Back to BVA DecisionsMIXEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 201105-119690
HEARING LOSS
M. SORISIO · 2026 · Case ID: A26036735
Summary
The veteran, who served from August 1990 to November 1994, appeals a November 2020 rating decision. The veteran sought service connection for bilateral hearing loss, a sinus condition, and an earlier effective date for tinnitus. The Board granted service connection for bilateral hearing loss, noting a favorable finding from a prior AOJ decision that was not mooted by the pending appeal. Service connection for a sinus condition was denied because the evidence did not establish a current diagnosis or functional impairment, despite a favorable finding of in-service treatment and a private medical opinion. The Board found the private opinion inadequate as it lacked current medical records, examination, or interview details. The claim for an earlier effective date for tinnitus was denied because the February 2018 denial became final due to no appeal or new and material evidence within a year, and the subsequent September 2020 supplemental claim established the earliest possible effective date. Service connection for a left hip condition was remanded for a new VA examination to determine if symptoms cause functional impairment and to provide a nexus opinion, considering the favorable in-service finding of left hip strain and the inadequacy of prior evidence.
Rationale
AOJ granted service connection for bilateral hearing loss in November 2023.; Board is bound by favorable AOJ findings.; Claim not moot as Board appeal was pending prior to AOJ decision.
Full Decision Text
Citation Nr: A26036735 Decision Date: 04/21/26 Archive Date: 04/21/26 DOCKET NO. 201105-119690 DATE: April 21, 2026 ORDER Service connection for bilateral hearing loss is granted. Service connection for a sinus condition is denied. Entitlement to an effective date prior to September 28, 2020, for the grant of service connection for tinnitus is denied. REMANDED Service connection for a left hip condition is remanded. FINDINGS OF FACT 1. A November 2023 rating decision granted service connection for bilateral hearing loss. 2. The evidence persuasively weighs against a finding that the Veteran has had a sinus condition or symptoms of a sinus condition causing functional impairment of earning capacity at any time during or approximate to the pendency of the claim. 3. A claim for service connection for tinnitus was received in December 2017 and denied in a rating decision in February 2018. The Veteran did not appeal the February 2018 rating decision during the appellate period and new and material evidence was not received within a year of the decision, and the decision became final. 4. The Veteran filed a Supplemental Claim seeking to reopen the claim for service connection for tinnitus in September 2020. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for sinusitis are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for an effective date prior to September 28, 2020, for entitlement to service connection for tinnitus are not met. 38 U.S.C. §§ 5107, 5110; 38 C.F.R. §§ 3.102, 3.155, 3.400. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1990 to November 1994. The rating decision on appeal was issued in October 2020 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. In the November 2020 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held before the undersigned in July 2024. A transcript of the hearing is of record. Therefore, the Board may only consider the evidence of record at the time of the October 2020 Agency of Original Jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801. However, because the Board is remanding the claim of entitlement to service connection for a left hip condition, 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). 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. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Establishing entitlement to direct service connection generally requires: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present 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. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Establishing entitlement to direct service connection generally requires: (1) the existence of a present disability; (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 or aggravated during service - which is the so-called "nexus" requirement. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). A "current disability" means a disability shown by competent medical evidence to exist. Chelte v. Brown, 10 Vet. App. 268 (1997). With any claim for service connection, it is necessary for a current disability to be present. See Brammer v. Derwinski, 3 Vet. App. 223 (1992); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007) (recognizing the disability could arise at any time during the claim); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013) (recognizing disabilities that occur immediately prior to filing of a claim). The requirement that a current disability be present is satisfied "when the claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim even though the disability resolves prior to the Secretary's adjudication of the claim." McClain, 21 Vet. App. at 321. Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information and lay and medical evidence of record in a case and when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (benefit-of-the-doubt rule not for application when evidence persuasively favors one side or the other). 