TINNITUS

R. JANOFSKY · 2026 · Case ID: A26036038

MIXED

Summary

The veteran, who served from April 2003 to April 2007, appeals the denial of an increased rating for PTSD and the denial of service connection for tinnitus. The Board granted service connection for tinnitus, finding the evidence in approximate balance and affording the veteran the benefit of the doubt. The decision noted the veteran's contemporaneous complaints of tinnitus during service and continuity of symptoms thereafter, despite a negative VA audiological exam finding no history of recurrent tinnitus. A negative VA nexus opinion for tinnitus was given no weight due to factual inaccuracies. However, the Board denied an increased rating for PTSD beyond the existing 30 percent. While acknowledging symptoms like anxiety, depression, nightmares, and difficulty with social/work relationships, the Board found they did not rise to the level required for a 50 or 70 percent rating. The Board gave significant weight to the VA examiner's findings that the veteran generally functioned satisfactorily, maintained positive social relationships, and successfully ran his own business, despite reported memory issues and some social difficulties. The case was remanded for adjudication of an inferred TDIU claim, as the veteran asserted he had not held long-term employment and worked in a protected environment.

Rationale

Contemporaneous service treatment records noted tinnitus symptoms.; Continuity of symptomatology since service.; Negative VA nexus opinion afforded no weight due to factual inaccuracies.

Special Benefit

TDIU

Docket No.

250407-531185

Full Decision Text

Citation Nr: A26036038
Decision Date: 04/17/26 Archive Date: 04/17/26

DOCKET NO. 250407-531185
DATE: April 17, 2026

ORDER

Entitlement to service connection for tinnitus is granted, subject to the laws and regulations governing the award of monetary benefits.

Entitlement to a disability rating in excess of 30 percent for posttraumatic stress disorder (PTSD) is denied.

REMANDED

Entitlement to a total disability rating based on individual unemployability (TDIU) due to service connected disabilities is remanded.

FINDINGS OF FACT

1. The evidence is at least in approximate balance that the Veteran's current tinnitus disability was incurred in and is etiologically related to active service based on continuity of symptomatology.

2. During the appeal period, the Veteran's service-connected PTSD manifested as no worse than occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks (although he was generally functioning satisfactorily, with normal routine, behavior, self-care, and conversation), due to symptoms such as: recurrent, involuntary, and intrusive thoughts of traumatic events; avoidance of or efforts to avoid external reminders of traumatic events; feelings of detachment or estrangement from others; irritable behavior and angry outbursts; hypervigilance; distrust of others; depressed mood; anxiety; and chronic sleep impairment (including nightmares).

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for entitlement to a disability rating in excess of 30 percent for PTSD have not been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.6, 4.7, 4.125, 4.126, 4.130, Diagnostic Code (DC) 9411.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

Preliminary Matters

The Veteran served on active duty from April 2003 to April 2007.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from March 2025 rating decisions issued by a U.S. Department of Veterans Affairs (VA) Regional Office (RO), which is the agency of original jurisdiction (AOJ).

In April 2025, the Veteran timely appealed those rating decisions to the Board of Veterans' Appeals (Board) by filing a VA Form 10182 (Notice of Disagreement), in which he elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the March 2025 AOJ decisions on appeal. 38 C.F.R. § 20.301.

Regarding the decided issues, 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. Regarding the remanded issue, any evidence the Board could not consider will be considered by the AOJ in the adjudication of that claim. 38 C.F.R. § 3.103(c)(2)(ii).

The Board finds that the Veteran implicitly raised the issue of entitlement to a TDIU as part and parcel of the increased rating claim for PTSD that is currently on appeal before the Board. Specifically, in a January 2025 VA Form 21-526EZ, regarding the increased rating claim for PTSD, the Veteran asserted that he has not held a long-term job and worked in a protected environment. Therefore, the inferred issue of entitlement to a TDIU is on appeal before the Board. See Rice v. Shinseki, 22 Vet. App. 447 (2009).

