LEFT WRIST CONDITION

DONNIE R. HACHEY · 2026 · Case ID: A26036029

MIXED

Summary

The Veteran served on active duty from August 2018 to December 2022. He appeals a rating decision denying service connection for bilateral hearing loss and remanding claims for a back condition, right knee condition, left ankle condition, and left wrist condition. The Board denied service connection for bilateral hearing loss, finding that the Veteran's pure tone thresholds and speech discrimination scores from a February 2025 VA examination did not meet the criteria for a hearing loss disability for VA purposes. No other evidence of hearing loss was present. For the remanded conditions, the Board found the VA examiner's opinions inadequate. The examiner's opinions for the back and right knee conditions failed to consider the Veteran's lay statements and, for the back condition, failed to address a specific service treatment record entry. The Board remanded these issues for new medical opinions addressing the nature, etiology, and service connection of the back and right knee conditions, specifically asking if they were at least as likely as not incurred in or related to service. For the left ankle and left wrist conditions, the Board found the Veteran's lay statements sufficient to establish a need for VA examinations, as the AOJ had not scheduled them. These issues were remanded for new examinations to determine the nature, etiology, and service connection, with the examiner to opine if the conditions were at least as likely as not incurred in or related to service.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250409-534170

Full Decision Text

Citation Nr: A26036029
Decision Date: 04/17/26 Archive Date: 04/17/26

DOCKET NO. 250409-534170
DATE: April 17, 2026

ORDER

Entitlement to service connection for bilateral hearing loss is denied.

REMANDED

Entitlement to service connection for a back condition is remanded.

Entitlement to service connection for a right knee condition is remanded.

Entitlement to service connection for left ankle condition is remanded.

Entitlement to service connection for left wrist condition is remanded.

FINDING OF FACT

The Veteran does not have a bilateral hearing loss disability for VA purposes.

CONCLUSION OF LAW

The criteria to establish service connection for bilateral hearing loss have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.308, 3.385.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from August 2018 to December 2022. He appeals an April 2025 rating decision by the Agency of Original Jurisdiction (AOJ).

The Veteran requested that his appeal be placed on the direct review docket. See April 2025 VA Form 10182. Under the direct review docket, the Board is only authorized to review the evidence of record at the time of the AOJ's April 2025 rating decision. 38 C.F.R. § 20.301.

In the rating decision on appeal, the AOJ also deferred a decision on entitlement to service connection for generalized anxiety disorder. See April 2025 rating decision. The Veteran sought to appeal this decision as well. See April 2025 VA Form 10182. However, this deferral is not an appealable decision as it did not decide any question of law or fact. Accordingly, the issue is not properly before the Board.

Entitlement to service connection for bilateral hearing loss

The Veteran seeks service connection for bilateral hearing loss. To establish service connection, a claimant must show (1) the existence of a present disability, (2) an in-service incurrence or aggravation of an injury or disease, and (3) a causal relationship or "nexus" between the present disability and the in-service injury or disease. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

For VA purposes, a hearing loss disability exists when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels of greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385.

In a February 2025 VA examination, the Veteran exhibited the following pure tone thresholds:

HERTZ

500 1000 2000 3000 4000

RIGHT 15 15 20 25 15

LEFT 10 20 20 15 20

He was given a speech discrimination test using the Maryland CNC word list and received a score of 100 percent in the right ear and 94 percent in the left ear. See February 2025 VA examination. These results do not establish that the Veteran has a hearing loss disability for VA purposes. The record contains no other evidence indicating the existence of a hearing loss disability for VA purposes. Accordingly, service connection for bilateral hearing loss is not warranted.

REASONS FOR REMAND

1. Entitlement to service connection for a back condition and a right knee condition

The Veteran next seeks service connection for a back condition and a right knee condition. He has been diagnosed with a lumbosacral strain and a right knee strain. See March 2025 VA examinations. Thus, the question is whether these conditions are related to his service.