1. Service connection for bilateral hearing loss is granted. The Veteran contends that he has bilateral hearing loss due to his service. While the Veteran's appeal seeking service connection for bilateral hearing loss was pending before the Board, in August 2023, the Veteran's representative filed a VA Form 20-0995, Decision Review Request, Supplemental Claim, seeking readjudication of the issue of service connection for bilateral hearing loss. Although this was an improper concurrent election, a November 2023 rating decision granted service connection for bilateral hearing loss, with a noncompensable evaluation, effective August 1, 2023. 38 U.S.C. § 5104C; 38 C.F.R. § 3.2500(b); see Terry v. McDonough, 37 Vet. App. 1, 14 (2023). A decision by the AOJ or by the Board is not evidence and the Board is bound by the favorable findings in that decision. See Green v. McDonough, 37 Vet. App. 127, 136 (2024) (adjudications are not evidence and can be considered if they are outside of the evidentiary window); 38 C.F.R. § 3.104. Thus, the Board finds that entitlement to service connection for bilateral hearing loss is warranted. The Board notes that although the November 2023 rating decision's finding that service connection for bilateral hearing loss was warranted because the evidence established that it is directly related to the Veteran's military service, which is the basis of the pending appeal, the Veteran's claim seeking service connection for bilateral hearing loss is not moot, as the appeal before the Board was pending prior to when the November 2023 decision was issued, specifically from a November 2020 claim. See Concepcion-Maldonado v. Collins, 38 Vet. App. 294 (2025) (holding that the AOJ's grant of service connection for a disability cannot moot a pending Board appeal for the same disability unless the Veteran has been awarded the earliest effective date possible). Accordingly, service connection for bilateral hearing loss, with respect to the current do hearing loss was warranted because the evidence established that it is directly related to the Veteran's military service, which is the basis of the pending appeal, the Veteran's claim seeking service connection for bilateral hearing loss is not moot, as the appeal before the Board was pending prior to when the November 2023 decision was issued, specifically from a November 2020 claim. See Concepcion-Maldonado v. Collins, 38 Vet. App. 294 (2025) (holding that the AOJ's grant of service connection for a disability cannot moot a pending Board appeal for the same disability unless the Veteran has been awarded the earliest effective date possible). Accordingly, service connection for bilateral hearing loss, with respect to the current docket, is granted. 2. Service connection for a sinus condition is denied. The Veteran contends that he has a sinus condition due to service. Specifically, the Veteran asserts that he was exposed to toxic fumes during service and was treated for sinus issues during service. July 2024 Hearing Transcript. Effective August 5, 2021, VA established presumptive service connection for asthma, rhinitis, and sinusitis for veterans with service in the Southwest Asia theater of operations during the Persian Gulf War. See 86 Fed. Reg. 42, 724-33 (2021). Specifically, VA will presume exposure to fine particulate matter for Gulf War veterans deployed in the Southwest Asia theater of operations during the Persian Gulf War (on or after August 2, 1990) or Veterans deployed to Afghanistan, Syria, Djibouti, or Uzbekistan on or after September 19, 2001, regardless of length of deployment. 38 C.F.R. § 3.320(a)(3), (a)(4). The conditions shall not be presumed service connected if there is affirmative evidence that: (1) the disease was not incurred during or aggravated by a qualifying period of service; or (2) the disease was caused by a supervening condition or event that occurred between the veteran's most recent departure from a qualifying period of service and the onset of the disease; or (3) the disease is the result of the veteran's own willful misconduct. 38 C.F.R. § 3.320(b). The October 2020 rating decision made a favorable finding that a qualifying event, injury, or disease had its onset during service, in that service treatment records confirm complaints of sinusitis. The Board is bound by this favorable finding. 38 C.F.R. § 3.104. A January 2024 rating decision on a different matter of service connection made a favorable finding that participation in a toxic exposure risk activity (TERA) was conceded. A decision by the AOJ or by the Board is not evidence and the Board can consider the favorable findings therein. See Green, 37 Vet. App. at 136. The question for the Board is whether the Veteran has a current disability that began during service or is otherwise related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current diagnosis of sinusitis or any other condition of the sinuses and has not had one at any time during the pendency of the claim or recent to the filing of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. § 3.303(a), (d), 3.304(f); Holton v. Shinseki, 557 F.3d 1363, 1366 (2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); see also Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). A review of the record illustrates there is no diagnosis of sinusitis or other sinus disability. VA treatment records reflect