TINNITUS

Summary

The veteran, who served in the Army from March 1989 to February 1992 as an equipment records and parts specialist, appeals the denial of service connection for bilateral hearing loss and the denial of a compensable rating for ingrown left great toe toenail residuals. The Board granted service connection for tinnitus, finding the evidence in equipoise and resolving doubt in the veteran's favor based on her testimony of experiencing tinnitus during service and a February 2021 VA audiological examination that diagnosed recurrent tinnitus. For bilateral hearing loss, the Board denied service connection, noting that the February 2021 VA audiological examination showed normal hearing thresholds and speech recognition, and the veteran's lay testimony was not competent to establish a diagnosis meeting VA criteria. The claim for ingrown left great toe toenail residuals was remanded for a new VA examination to determine the nature and severity of the residuals, as the prior examination was inadequate.

Rationale

Service treatment records do not refer to tinnitus.; Service personnel records reflect MOS as equipment records and parts specialist.; February 2021 VA audiological exam diagnosed recurrent tinnitus.; Veteran testified to experiencing tinnitus during active service.; Evidence in equipoise, doubt resolved in veteran's favor.

Full Decision Text

Citation Nr: A26036415
Decision Date: 04/20/26	Archive Date: 04/20/26

DOCKET NO. 210420-154498
DATE: April 20, 2026

ORDER

Entitlement to service connection for tinnitus is granted.  

Entitlement to service connection for bilateral hearing loss is denied.  

REMANDED

Entitlement to a compensable rating for ingrown left great toe toenail residuals is remanded.  

FINDINGS OF FACT

1. Tinnitus originated during active service.  

2. Bilateral hearing loss meeting the criteria of 38 C.F.R. § 3.385 was not shown during active service or at any time thereafter.  

CONCLUSIONS OF LAW

1. The criteria for service connection for tinnitus have been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for bilateral hearing loss have not been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.385.  

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from March 1989 to February 1992.  

The Veteran appeared at a February 2025 virtual hearing before the undersigned Veterans Law Judge.  The hearing transcript is of record.  

In September 2020, the Agency of Original Jurisdiction denied a compensable rating for ingrown left great toe toenail residuals.  In October 2020, the Veteran submitted a Decision Review Request: Higher-Level Review, VA Form 20-0996.  In March 2021, the Agency of Original Jurisdiction denied a compensable rating for ingrown left great toe toenail residuals.  In April 2021, the Agency of Original Jurisdiction denied service connection for both tinnitus and bilateral hearing loss.  In April 2021, the Veteran submitted a Decision Review Request: Board Appeal (Notice of Disagreement), VA Form 10182, and elected the Hearing docket.  Therefore, the Board of Veterans' Appeals (Board) may only consider the evidence of record at the time of the September 2020 Agency of Original Jurisdiction, that was subsequently subject to higher level review, and the April 2021 Agency of Original Jurisdiction decision, as well as any evidence submitted by the Veteran at the hearing or within 90 days following the hearing.  38 C.F.R. § 20.302(a).  If evidence was submitted during the period after the Agency of Original Jurisdiction issued the Agency of Original Jurisdiction decisions, the Board did not consider it in its decision.  38 C.F.R. §§ 20.300, 20.301, 20.801.  If the Veteran would like the Department of Veterans Affairs (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.  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.  38 C.F.R. § 3.2501.  Specific instructions for filing a Supplemental Claim are included with this decision.  However, as the Board is remanding the claim for a compensable rating for ingrown left great toe toenail residuals, any evidence the Board could not consider will be considered by the Agency of Original Jurisdiction in the adjudication of that claim.  38 C.F.R. § 3.103 (c)(2)(ii).  

Service Connection 

Service connection may be granted for recurrent disability arising from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a).  Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303(d).

Tinnitus

The Veteran asserts that service connection for tinnitus is warranted as the claimed disability was initially manifested during active service.  

The service treatment records do not refer to tinnitus or ringing of the ears.  The service personnel records reflect that the Veteran served as an equipment records and parts specialist.  

The report of a February 2021 audiological examination conducted for VA states that the Veteran reported experiencing ringing of the ears during active service.  She was diagnosed with recurrent tinnitus.  

At the February 2025 Board
 connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303(d).

Tinnitus

The Veteran asserts that service connection for tinnitus is warranted as the claimed disability was initially manifested during active service.  

The service treatment records do not refer to tinnitus or ringing of the ears.  The service personnel records reflect that the Veteran served as an equipment records and parts specialist.  

The report of a February 2021 audiological examination conducted for VA states that the Veteran reported experiencing ringing of the ears during active service.  She was diagnosed with recurrent tinnitus.  

At the February 2025 Board hearing, the Veteran testified that she has initially noticed tinnitus during active service and the tinnitus had persisted to the present time.  

The Board finds that the evidence is in at least equipoise as to whether the diagnosed tinnitus arose during active service.  She reported experiencing tinnitus during active service which has persisted to the present time.  The Veteran has been diagnosed with tinnitus.  The Veteran is competent to report ringing in her ears and having tinnitus since active service.  38 C.F.R. § 3.159 (a)(2); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Charles v. Principi, 16 Vet. App. 370 (2002).  Upon resolution of all reasonable doubt in the Veteran's favor, the Board concludes that service connection for tinnitus is warranted.   38 U.S.C. § 5107; 38 C.F.R. § 3.102.  

