HEARING LOSS

JENNA BRANT · 2026 · Case ID: A26037304

MIXED

Summary

The veteran, who served from May 2017 to May 2022, appeals the denial of service connection for bilateral hearing loss and the grant of service connection for tinnitus and costochondritis. The Board reviewed the evidence of record as of January 2024, as the appeal was filed via a Higher-Level Review of a March 2025 decision. For the bilateral hearing loss claim, the Board denied service connection, noting that the November 2023 VA examination did not demonstrate a disability for VA purposes, and no other records supported the claim. The Board found the veteran's lay testimony regarding hearing difficulties competent but insufficient without audiometric testing meeting VA thresholds. For tinnitus, the Board granted service connection, finding the evidence in approximate balance. While the VA examiner offered a negative opinion, the Board gave the veteran the benefit of the doubt, considering his competent testimony of in-service tinnitus and the conceded noise exposure consistent with his MOS. For costochondritis, the Board also granted service connection, finding the evidence in approximate balance. Despite a negative etiological opinion from the VA examiner, the Board considered the veteran's competent testimony and in-service diagnosis of costochondritis with subsequent symptoms, granting the claim by resolving doubt in the veteran's favor. The claims for left ventricular hypertrophy, pericarditis, and myxomatous mitral valve were remanded due to an inadequate VA examination that failed to address the veteran's prior cardiac history, including specific findings from service treatment records.

Rationale

No bilateral hearing loss disability for VA purposes.; Lay testimony competent but insufficient without audiometric testing.; No audiometric test results meet VA threshold.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250307-526917

Full Decision Text

Citation Nr: A26037304
Decision Date: 04/21/26 Archive Date: 04/21/26

DOCKET NO. 250307-526917
DATE: April 21, 2026

ORDER

Entitlement to service connection for a bilateral hearing loss disability is denied.

Entitlement to service connection for tinnitus is granted.

Entitlement to service connection for costochondritis is granted.

REMANDED

Entitlement to service connection for left ventricular hypertrophy (LVH) is remanded.

Entitlement to service connection for pericarditis is remanded.

Entitlement to service connection for myxomatous mitral valve is remanded.

FINDINGS OF FACT

1. The Veteran does not have bilateral hearing loss considered to be a disability for VA purposes.

2. The Veteran's tinnitus began in service.

3. The Veteran's costochondritis began in service.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for a bilateral hearing loss disability are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385.

2. The criteria for entitlement to service connection for tinnitus are met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

3. The criteria for entitlement to service connection for costochondritis are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from May 2017 to May 2022.

The rating decision on appeal was issued in March 2025.

In November 2024, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a January 2024 decision. In March 2025, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior January 2024 decision. Therefore, the Board may only consider the evidence of record at the time of the January 2024 decision.

In the March 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the January 2024 AOJ decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the 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.

However, regarding the remanded claims, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

Service Connection

General Legal Criteria

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(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." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden
).

Service Connection

General Legal Criteria

Certain chronic diseases, such as other organic disease of the nervous system like hearing loss and tinnitus, will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

For the purposes of applying the laws administered by VA, impaired hearing will be considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or 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.

Where 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(b); 38 C.F.R. § 3.102; see also Lynch v. McDonough, 21 F.4th 776, 778 (Fed. Cir. 2021).

Entitlement to service connection for a bilateral hearing loss disability.

In furtherance of substantiating his claims, the Veteran was afforded a VA examination November 2023. Examination at that time did not demonstrate a bilateral hearing loss disability for VA purposes. See 38 C.F.R. § 3.385. No other records show a bilateral hearing loss disability for VA purposes.

Entitlement to service connection for a bilateral hearing loss disability is not established. The Board acknowledges the Veteran's complaints regarding having hearing difficulties, which he is certainly competent to relate. See e.g., Layno v. Brown, 6 Vet. App. 465 (1994); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F.3d 1331, 1337 (2006). Nevertheless, the diagnosis of a bilateral hearing loss disability is not capable of lay observation, as it requires audiometric testing. In the present case, no audiometric test results meet VA's threshold for considering hearing loss a disability for VA purposes. See 38 C.F.R. § 3.385. No evidence indicates that the Veteran had a bilateral hearing disability during the course of the present claim. See McLain v. Nicholson, 21 Vet. App. 319, 321 (2007) (the current disability requirement is satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim).

Entitlement to service connection for tinnitus.

The Veteran contends that he has tinnitus incurred in, or attributable to, service.

The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

In support of his claim, the Veteran was examined in November 2023 and was assessed with tinnitus. The examiner conceded noise exposure based on the Veteran's military
321 (2007) (the current disability requirement is satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim).

Entitlement to service connection for tinnitus.

The Veteran contends that he has tinnitus incurred in, or attributable to, service.

The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

In support of his claim, the Veteran was examined in November 2023 and was assessed with tinnitus. The examiner conceded noise exposure based on the Veteran's military occupational specialty (MOS) and noted that the Veteran reported that his tinnitus began in service. Nevertheless, the examiner concluded that the Veteran's tinnitus was less likely than not incurred in, or attributable to, service because there was no hearing loss in service, which was the most common cause of tinnitus.