that the Veteran has not sought treatment for a sinus condition at a VA medical center and the Veteran provided no private treatment records or any information suggesting that he has sought private treatment for his claimed sinus condition during the pendency of the claim or recent to the filing of the claim. The Board acknowledges the Veteran's testimony that he sought treatment at the VA clinic in Pensacola, Florida, but the records were lost due to Hurricane Andrew; the Board notes that Hurricane Andrew hit Florida in 1992, during his period of service and approximately 28 years prior to the pendency of the claim. The Veteran further testified that surgery was discussed for his sinuses but did not occur because he was deployed again. The Board additionally acknowledges that the Veteran testified that he has always treatment for a sinus condition at a VA medical center and the Veteran provided no private treatment records or any information suggesting that he has sought private treatment for his claimed sinus condition during the pendency of the claim or recent to the filing of the claim. The Board acknowledges the Veteran's testimony that he sought treatment at the VA clinic in Pensacola, Florida, but the records were lost due to Hurricane Andrew; the Board notes that Hurricane Andrew hit Florida in 1992, during his period of service and approximately 28 years prior to the pendency of the claim. The Veteran further testified that surgery was discussed for his sinuses but did not occur because he was deployed again. The Board additionally acknowledges that the Veteran testified that he has always complained to his doctors, even when he goes to the VA clinic. The existence of a current disability is the cornerstone of a claim for service connection and VA disability compensation. 38 U.S.C. § 1110, 1131; Degmetich v. Brown, 104 F.3d 1328, 1332 (Fed. Cir. 1997). Evidence must show that the Veteran currently has the disability for which benefits are being claimed. Here, the evidence does not reflect that the Veteran has had any sinus condition, including sinusitis, at any point during the appeal period or recent to the filing of the claim. Additionally, there is no indication or lay statements suggesting that the Veteran has had symptoms of the condition that have caused him any functional impairment of earning capacity. See Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018). Therefore, the Board cannot grant his claim under any theory of entitlement. The Veteran was provided with a VA examination in February 2018. At the time of the VA examination, the VA examiner noted that the Veteran's service treatment records show a history of acute and transient sinusitis. However, the VA examiner noted that treatment records after service show prolonged periods without any findings of chronic sinusitis, including the prior five years of VA treatment records showing no findings, diagnosis, or treatment for chronic sinusitis. At the VA examination, the Veteran reported some nasal congestion and stated that his "sinuses feels dry." The VA examiner noted the Veteran's history of cocaine abuse and further noted that such cocaine abuse might predispose the Veteran to nasal problems. Imaging was completed and did not support chronic sinusitis. The sinus series revealed no significant radiographic abnormality of the paranasal sinuses. The VA examiner opined that there was insufficient evidence to warrant or confirm a diagnosis of chronic sinusitis and no medical opinion could be rendered as no condition was diagnosed. The Veteran's examination was a normal examination and the most recent sinus series showed normal results. The VA examiner opined that the Veteran's reported symptomatology was most likely than not due to multiple overlays and did not issue a medical opinion regarding etiology due to the lack of a current disability. The Board acknowledges the Veteran's September 2024 private medical opinion, submitted in October 2024, wherein Dr. G.S. opined that the Veteran as likely as not has a service-connected disability of chronic sinusitis, based on the medical documentation and considering the testimony reflecting his exposure to burn pits, diesel fluid, and burning feces while on active duty and the lack of other non-service-connected risk factors. Dr. G.S. rationalized that based on the Veteran's documentation confirming continual episodes of gradually worsening sinusitis requiring chronic medication use and scheduled surgery, according to diagnostic code 6510, the Veteran should have a disability rating consistent with 50 percent disability evaluation. For records reviewed, Dr. G.S. cited the Veteran's September 1991 to November 1994 service treatment records, a February 1994 screening note, a March 1994 medical record consultation request; an August 2023 Toxic Exposure Risk Activity (TERA) memorandum, and a September 2024 evaluation request letter. He noted that the Veteran had testified that he continued to receive treatment after service, and indicated the assertion seemed reasonable given the numerous times he sought treatment during service. The opinion does not indicate that the Veteran was interviewed or examined and does not indicate that any post-November 1994 medical records were reviewed. The Board finds that this opinion is inadequate. To the extent that Dr. G.S. is providing a diagnosis of chronic sinusitis, this opinion fails to indicate or even imply review of medical records relevant to a current disability during or proximate to the pendency of the claim or to indicate that the Veteran was examined. The opinion also fails to describe how important details of the Veteran's medical history factored into a current diagnosis. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 reasonable given the numerous times he sought treatment during service. The opinion does not indicate that the Veteran was interviewed or examined and does not indicate that any post-November 1994 medical records were reviewed. The Board finds that this opinion is inadequate. To the extent that Dr. G.S. is providing a diagnosis of chronic sinusitis, this opinion fails to indicate or even imply review of medical records relevant to a current disability during or proximate to the pendency of the claim or to indicate that the Veteran was examined. The opinion also fails to describe how important details of the Veteran's medical history factored into a current diagnosis. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008) (stating that the Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion); but see D'Aries v. Peake, 22 Vet. App. 97, 106-07 (holding that an examiner need not specify that they have reviewed the entire record if the report leaves little doubt that they have done so). The Board must evaluate the probative value of an opinion based in part on whether the medical professional is sufficiently informed of the facts or data. See Nieves-Rodriguez, 22 Vet. App. at 302. Here, where there is no indication that current medical records or medical records close to the pendency of the claim were reviewed, no indication that the Veteran was examined, no indication the Veteran was interviewed, and no indication imaging was completed, there is no basis for a finding of a current diagnosis of chronic sinusitis. Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007) (stating that a medical opinion must support its conclusion with an analysis that the Board can weigh, and a mere conclusion by a medical doctor is insufficient to allow the Board to make an informed decision); see also Dennis v. Nicholson, 21 Vet. App. 18, 22 (2007) (merely listing evidence before stating a conclusion does not constitute an adequate statement of reasons and bases); see also Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (finding that a medical opinion that is based on an inaccurate factual premise is inadequate for evaluation purposes). Therefore, this opinion is inadequate to establish a current diagnosis of a sinus condition and the Board places no weight of probative value on the opinion. Additionally, although the AOJ issued a favorable finding as to an in-service injury, disease, or event regarding the Veteran's in-service sinus treatment, and although chronic sinusitis is a respiratory condition subject to presumptive service connection based on the Veteran's service, there is no record of a current disability to allow for the establishment of presumptive service connection. The Board is mindful of Saunders v. Wilkie, 886 F.3d 1356, 1364-65 (Fed. Cir. 2018), in which the Federal Circuit explained that where pain alone results in functional impairment that affects earning capacity, even if there is no identified underlying diagnosis, it can constitute a disability. However, in this case, there is no showing of impaired earning capacity due to any claimed symptoms. The Veteran's application for service connection for sinusitis illustrates that the Veteran believes he has a current sinus condition, and the Veteran is competent to report observable sinus symptoms. See Charles v. Principi, 16 Vet. App. 370, 374 (2002) (finding the Veteran competent to testify to symptomatology capable of lay observation); Layno v. Brown, 6 Vet. App. 465, 469 (1994) (noting competent lay evidence requires facts perceived through the uses of the five senses). However, other than the February 2018 report of some nasal congestion and dry sinuses, the Veteran has not reported having any other observable sinus symptoms, and he has not indicated that any of the reported symptoms have resulted in functional impairment of earning capacity. The Board acknowledges that during the July 2024 Board hearing, the Veteran testified that a doctor had suggested that he have surgery to have tubes placed to help drain his sinuses. However, he indicated that this occurred during service and that he did not have the surgery due to being sent out on deployment. July 2024 Board Hearing Tr. at 4-6. Therefore, the Board finds this testimony is not relevant to whether the Veteran has a current disability of sinusitis. Notably, the Veteran did not report any current sinus symptoms in his July 2024 hearing testimony. The Veteran is not competent to provide a diagnosis in this case. The issue symptoms have resulted in functional impairment of earning capacity. The Board acknowledges that during the July 2024 Board hearing, the Veteran testified that a doctor had suggested that he have surgery to have tubes placed to help drain his sinuses. However, he indicated that this occurred during service and that he did not have the surgery due to being sent out on deployment. July 2024 Board Hearing Tr. at 4-6. Therefore, the Board finds this testimony is not relevant to whether the Veteran has a current disability of sinusitis. Notably, the Veteran did not report any current sinus symptoms in his July 2024 hearing testimony. The Veteran is not