The Board has thoroughly reviewed all evidence in the claims file. Consistent with the law, the analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claim, and the Board's reasons for rejecting evidence favorable to the appellant. See Timberlake v. Gober, 14 Vet. App. 122 (2000). The
increased rating claim for PTSD, the Veteran asserted that he has not held a long-term job and worked in a protected environment. Therefore, the inferred issue of entitlement to a TDIU is on appeal before the Board. See Rice v. Shinseki, 22 Vet. App. 447 (2009).

The Board has thoroughly reviewed all evidence in the claims file. Consistent with the law, the analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claim, and the Board's reasons for rejecting evidence favorable to the appellant. See Timberlake v. Gober, 14 Vet. App. 122 (2000). The appellant must not assume the Board has overlooked evidence not explicitly discussed in this decision.

1. Entitlement to service connection for tinnitus is granted.

The Veteran claims entitlement to service connection for tinnitus. He contends that he has a current tinnitus disability that is etiologically related to acoustic trauma from noise exposure during active service. He also contends that he has experienced tinnitus symptoms since active service.

Initially, in the March 2025 rating decision on appeal, the AOJ found that new and relevant evidence had been received to readjudicate this previously denied claim. The Board is bound by this prior favorable finding (which was not clearly and unmistakably erroneous). See 38 C.F.R. § 3.104(c). The Board has phrased this appellate issue accordingly.

Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a disability during the pendency of the appeal; (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009).

Service connection may be granted on a presumptive basis for diseases listed in 38 C.F.R. § 3.309 under the following circumstances: (1) where a chronic disease or injury is shown in service and subsequent manifestations of the same disease or injury are shown at a later date unless clearly attributable to an intercurrent cause; or (2) where there is continuity of symptomatology since service; or (3) by showing that the disorder manifested itself to a degree of 10 percent or more within one year from the date of separation from service. See 38 C.F.R. § 3.307.

Tinnitus is considered an other organic disease of the nervous system for purposes of application of the "chronic disease" presumptive provisions. See 38 C.F.R. § 3.309(a). Therefore, the presumptive provisions of 38 C.F.R. §§ 3.303(b), 3.307, and 3.309 apply. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); Fountain v. McDonald, 27 Vet. App. 258 (2015).

In this case, in the March 2025 rating decision, the AOJ found that the Veteran has a currently diagnosed tinnitus disability. The AOJ also found that the Veteran's military occupational specialty (MOS) duties in the fields of engineering, construction, facilities, and equipment had a high probability for hazardous noise exposure. The Board is bound by these prior favorable findings (which were not clearly and unmistakably erroneous). See 38 C.F.R. § 3.104(c). Therefore, this appeal primarily hinges on whether the Veteran's current tinnitus disability is etiologically related to active service, to include his acknowledged, in-service hazardous noise exposure.

Service treatment records include a February 2007 separation report of medical history. The Veteran endorsed ear, nose, and throat trouble, and specifically reported ringing in his ears at night and sometimes during the day. In a February 2007 separation report of medical assessment, the Veteran indicated that he intended to file a VA disability claim for tinnitus.

In July 2007, just a few months after service separation, the Veteran filed an original service connection claim for tinnitus. A July 2007 VA primary care note also shows the Veteran's report of tinnitus.

In September 2007, the Veteran was afforded a VA general medical examination and a VA audiological examination. The former noted the Veteran's endorsement of tinnitus; however, the latter noted no history of recurrent tinnitus.

In February 2025, the Veteran was afforded
trouble, and specifically reported ringing in his ears at night and sometimes during the day. In a February 2007 separation report of medical assessment, the Veteran indicated that he intended to file a VA disability claim for tinnitus.

In February 2025, the Veteran was afforded another VA audiological examination. The Veteran reported that his current tinnitus symptoms had been present since 2005 and progressed through the present ("stayed the same"). The Veteran described his tinnitus as intermittent.