The Veteran states that he has experienced back issues and right knee pain and popping since service. He attributes these conditions to physical activity such as ruck marches. See September 2024 VA Form 21-526EZ. He contends that both conditions began in approximately 2022. See March 2025 VA examinations. The Veteran's service treatment records also show that he reported low back pain in September 2020.

The Veteran was given VA examinations in March
condition and a right knee condition. He has been diagnosed with a lumbosacral strain and a right knee strain. See March 2025 VA examinations. Thus, the question is whether these conditions are related to his service.

The Veteran was given VA examinations in March 2025. The examiner concluded that both conditions were less likely than not related to the Veteran's service. See March 2025 VA examinations. The examiner stated that these conclusions were based on a review of the Veteran's service treatment records. Id. The examiner did not address the Veteran's lay statements, nor did he note the Veteran's in-service report of back pain. Id.

The Board finds these opinions inadequate. The Board notes that the Veteran is competent to report his symptoms, and that competent lay evidence must be considered when a veteran seeks service connection. See Buchanan v. Nicholson, 451 F.3d 1331, 1335 (Fed. Cir. 2006); McKinney v. McDonald, 28 Vet. App. 15, 30-31 (2016) (the examiner must consider the Veteran's lay reports of symptoms). The examiner's opinions are based solely on the Veteran's service treatment records and make no mention of his lay statements. The opinion concerning the Veteran's back condition also fails to address a service treatment record concerning low back pain. Accordingly, remand is necessary for new medical opinions.

2. Entitlement to service connection for a left ankle condition and a left wrist condition

The Veteran also seeks service connection for a left ankle condition and a left wrist condition. The AOJ did not schedule the Veteran for VA examinations concerning these conditions.

VA must provide a medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (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) insufficient competent medical evidence exists to decide the claim. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006).

The Veteran reports that he has a left ankle sprain and bursitis in his left wrist which he attributes to physical activity in service. See February 2025 VA Form 21-526EZ. While the Veteran is not competent to diagnose a strain or bursitis, the Board understands his statements to mean that he experiences pain in his left ankle and wrist, which he is competent to report. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). The Board finds the Veteran's statements sufficient to meet the low threshold for obtaining a VA examination. See McLendon, 20 Vet. App. at 81. Remand is therefore necessary. See 38 C.F.R. § 20.802.

The matters are REMANDED for the following action:

1. Obtain an opinion from an appropriately qualified reviewing clinician to determine the nature and etiology of the Veteran's back condition. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the clinician. The opinion must include a notation that this record review took place. It is up to the discretion of the reviewing clinician as to whether a new examination is necessary to provide an adequate opinion.

After review, the clinician is to answer the following medical question:

Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's back condition was incurred in, or is otherwise related to, his active service?

2. Obtain an opinion from an appropriately qualified reviewing clinician to determine the nature and etiology of the Veteran's right knee condition. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the clinician. The opinion must include a notation that this record review took place. It is up to the discretion of the reviewing clinician as to whether a new examination is necessary to provide an adequate opinion.

After review, the clinician is
answer the following medical question:

After review, the clinician is to answer the following medical question:

Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's right knee condition was incurred in, or is otherwise related to, his active service?

3. Schedule the Veteran for an examination to determine the nature and etiology of his left ankle condition. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. The examination report must include a notation that this record review took place.

After review, the examiner is to answer the following medical question:

Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's left ankle condition was incurred in, or is otherwise related to, his active service?

4. Schedule the Veteran for an examination to determine the nature and etiology of his left wrist condition. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. The examination report must include a notation that this record review took place.

After review, the examiner is to answer the following medical question:

Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's left wrist condition was incurred in, or is otherwise related to, his active service?

The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the reviewing clinician must provide a complete explanation for why an opinion cannot be rendered. In doing so, the clinician must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to the question.

DONNIE R. HACHEY

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Moore, Thomas J.

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.

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