competent to provide a diagnosis in this case. The issue is medically complex as it requires the interpretation of diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007); see also Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (the Board may consider evidence of a prolonged period without medical complaint, along with other factors). As an aside, the Board notes that in July 2024, the Veteran's representative submitted correspondence to the Board requesting the personnel file of the February 2018 VA examiner in order to determine the qualifications of the examiner. In a December 2024 response, it was noted that the Board does not gather or maintain such records and the Veteran's representative was provided with instructions as to where and how to resubmit such a request with the AOJ. In a January 2025 correspondence, the Veteran's representative again requested that the Board provide the February 2018 VA examiner's information and specifically noted that it was not a Freedom of Information Act (FOIA) Request, the information sought was not covered by or related to FOIA, and the examiner's information requested was to be provided without any further reference to the FOIA process, as it has no bearing whatsoever on the request for the VA examiner's information. It is unclear whether the Veteran or his representative resubmitted the request for the February 2018 VA examiner's information through the directed channel. However, the Veteran's representative has not raised a specific challenge to the competency of the February 2018 VA examiner. The U.S. Court of Appeals for Veterans Claims and the U.S. Court of Appeals for the Federal Circuit have held that the Board is entitled to presume the competence of a VA examiner, and specific challenges to a VA examiner's competency must be raised by the Veteran to overcome this presumption. Rizzo v. Shinseki, 580 F.3d 1288 (Fed. Cir. 2009); Bastien v. Shinseki, 599 F.3d 1301 (Fed. Cir. 2010); Cox v. Nicholson, 20 Vet. App. 563, 569 (2007) (citing Hilkert v. West, 12 Vet. App. 145, 151 (1999)); see also Francway v. Wilkie, 940 F.3d 1304 (Fed. Cir. 2019) (en banc). As no specific challenges to the competency of the February 2018 VA examiner have been made, the Board is entitled to presume the competence of the February 2018 VA examiner. Additionally, as the request for the examiner's personnel file was made subsequent to the decision on appeal, there was no pre-decisional duty to assist error that the AOJ did not provide that information, and the Board does not have a duty to remand to have the AOJ give that information. The Board does not question the Veteran's sincerity in his belief that service connection is warranted for a sinus condition. However, without evidence of a current sinus condition or symptoms causing functional impairment of earning capacity, the evidence is persuasively against the claim. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable and service connection for sinusitis is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). 3. Entitlement to an effective date prior to September 28, 2020, for the grant of service connection for tinnitus is denied. The Veteran asserts that he is entitled to an earlier effective date for his award of entitlement to service connection for tinnitus. Unless specifically provided otherwise, the effective date of an award based on a claim for compensation is to be fixed in accordance with the facts found but will not be earlier -doubt doctrine is not applicable and service connection for sinusitis is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021). 3. Entitlement to an effective date prior to September 28, 2020, for the grant of service connection for tinnitus is denied. The Veteran asserts that he is entitled to an earlier effective date for his award of entitlement to service connection for tinnitus. Unless specifically provided otherwise, the effective date of an award based on a claim for compensation is to be fixed in accordance with the facts found but will not be earlier than the date the claim was received. 38 U.S.C. § 5110(a). The implementing regulation clarifies that the effective date of an evaluation and an award of compensation based on an original claim will be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 C.F.R. § 3.400. VA amended its adjudication regulations on March 24, 2015, to require that all claims governed by VA's adjudication regulations be filed on standard forms prescribed by the Secretary, regardless of the type of claim or posture in which the claim arises. The amendments were effective only for claims and appeals filed on or after March 24, 2015. See 38 C.F.R. §§ 3.1(p), 3.150, 3.155, 3.160(a). A claimant may also indicate their intent to file a claim for compensation by submitting an intent to file with VA. 38 C.F.R. § 3.155(b). If a complete application for benefits on the form prescribed by the Secretary is received by VA within one year of receipt of the intent to file, VA will consider the formal claim to have been filed as of the date the intent to file a claim was received. An intent to file a claim must be submitted using one of three approved methods and must identify the general benefit and the claimant. Id. Under the AMA, a claim can be continuously pursued by filing an appropriate administrative review option to an AMA decision, generally within one year from when the decision was issued. If a claim is continuously pursued, it