The Board finds that the lay evidence of tinnitus symptoms during and continuing since active service both competent and credible. Notably, he contemporaneously reported tinnitus symptoms during active service and has continued to do so since soon thereafter, including during medical care. His lay statements on this point have been generally consistent. Thus, the Board assigns his lay statements high probative weight.

A March 2025 VA medical opinion found that the Veteran's tinnitus was less likely than not related to military service. However, this opinion was based in part on the inaccurate factual premise that there was no complaint of tinnitus in service treatment records or at separation. Therefore, the Board affords this negative VA nexus opinion no probative weight.

In summary, the evidence is at least in approximate balance that the Veteran's current tinnitus disability was incurred in and is etiologically related to active service based on competent, credible, and persuasive evidence of continuity of symptomatology since service. 38 C.F.R. § 3.303(b). Affording the Veteran the benefit of the doubt, entitlement to service connection for tinnitus is granted.

2. Entitlement to a disability rating in excess of 30 percent for PTSD is denied.

The Veteran has a 30 percent disability rating for PTSD throughout the appeal period. 38 C.F.R. § 4.130, DC 9411. He claims entitlement to an increased rating of 70 percent. See April 2025 Notice of Disagreement.

Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Generally, the degrees of disability specified are considered adequate to compensate for considerable loss of working time from exacerbations or illnesses proportionate to the severity of the several grades of disability. 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4.

The Veteran's service-connected PTSD is evaluated under a General Rating Formula for Mental Disorders. 38 C.F.R. § 4.130, DC 9411. A 50 percent rating is warranted for occupational and social impairment with reduced reliability and productivity due to such symptoms as: flattened affect, circumstantial, circumlocutory, or stereotyped speech; panic attacks occurring more than once a week, difficulty in understanding complex commands, impaired judgment, impaired abstract thinking, disturbances of motivation and mood, difficulty in establishing and maintaining effective social and work relationships, or impaired short- and long-term memory, to include retention of only highly learned material and forgetting to complete tasks. Id.

A higher, 70 percent rating is warranted for occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. Id.

The symptoms listed under the rating criteria are meant to be examples of symptoms that would warrant the rating, but they are not meant to be exhaustive, and the Board need not find all or even some of the symptoms to award a specific rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002).

However, "the presence or lack of evidence of a specific sign or symptom listed in the evaluation criteria is not necessarily dispositive of any particular disability level." Bankhead v. Shulkin, 29 Vet. App. 10,
of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a worklike setting); inability to establish and maintain effective relationships. Id.

However, "the presence or lack of evidence of a specific sign or symptom listed in the evaluation criteria is not necessarily dispositive of any particular disability level." Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017). Rather, the Board must engage in a holistic analysis in which it assesses the severity, frequency, and duration of the signs and symptoms, quantify the level of occupational and social impairment caused by those signs and symptoms, and assign an evaluation that most nearly approximates that level of occupational and social impairment. Id.

In this case, in a January 2025 VA Form 21-526EZ, the Veteran reported PTSD symptoms including hypervigilance, being easily angered, and feeling anxious and depressed.

The Veteran had a February 2025 VA PTSD examination. The February 2025 VA PTSD examiner found that the Veteran's PTSD symptoms caused occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although the Veteran was generally functioning satisfactorily, with normal routine behavior, self-care, and conversation.

The February 2025 VA PTSD examiner noted symptoms including depressed mood, anxiety, chronic sleep impairment, and difficulty in establishing and maintaining effective work and social relationships. Furthermore, the Veteran reported nightmares and intrusive thoughts of combat. He would attempt to avoid talking about combat or reminders. He also reported distrust of others, sleep disruption, irritability, and hypervigilance, with periodic anxiety and depressed mood. He denied suicidal ideation.

On examination, the February 2025 VA PTSD examiner observed that the Veteran was well-groomed, spoke freely, and was talkative. He was oriented to person, place, time, and purpose. The Veteran was able to answer all questions appropriately, remember remote events, and track the conversation. Thoughts were logical and goal directed, without signs of hallucinations or delusions. Affect was normal and mood was happy. Attention and memory were grossly intact. The Veteran was also found competent to manage his own financial affairs.

