is whether the tinnitus is etiologically related to the Veteran's service.

As will be explained below, the Board finds evidence of record persuasively weighs against finding the Veteran's tinnitus had its onset during active service, manifested in the first post-service year, or is otherwise etiologically related to his service.

The Veteran's service treatment records are silent for complaints, treatment, or diagnoses related to tinnitus. He denied having ear trouble and hearing loss in May 1975. His ears were clinically evaluated as normal on May 1975 separation examination. 

The Veteran filed his first claim of service connection for tinnitus in May 2015.

The Veteran was provided a VA hearing loss examination in June 2021. The examiner diagnosed tinnitus and opined it was less likely than not caused by military noise exposure. She explained his service treatment records were silent for tinnitus and the May 1975 separation audiogram revealed normal hearing bilaterally.  

In February 2025, the Veteran submitted a February 2025 non-VA medical opinion. The physician opined the Veteran's tinnitus was as likely as not related to service based on the "documented service-connected loud noise exposure with reported onset of tinnitus and hearing loss with continuation." He noted the Veteran filed a claim for service connection for tinnitus in May 2015. 

Initially, the Board finds the Veteran is not entitled to service connection for tinnitus on a presumptive basis. There is no evidence the tinnitus manifested in the first post-service year. The Veteran denied having ear trouble in May 1975, and his ears were clinically evaluated as normal on May 1975 separation examination. In addition, the Veteran's hearing was noted to be normal in March 2011, and the tinnitus was diagnosed in June 2021, more than 30 years following his discharge from service. The Veteran himself has not asserted tinnitus manifested or was diagnosed within the first post-service year. Therefore, the presumptive provisions based on chronic symptoms in service and continuous symptoms since service do not apply. Walker v. Shinseki, 708 F.3d 1331, 1338-39 (Fed. Cir. 2013); 38 C.F.R. § 3.309(a).

The Board finds the June 2021 VA examiner's opinion adequate for appellate review and highly probative. There is no evidence that the examiner is not competent or credible, and the opinion is based on a full review of the evidence of record, as well as an in-person examination of the Veteran. The examiner reviewed the pertinent evidence and provided a fully articulated opinion supported by the evidence of record. For these reasons, the Board affords the opinion significant probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-05 (2008). 

On the other hand, the Board finds the private February 2025 opinion is of limited value. The examiner opined the Veteran's tinnitus resulted from service, but provided no explanation other than citing the Veteran's conceded exposure to hazardous noise levels in service and reported continuation of tinnitus since service. The examiner did not address the Veteran's denial of ear trouble in May 1975, lack of abnormalities on May 1975 separation examination, or indication of normal hearing in March 2011. In other words, the examiner's opinion was conclusory and unaccompanied by a sufficient explanation of rationale. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (holding that to have probative value, a medical examination must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two); see also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions").

The Board has considered the Veteran's general assertion that his tinnitus is related to service. However, because he is a layperson, he is not competent to opine on the etiology of tinnitus, which is a medically complex question. See Jandreau v. Nicholson, 492 F. 3d 1372, 1377 (2007
 have probative value, a medical examination must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two); see also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions").

The Board has considered the Veteran's general assertion that his tinnitus is related to service. However, because he is a layperson, he is not competent to opine on the etiology of tinnitus, which is a medically complex question. See Jandreau v. Nicholson, 492 F. 3d 1372, 1377 (2007). To the extent the Veteran has reported he has experienced tinnitus since service, the Board finds such assertions lack credibility. Significantly, he denied experiencing ear trouble in May 1975 and was noted to have normal hearing in March 2011.

Based on the June 2021 VA examiner's probative opinion and the absence of competent evidence linking the Veteran's current tinnitus to service, the Board finds that the evidence of record persuasively weighs against finding the Veteran's tinnitus had its onset during active service, manifested in the first post-service year, or is otherwise etiologically related to his service. Accordingly, the criteria for service connection for tinnitus have not been met, and the appeal is denied.

REASONS FOR REMAND

3. Entitlement to service connection for a low back disability.

The Veteran is seeking service connection for a low back disability that he asserts manifested during active service.

The Board sincerely regrets the additional delay in adjudication, but finds a remand is necessary to obtain a VA addendum opinion regarding the etiology of the Veteran's claimed low back disability and obtain outstanding non-VA treatment records.  

Under the AMA, the Board must remand a claim to correct an error by the AOJ to satisfy its duty to assist the Veteran under 38 U.S.C. § 5103A if the error occurred prior to the AOJ decision on appeal. 38 U.S.C. § 5103A(f)(2)(A); 38 C.F.R. § 20.802(a).

The Veteran was provided a VA back examination in June 2021. The examiner diagnosed lumbosacral strain and opined it was less likely than not related to service, explaining in part that the Veteran did not make any recorded complaints of back pain during service, including in 1975. However, the examiner failed to address a June 1975 service treatment record that notes the Veteran complained of back pain. 

Accordingly, the Board finds the VA examiner's June 2021 opinion is inadequate. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (finding a medical opinion based on an inaccurate factual premise has no probative value).

 

Therefore, the Board finds the AOJ erred in not ensuring an adequate pre-decisional opinion was provided and must remand the matter of service connection for a low back disability to obtain a VA addendum opinion. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate); see 38 C.F.R. § 20.802.

In addition, in a July 2005 claim for service connection, the Veteran reported he sought treatment for back pain at Mount Sinai Hospital after a 2005 car accident. However, it does not appear such non-VA treatment records have been sought. A remand is therefore necessary to attempt to obtain these records.

The matter is REMANDED for the following action:

1. After obtaining any necessary authorization from the Veteran, obtain any outstanding non-VA treatment records regarding treatment for the claimed low back disability in 2005, including from Mount Sinai Hospital.

2. Obtain an addendum opinion from an appropriate clinician regarding the etiology of the Veteran's low back disability.

Following consideration of the evidence of record (both lay and medical), the examiner is asked to address the following:

(a) Identify (by medical diagnosis) each low back disability found.

(b) As to any (and each) low back disability diagnosed, is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that such disability is related to the Veteran's military service, to include his documented June 1975 complaint of back pain.

The examiner must explain the rationale for all opinions. 

 

William Skowronski

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Fields, Ashley N.

The Board's decision in this case is binding only with respect