will be considered filed as of the date of the first claim in the continuously pursued chain, not the date the most recent request for review was received. See 38 C.F.R. § 3.2500. While a supplemental claim may establish continuous pursuit, a claim for an increased rating on VA Form 21-526EZ cannot establish continuous pursuit, regardless of whether it was received within one year of the issuance of the prior VA decision. Id.; see Jackson v. McDonough, 37 Vet. App. 277 (2024). The evidence is not approximately balanced as to whether an earlier effective date is warranted. To that end, in December 2017, the Veteran filed a claim for service connection for tinnitus. That claim was denied in a February 2018 rating decision and notification was provided on February 26, 2018. The Veteran did not appeal that decision, nor was any new and material evidence actually or constructively received within a year following the decision; therefore, the decision became final. 38 U.S.C. § 7105(c); 38 C.F.R. §§ 3.104(a), 3.156(b), 19.20, 19.21, 19.52, 20.1103. On September 28, 2020, the Veteran filed a supplemental claim for service connection for tinnitus. The record does not reflect any earlier submission after the February 2018 decision that would qualify as an intent to file a claim or a claim for benefits for tinnitus. 38 C.F.R. §§ 3.155, 3.160. An October 2020 rating decision granted service connection for tinnitus with an evaluation of 10 percent, effective September 28, 2020, based on the date the supplemental claim was received. Therefore, considering the record in light of the governing legal authority, the Board finds that an effective date earlier than September 28, 2020, is not assignable for the award of service connection for tinnitus. The earliest possible date of claim is the date of the September 28, 2020 supplemental claim, as no earlier claim or intent to file was received subsequent to the February 2018 final decision. The pertinent legal authority governing effective dates in this case is clear and specific, and the Board is bound by such authority. Pursuant to that authority, the Board finds that there is no legal basis for 10 percent, effective September 28, 2020, based on the date the supplemental claim was received. Therefore, considering the record in light of the governing legal authority, the Board finds that an effective date earlier than September 28, 2020, is not assignable for the award of service connection for tinnitus. The earliest possible date of claim is the date of the September 28, 2020 supplemental claim, as no earlier claim or intent to file was received subsequent to the February 2018 final decision. The pertinent legal authority governing effective dates in this case is clear and specific, and the Board is bound by such authority. Pursuant to that authority, the Board finds that there is no legal basis for an earlier effective date for the award of service connection for tinnitus. Further, there has been no allegation of clear and unmistakable error (CUE) to vitiate the finality of the prior February 2018 rating decision. A valid motion of CUE must allege an error with some specificity and must be addressed by the regional office in the first instance. Non-specific claims do not meet the restrictive definition of CUE. In the instant case, neither the Veteran nor his representative has alleged CUE in any prior rating decision. In the absence of CUE, a prior final determination cannot serve as a basis for an earlier effective date. 38 C.F.R. § 3.105(a). Because the law, rather than the facts, is dispositive of the outcome of this appeal, there is no reasonable doubt to be resolved in favor of the Veteran. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). For this reason, the Veteran's appeal is denied. REASONS FOR REMAND Service connection for a left hip condition is remanded. The Veteran contends that he has a left hip condition due to his service. He reports that he injured his hip when he crashed against a cliff while repelling and doing road marches with a rucksack in service. See July 2024 Hearing Transcript. The October 2020 rating decision made a favorable finding that a qualifying event, injury, or disease had its onset during service, in that service treatment records confirm complaints of left hip strain in service. The Board is bound by this favorable finding. 38 C.F.R. § 3.104. The January 2024 rating decision made a favorable finding that participation in a TERA was conceded. A decision by the AOJ or by the Board is not evidence and the Board can consider the favorable findings therein. See Green, 37 Vet. App. at 127. The Veteran reports left hip condition symptoms such as pain and strain. See December 2017 Claim; see also February 2018 VA Examination Report. However, the Veteran does not have a current left hip condition diagnosis. A February 2018 VA medical examiner rendered a negative nexus opinion for the claimed left hip condition based on a finding of no current diagnosis. However, the record contains reports suggesting potential functional impairment due to pain from the claimed left hip condition, and the examiner failed to provide a substantive opinion as to why the left hip condition symptoms did not reflect functional impairment of earning capacity. See February 2018 VA Examination Report. A remand is necessary for a new VA examination to determine whether the claimed left hip condition reaches the level of a functional impairment