Regarding the Veteran's social history, the February 2025 VA PTSD examiner noted that the Veteran had been married for eleven years and had two children. The Veteran reported being an active parent and attending his children's school functions. He described his marriage as generally going well and stated that he and his wife got along. He also reported having a few close friends, although he reported avoiding close relationships generally.

Regarding the Veteran's occupational history, the February 2025 VA PTSD examiner noted that the Veteran had run his own business for the past four years and indicated no trouble doing required occupational tasks. The Veteran also worked for his father-in-law one week per month. Previously, the Veteran had worked at a factory and reported difficulty working around others at that unspecified time.

The Veteran also had a February 2025 VA traumatic brain injury (TBI) examination. The examiner noted an anxious affect. The Veteran reported forgetting musician names and recent conversations, distraction, and short- and long- term memory difficulty. Following testing, the February 2025 VA TBI examiner found no impairments in memory, attention, or concentration. The Veteran was capable of executive functions, had normal judgment, and his social interaction was routinely appropriate. Abstraction was intact. The Veteran was able to complete a three-step command.

After a full review of the evidence of record summarized above, the Board finds that the evidence does not warrant a disability rating greater than 30 percent for the Veteran's service-connected PTSD. The weight of the evidence shows that his PTSD symptoms were not severe enough (in terms of their nature, frequency, and/or duration) to result in or more nearly approximate occupational and social impairment with reduced reliability and productivity, as required for a higher, 50 percent rating.

The Board affords great probative weight to the February 2025 VA PTSD examiner's finding that the Veteran's service-connected PTSD resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although the Veteran was generally functioning satisfactorily, with normal routine behavior, self-care and conversation. The Board also affords great probative weight to the February 2025 VA PTSD examiner's finding that the Veteran described "mild to moderate" PTSD symptoms. These findings are generally consistent with and supported by lay and medical evidence
frequency, and/or duration) to result in or more nearly approximate occupational and social impairment with reduced reliability and productivity, as required for a higher, 50 percent rating.

The Board affords great probative weight to the February 2025 VA PTSD examiner's finding that the Veteran's service-connected PTSD resulted in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational tasks, although the Veteran was generally functioning satisfactorily, with normal routine behavior, self-care and conversation. The Board also affords great probative weight to the February 2025 VA PTSD examiner's finding that the Veteran described "mild to moderate" PTSD symptoms. These findings are generally consistent with and supported by lay and medical evidence noted elsewhere in this VA examination report, which thoroughly documented the Veteran's pertinent social, occupational, and mental health history, as well as detailed in-person examination findings.

The Board notes that the February 2025 VA PTSD examiner found that the Veteran's PTSD symptoms included difficulty in establishing and maintaining effective work and social relationships, a symptom listed in the 50 percent rating criteria. However, the weight of the evidence shows that this symptom (considered alone or in combination with other symptoms) was not severe enough in terms of its nature, frequency, and/or duration to result in or more nearly approximate occupational and social impairment with reduced reliability and productivity. To the contrary, despite this symptom, the Veteran maintained positive social relationships with his spouse, children, father-in-law, and a few close friends. He described himself as an active parent who attends his children's school functions and described his marriage as generally going well. He also was able to work by running his own business, which he had done for four years.

The February 2025 VA TBI examiner noted the Veteran's report of memory issues, which the neurology examiner found was most likely due to PTSD, insomnia, and alcohol abuse. Specifically, the Veteran complained of a several-year history of short- and long-term memory difficulty, which the Veteran described as forgetting names, who performed songs he likes, and recent conversations. However, on examination, the February 2025 VA TBI examiner found that the Veteran's long-term memory was intact. Similarly, the February 2025 VA PTSD examiner found that on examination, the Veteran's memory was grossly intact. Thus, the weight of the most probative evidence does not show that the Veteran's service-connected PTSD manifested as or more nearly approximated impairment of short-and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks), as contemplated by the 50 percent rating criteria.