The evidence is at least in approximate balance that the Veteran's tinnitus was incurred in service. Noise exposure is conceded as consistent with the circumstances of the Veteran's service. While the November 2023 VA examiner offered a negative opinion, the Veteran is competent to relate his observations of tinnitus. See Charles v. Principi, 16 Vet. App. 370, 374- 75 (2002). Thus, as the Veteran has competently described symptoms of ringing in the ears in and since service which have been attributed to tinnitus, the evidence is at least approximately balanced and in resolving doubt in the Veteran's favor, the claim is granted. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309.

Entitlement to service connection for costochondritis.

The Veteran contends that he incurred costochondritis in service.

The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

In an attempt to substantiate the claim, VA afforded the Veteran a VA examination in November 2023, at which time costochondritis was assessed. However, the examiner offered a negative etiological opinion, concluding that the Veteran's costochondritis was less likely than not incurred in, or attributable service. In terms of rationale, the examiner explained that the "records have been silent for multiple years after service about the claimed" costochondritis.

The evidence is at least in approximate balance that the Veteran's tinnitus was incurred in service. While the November 2023 VA examiner offered a negative opinion, the Veteran is competent to relate his observations of costochondritis. See Charles at 374- 75. He was diagnosed with costochondritis in service in 2019 and has reported a history of symptoms, such as chest pain, since then. He also has a current diagnosis of costochondritis. Thus, as the Veteran has competently described symptoms of chest pain which have been attributed to costochondritis, the evidence is at least approximately balanced and in resolving doubt in the Veteran's favor, the claim is granted. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309.

REASONS FOR REMAND

Entitlement to service connection for LVH is remanded.

Entitlement to service connection for pericarditis is remanded.

Entitlement to service connection for myxomatous mitral valve is remanded.

A review of the Veteran's service treatment records notes that in March 2019 the Veteran presented with a complaint of left-sided chest pain. Cardiovascular examination was normal, but there was an apparent holosystolic murmur noted that was thought to be unrelated to the chest pain. An EKG suggested possible lateral ischemia, which was doubted.

Of record is a September 2019 ECG/EKG report. The report, inter alia, reflects probable left atrial enlargement.

Also of record is a March 2020 transthoracic echocardiogram report. The report documents a mildly thickened left ventricular posterior wall, among other findings. The Veteran also had an exercise stress test at this time, which showed, inter alia, an inconclusive ECG response to limited treadmill exercise at 99 percent maximum age predicted heart rate.

In furtherance of attempting to substantiate the Veteran's claim, the Veteran was provided with a VA examination in December 2023. Examination resulted in a non-diagnosis with the examiner finding no pathology to warrant a diagnosis
a September 2019 ECG/EKG report. The report, inter alia, reflects probable left atrial enlargement.

In furtherance of attempting to substantiate the Veteran's claim, the Veteran was provided with a VA examination in December 2023. Examination resulted in a non-diagnosis with the examiner finding no pathology to warrant a diagnosis. The examiner did not discuss any of the service treatment records, as outlined above.

Once VA provides an examination, it must be adequate, or VA must notify the Veteran why one will not or cannot be provided. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). An examination is adequate if it considers the records of prior medical treatment, so that the evaluation of the claimed disability will be a fully informed one. Barr, 21 Vet. App. at 311 (quoting Green v. Derwinski, 1 Vet. App. 121, 124 (1991)). Moreover, an examination must be based upon consideration of the Veteran's prior medical history and examinations. Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). The Secretary has an affirmative duty to gather the evidence necessary to render an informed decision on a claim. Douglas v. Shinseki, 23 Vet. App. 19 (2009).

VA committed a pre-decisional duty to assist error in obtaining an inadequate examination and opinion. While the examiner found no pathology to warrant a diagnosis, they failed to discuss the significance of the cardiac history noted in the Veteran's service records. An examination must be based on the Veteran's prior medical history. Stefl, at 123. Because the examiner failed to discuss the Veteran's medical history, the examination is inadequate. Accordingly, the claim is remanded to correct this pre-decisional duty to assist error. 38 C.F.R. § 20.802(a).

The matters are REMANDED for the following action:

Obtain an examination regarding the etiology of the Veteran's claimed left ventricular hypertrophy (LVH), pericarditis and myxomatous mitral valve. The claims file must be reviewed, and the examination report must reflect that such review was accomplished.

The examiner is requested to clarify whether the Veteran has a diagnosed heart disability, to include LVH, pericarditis, and myxomatous mitral valve.

The examiner is also requested to provide an opinion as to whether a heart disability, to include LVH, pericarditis and myxomatous mitral valve, was incurred in service or is otherwise attributable to an in-service event, injury, or disease.

In offering this opinion the examiner's attention is directed to the following:

a) An apparent holosystolic murmur, as well as an EKG suggesting possible lateral ischemia, which was doubted, in March 2019;

b) A September 2019 ECG/EKG report reflecting, inter alia, probable left atrial enlargement;

c) A March 2020 transthoracic echocardiogram report documenting a mildly thickened left ventricular posterior wall, among other findings;

d) A March 2020 exercise stress test, which showed, inter alia, an inconclusive ECG response to limited treadmill exercise at 99 percent maximum age predicted heart rate; and.

e) The Veteran's reports of left-sided chest pain in service.

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A complete, well-reasoned rationale must be provided for any opinion offered.

Jenna Brant

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Joseph R. Keselyak, 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.

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