Bilateral Hearing Loss

The Veteran contends that service connection for hearing loss is warranted as the claimed disability was manifested as the result of her in-service noise exposure.

Service connection for impaired hearing shall be established when the thresholds for any of the frequencies of 500, 1000, 2000, 3000 and 4000 Hertz are 40 decibels or more; or the thresholds for at least three of these frequencies are 26 decibels; or speech recognition scores using the Maryland CNC Test are less than 94 percent.  38 C.F.R. § 3.385.  The provisions of 38 C.F.R. § 3.385 prohibit the award of service connection for hearing loss where audiometric test scores are within the established limits.  Hensley v. Brown, 5 Vet. App. 155, 158 (1993) citing Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992).

The service treatment records do not refer to hearing loss.  The service personnel records state that the Veteran served in the Army and her military occupational specialty was equipment records and parts specialist.  

The report of the February 2021 audiological examination states that the Veteran did "not report a noticeable problem with hearing."  On audiological evaluation, the Veteran exhibited pure tone thresholds, in decibels, as follows:  

	HERTZ

 	500	1000	2000	3000	4000	Avg

RIGHT	10	5	10	10	10	9

LEFT	15	0	5	5	5	4

Speech audiometry revealed bilateral speech recognition ability of 96 percent.  The examiner stated that the Veteran had normal bilateral hearing acuity.  

At the February 2025 Board hearing, the Veteran testified that she had experienced difficulty hearing during active service.  

Bilateral hearing loss meeting the criteria set forth in 38 C.F.R. § 3.385 was not shown during active service or at any time thereafter.  In the absence of such disability, service connection for bilateral hearing loss may not be established.  The Veteran's claim for service connection for bilateral hearing loss is supported solely by her own statements.  Lay assertions may serve to support a claim for service connection by establishing the occurrence of observable events or the presence of disability or symptoms of disability subject to lay observation.  38 U.S.C. § 1154(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006).  Lay evidence can be competent and sufficient to establish a diagnosis or etiology when (1) a lay person is competent to identify a medical condition; (2) the lay person is reporting a contemporaneous medical diagnosis; or (3) lay testimony at the time supports a later diagnosis by a medical professional.  Davidson v. Shinseki, 581 F
 lay observation.  38 U.S.C. § 1154(a); 38 C.F.R. § 3.303(a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006).  Lay evidence can be competent and sufficient to establish a diagnosis or etiology when (1) a lay person is competent to identify a medical condition; (2) the lay person is reporting a contemporaneous medical diagnosis; or (3) lay testimony at the time supports a later diagnosis by a medical professional.  Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).  The Board finds that the lay statements of the Veteran do not constitute competent evidence to establish a diagnosis of bilateral hearing loss which meets the criteria set forth in 38 C.F.R. § 3.385.  The Veteran has not offered any audiological or medical qualifications.  She is not competent to diagnose bilateral hearing loss meeting the criteria set forth in 38 C.F.R. § 3.385.  While she is competent to report impaired hearing acuity, she is not competent to assess hearing loss for VA purposes.  Palczewski v. Nicholson, 21 Vet. App. 174, 178-80 (2007).  The question of such a diagnosis requires audiological and/or medical training and testing.  It is too complex to be addressed by a layperson.

Bilateral hearing loss disability meeting the criteria of 38 C.F.R. § 3.385 was not shown during active service or at any time thereafter.  Therefore, the Board concludes that service connection for bilateral hearing loss is not warranted.  38 C.F.R. § 3.385.  

REASONS FOR REMAND

Entitlement to a compensable rating for ingrown left great toe toenail residuals is remanded.  

Unfortunately, a demand is required in this case.  Although the Board acknowledges and regrets the additional delay to the Veteran, it is necessary to ensure that there is a complete record upon which to decide the claim. 

VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive.  McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121, 124 (1991).  When VA undertakes to obtain an evaluation, it must ensure that the evaluation is adequate.  Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).  

At the February 2025 Board hearing, the Veteran testified that the left great toe pain affected her ability to wear socks and sleep.  She reported taking ibuprofen or Tylenol for the pain.  She reported extreme pain when she bumped her toe.  

The report of an August 2020 foot examination conducted for VA states that the Veteran complained of experiencing intermittent left foot pain while wearing closed toe footwear.  On examination of the left foot, the Veteran exhibited pain on movement, weight-bearing, and plantar flexion.  The examiner commented that the left great toe pain limited her ability to walk for prolonged periods.  The physician assistant made no specific findings as to the presence or absence of any left great toe abnormalities including painful scarring or nerve involvement.  Further VA left great toe evaluation is needed.  That is a pre decisional error.  

The matters are REMANDED for the following action:

Schedule the Veteran for a VA left great toe examination conducted by a medical doctor or a podiatrist to assist in determining the nature and severity of the service connected ingrown left great toe toenail residuals.  The examiner must review the record and should note that review in the report. A rationale for all opinions should be provided. 

 

 

J. T. HUTCHESON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Smith, 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.