TINNITUS

THOMAS L. ENGLISH · 2026 · Case ID: A26037785

MIXED

Summary

The veteran, who served in the National Guard as a full-time dual status technician from January 2006 to February 2019, appeals the denial of service connection for right ankle tarsal tunnel syndrome and the grant of service connection for several other conditions. The Board found that the veteran had a current disability for tinnitus, cervical spine degenerative arthritis, thoracic strain, right upper extremity radiculopathy, bilateral knee degenerative arthritis and chondromalacia patella, left ankle ganglion cyst and ruptured saphenous vein, and left great toe matrixectomy with left medial foot scar. The Board also found that the veteran had an in-service event or disease for these conditions, supported by his lay testimony and service treatment records, which noted complaints of pain and diagnoses related to these conditions. The Board afforded significant probative value to a VA examiner's October 2019 opinion linking tinnitus to noise exposure during service, despite a later addendum opinion that was based on an inaccurate premise. For the other musculoskeletal conditions, the Board found the veteran's credible lay testimony, corroborated by service treatment records and statements from fellow servicemembers, was sufficient to establish service connection. However, for the right ankle tarsal tunnel syndrome, the Board denied service connection due to the absence of a current diagnosis and the veteran's denial of pain or functional loss at examination. The Board noted that while the service treatment records mentioned possible tarsal tunnel syndrome, a current diagnosis is required for service connection.

Rationale

Current diagnosis of tinnitus confirmed by VA exam.; In-service event linked to noise exposure from MOS (aircraft metals technology).; VA examiner provided a positive nexus opinion, finding it at least as likely as not related to service.

Service Branch

NATIONAL GUARD

Special Benefit

NO SPECIAL BENEFIT

Docket No.

201217-429217

Full Decision Text

Citation Nr: A26037785
Decision Date: 04/22/26 Archive Date: 04/22/26

DOCKET NO. 201217-429217
DATE: April 22, 2026

ORDER

Entitlement to service connection for tinnitus is granted.

Entitlement to service connection for cervical spine degenerative arthritis is granted.

Entitlement to service connection for thoracic strain is granted.

Entitlement to service connection for right upper extremity radiculopathy is granted.

Entitlement to service connection for right knee degenerative arthritis and chondromalacia patella is granted.

Entitlement to service connection for left knee degenerative arthritis and chondromalacia patella is granted.

Entitlement to service connection for right ankle tarsal tunnel syndrome is denied.

Entitlement to service connection for left ankle ganglion cyst and ruptured saphenous vein is granted.

Entitlement to service connection for left great toe matrixectomy, with left medial foot scar is granted.

FINDINGS OF FACT

1. The competent and credible evidence of record persuasively establishes a finding that the disabilities of tinnitus, the cervical and thoracic spines, radiculopathy of the right upper extremity, bilateral knees, left ankle, left great toe, and left foot scar are related to service.

2. The competent and credible evidence of record persuasively establishes a finding that there is no current right ankle diagnosis.

CONCLUSIONS OF LAW

1. The criteria for entitlement to 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 entitlement to service connection for cervical spine degenerative arthritis have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

3. The criteria for entitlement to service connection for thoracic strain have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

4. The criteria for entitlement to service connection for right upper extremity radiculopathy have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

5. The criteria for entitlement to service connection for right knee degenerative arthritis and chondromalacia patella have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

6. The criteria for entitlement to service connection for left knee degenerative arthritis and chondromalacia patella have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

7. The criteria for entitlement to service connection for right ankle tarsal tunnel syndrome have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

8. The criteria for entitlement to service connection for left ankle ganglion cyst and ruptured saphenous vein have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

9. The criteria for entitlement to service connection for left great toe matrixectomy, with left medial foot scar have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from January 2006 to
0, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from January 2006 to June 2006, with additional National Guard service. The record demonstrates that the Veteran was employed as an Excepted Service National Guard Dual Status Technician until February 2019. At the September 2024 Board hearing, he testified that he was a member of the National Guard and worked full time as a federal technician wearing the military uniform.

This case comes before the Board of Veterans' Appeals (Board) on appeal from a January 2020 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

In the December 2020 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held in September 2024. Therefore, the Board may only consider the evidence of record at the time of the January 2020 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or 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.

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.

Service Connection

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (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 - the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

In addition, service connection for certain chronic diseases may be established on a presumptive basis by showing that the condition manifested to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258, 271-72 (2015). Although the disease need not be diagnosed within the presumptive period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a).

Additionally, for certain chronic diseases with potential onset during service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at
C.F.R. §§ 3.307, 3.309(a); Fountain v. McDonald, 27 Vet. App. 258, 271-72 (2015). Although the disease need not be diagnosed within the presumptive period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a).

Additionally, for certain chronic diseases with potential onset during service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge may support the claim. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Significantly, certain statutes, including 32 U.S.C. § 709 (Technicians: employment, use, status), provide that National Guard members and Reservists may work for their respective components and may be required to wear the service uniform; however, this type of employment does not qualify as active duty for training (ACDUTRA) or inactive duty for training (INACDUTRA) for VA compensation purposes.