Also, even assuming for the sake of argument (without conceding) that the Veteran's reported memory issues more nearly approximated impairment of short-and long-term memory (e.g., retention of only highly learned material, forgetting to complete tasks), this symptom (considered either alone or with other symptoms) was not severe enough in terms of its nature, frequency, and/or duration to result in or more nearly approximate occupational and social impairment with reduced reliability and productivity. To the contrary, despite the Veteran's reported memory issues, the Veteran maintained positive social relationships with his spouse, children, father-in-law, and a few close friends. He described himself as an active parent who attends his children's school functions and described his marriage as generally going well. He also was able to work by running his own business, which he had done for four years.

Furthermore, the weight of the evidence shows that the Veteran's PTSD symptoms did not manifest as or more nearly approximate most of the symptoms contemplated by the 50 percent rating criteria (or symptoms of similar severity, frequency, and/or duration), including: flattened affect; circumstantial, circumlocutory, or stereotyped speech; panic attacks more than once a week; difficulty in understanding complex commands; impaired judgment; or impaired abstract thinking. See 38 C.F.R. § 4.130.

The Board considered the Veteran's contention that his service-connected PTSD warrants a higher, 70 percent disability rating. See April 2025 Notice of Disagreement. However, the weight of the evidence shows that the Veteran's service-connected PTSD symptoms did not result in or more nearly approximate occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, as required for a 70 percent rating. See 38 C.F.R. § 4.130. To the contrary, despite the Veteran's service-connected psychiatric symptoms and impairments, he maintained positive social relationships with his spouse, children, father-in-law, and a few close friends. The Veteran described himself as an active parent who attends his children's school functions and described his marriage as generally going well. He also was able to work by running his own business
. However, the weight of the evidence shows that the Veteran's service-connected PTSD symptoms did not result in or more nearly approximate occupational and social impairment with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, as required for a 70 percent rating. See 38 C.F.R. § 4.130. To the contrary, despite the Veteran's service-connected psychiatric symptoms and impairments, he maintained positive social relationships with his spouse, children, father-in-law, and a few close friends. The Veteran described himself as an active parent who attends his children's school functions and described his marriage as generally going well. He also was able to work by running his own business, which he had done for four years.

Moreover, the weight of the evidence shows that the Veteran's service-connected PTSD symptoms did not manifest as or more nearly approximate most of the symptoms contemplated by the 70 percent rating criteria (or symptoms of similar severity, frequency, and/or duration), including: obsessional rituals which interfere with routine activities; speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; or an inability to establish and maintain effective relationships. See 38 C.F.R. § 4.130.

In conclusion, entitlement to a disability rating in excess of 30 percent for PTSD is denied. Since the evidence is not at least in approximate balance, the benefit of the doubt rule does not apply.

REASONS FOR REMAND

Entitlement to a TDIU is remanded.

Remand of this issue is required for the AOJ to fulfill a statutory or regulatory duty and to correct a pre-decisional duty to assist error. See 38 C.F.R. § 20.802(a).

In the January 2025 VA Form 21-526EZ, regarding the Veteran's increased rating claim for PTSD, he reported that he had not lasted at a job long-term and that he is currently "working in a protected working environment." See Rice v. Shinseki, 22 Vet. App. 447 (2009). However, the AOJ failed to develop, adjudicate, or otherwise acknowledge this inferred, reasonably raised TDIU claim before issuing the March 2025 rating decision on appeal (regarding the increased rating claim for PTSD). Therefore, remand is required for the AOJ to take corrective action.

The matter is REMANDED for the following actions:

1. Send the Veteran and his representative a notice:

(a.) notifying them of the evidence needed to substantiate a TDIU claim;

(b.) asking the Veteran to submit a completed Application for Increased Compensation based on Unemployability (VA Form 21-8940); and

(c.) inviting the Veteran to submit any evidence he may have to substantiate the TDIU claim, including his protected or marginal employment theory, such as earnings records.

2. Then, process and adjudicate the TDIU claim.

R. JANOFSKY

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Stratton, C.

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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