of earning capacity, as contemplated in Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (holding that "pain alone, without an accompanying diagnosis of a present disease, can qualify as a disability" if it "reaches the level of a functional impairment of earning capacity"). In the October 2020 rating decision, the AOJ denied the claim without obtaining an additional addendum opinion or new VA examination to address the above-noted deficiency. This is a pre-decisional duty to assist error. A remand is necessary to correct it. The Board acknowledges the Veteran's September 2024 private medical opinion, submitted in October 2024, wherein, Dr. G.S. opined that the Veteran as likely as not has a service-connected disability of left hip condition (recurrent bursitis), based on the medical documentation and considering two documented service-connected episodes of trauma to the left hip and discussion showing ongoing needed for treatment for the hip condition. Dr. G.S. rationalized that based on the Veteran's documentation of two traumas to the hip and decades of persistent activity-related pain and according to diagnostic code 5252, the Veteran has a disability rating consistent with a 20 percent disability evaluation. For reviewed records, Dr. G.S. cited the Veteran's October 1993 to January 199 2024 private medical opinion, submitted in October 2024, wherein, Dr. G.S. opined that the Veteran as likely as not has a service-connected disability of left hip condition (recurrent bursitis), based on the medical documentation and considering two documented service-connected episodes of trauma to the left hip and discussion showing ongoing needed for treatment for the hip condition. Dr. G.S. rationalized that based on the Veteran's documentation of two traumas to the hip and decades of persistent activity-related pain and according to diagnostic code 5252, the Veteran has a disability rating consistent with a 20 percent disability evaluation. For reviewed records, Dr. G.S. cited the Veteran's October 1993 to January 1994 service treatment records, an October 1993 screening note of acute medical care, and a September 2024 evaluation request letter. There is no indication that the Veteran was interviewed or examined and no indication that any post-January 1994 medical records were reviewed. This opinion is inadequate. To the extent that Dr. G.S. is providing a diagnosis of recurrent bursitis, this opinion fails to indicate review of medical records relevant to a current disability during or proximate to the pendency of the claim and fails to describe how important details of the Veteran's medical history factored into a current diagnosis. Nieves-Rodriguez, 22 Vet. App. at 302; D'Aries, 22 Vet. App. at 106-07. The Board must evaluate the probative value of an opinion based in part on whether the medical professional is sufficiently informed of the facts or data. See Nieves-Rodriguez, 22 Vet. App. at 302. Here, where there is no indication that current medical records were reviewed, that the Veteran was examined, that the Veteran was interviewed, or that imaging was completed, there is no basis for a finding of a current diagnosis of recurrent bursitis. Stefl, 21 Vet. App. at 124-25; Dennis, 21 Vet. App. at 22 (2007); see also Reonal, 5 Vet. App. at 461. Therefore, this opinion is inadequate to establish a current diagnosis of a left hip condition. The matter is REMANDED for the following action: Schedule the Veteran for a VA examination with an appropriate clinician to address the etiology and pathophysiology of the Veteran's claimed left hip condition. Following examination of the Veteran and a review of the Veteran's claims file, the examiner is asked to provide an opinion on the following: (A) The clinician must identify all current left hip disabilities, even if currently resolved or asymptomatic (current: since September 2020). The clinician must also assess whether left hip pain symptoms result in any functional impairment. In doing so, the clinician must specifically consider the following reports of left hip pain 1) A December 2017 Claim, wherein, the Veteran reported pain and strain of the left hip; and 2) A February 2018 VA Examination Report, wherein, the Veteran reported pain in many joints, including his hips. (B) For each left hip diagnosis or functional impairment, the clinician must opine whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) due to the Veteran's service. In doing so, the clinician must specifically consider the following: The October 2020 rating decision, which made a favorable finding that a qualifying event, injury, or disease had its onset during service, in that service treatment records confirm complaints of left hip strain in service. A complete rationale must be provided for all opinions rendered. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. The clinician is asked to explain the reasons behind any opinions expressed and conclusions reached. The clinician is reminded that the term "as likely as not" does not mean "within the realm of medical possibility," but rather, that the likelihood is at least approximately balanced or nearly equal, if not higher. Note that the lack of documented treatment in service, or a long period after, while probative, cannot serve as the sole basis for a negative finding. The Veteran's lay contentions must be considered and weighed in making the determination. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K.