Only "veterans" are entitled to VA compensation. 38 U.S.C. § 1110. The term "veteran" means a person who served in the active military, naval, or air service, and who was discharged or released therefrom under conditions other than dishonorable. 38 U.S.C. § 101(2); 38 C.F.R. § 3.1(d).

Active military, naval, or air service includes any period of ACDUTRA during which the individual concerned was disabled or died from disease or injury incurred in or aggravated in the line of duty; or any period of INACDUTRA during which the individual concerned was disabled or died from injury, but not disease, incurred in or aggravated in the line of duty. 38 U.S.C. §§ 101(21), (24), 106; 38 C.F.R. § 3.6(a), (d). The fact that a claimant has established status as a "veteran" for other periods of service (active duty, etc.) does not obviate the need to establish that he is also a "veteran" for purposes of the period of ACDUTRA or INACDUTRA where the claim for benefits is premised on that period. Mercado-Martinez v. West, 11 Vet. App. 415, 419 (1998). However, once a claimant has achieved veteran status for a single disability incurred or aggravated during a period of ACDUTRA or INACDUTRA, that status applies to all disabilities claimed to have been incurred or aggravated during that period. Hill v. McDonald, 28 Vet. App. 243, 252 (2016).

Reserve and National Guard service generally means ACDUTRA and INACDUTRA, although in more recent times it also has come to include active duty. ACDUTRA is full time duty for training purposes performed by Reservists and National Guardsmen pursuant to 32 U.S.C. §§ 316, 502, 503, 504, or 505. 38 U.S.C. § 101(22); 38 C.F.R. § 3.6(c). Basically, this refers to the two weeks of annual training which each Reservist or National Guardsman must perform each year. It can also refer to the Reservist's or Guardsman's initial period of training. INACDUTRA includes duty, other than full-time duty, performed for training purposes by Reservists and National Guardsmen pursuant to 32 U.S.C. §§ 316, 502, 503, 504, or 505. 38 U.S.C. § 101(23); 38 C.F.R. § 3.6(d). Basically, this refers to the twelve four-hour weekend drills that each Reservist or National Guardsman must perform each year. These drills are deemed to be part-time training.

A military technician (dual status) is a Federal civilian employee who is employed under section 3101 of Title 5 or section 709(b) of Title 32; is required as a condition of that employment to maintain membership in the Selected Reserve; and is assigned to a civilian position as a technician in the organizing, administering, instructing, or training of the Selected Reserve or in the maintenance and repair of supplies or equipment issued to the Selected Reserve or the armed forces. 10 U.S.C. § 10216. There is no legal basis upon which to establish service connection for diseases or injuries incurred during civilian employment. See e.g., Venturella v. Gober, 10 Vet. App. 340 (1997) (holding that where a claimant has status as a Reserve/Guard member and as a civilian military employee, service connection is not in order for those diseases or injuries that were incurred during civilian employment).

1. Entitlement to service connection for tinnitus

The Veteran alleges that tinnitus began during service and has existed since that time.

First, the Board finds that there is a current disability. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). The Veteran underwent a VA examination in October 2019 where the examiner confirmed a diagnosis of tinnitus. Accordingly, the first element of service connection is met.

Second, the Board finds that there was an in-service event, injury or disease. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). A careful review of the Veteran's service treatment records (STRs) finds a complaint of tinnitus on a 2018 hearing conversation report. At the October 2019 VA examination, he asserted that the condition began in 2012, and was related to noise exposure during service. His DD-214 confirms that his military occupational specialty (MOS) was aircraft metals technology journeyman, which the Board concludes would reasonably expose him to loud noise. The Board finds the Veteran's statements competent as they are capable of lay observation. 38?U.S.C. §?1154(a); Washington v. Nicholson, 19 Vet. App. 362, 368 (2005) (noting that a lay witness is competent to report to factual matters of which he or she has first-hand knowledge). Further, these statements have been corroborated by the STRs and military personnel records. Caluza v. Brown, 7 Vet. App. 498, 511 (1995) (noting that the probative value of a witness statement may be affected by inconsistency with other evidence), aff'd, 78 F.3d 604 (Fed. Cir. 1996). Accordingly, the second element of service connection is met.

Third, the Board finds that the evidence of record does support a finding that the tinnitus is related to active service.

The October 2019 VA examiner provided a positive nexus opinion. They explained that the tinnitus is related to aircraft metals technology which has a high probability of hazardous noise exposure. They concluded that it was at least as likely as not that the condition began in 2012 related to metal shop sounds, and the flight line sounds of jets and helicopter engines. The examiner also noted that it had been less than one year post separation.

The AOJ obtained an addendum opinion in December 2019 where the examiner noted that there were no complaints of tinnitus during service, and that the 2018 report of tinnitus was outside service. They concluded that because the Veteran wore hearing protection, and had hearing within normal limits, it was less likely than not that the Veteran's tinnitus was related to service.

The Board affords the October 2019 medical opinion significant probative value as it was conducted by a medical professional with consideration of the Veteran's lay statements, and specific facts in this case, and is supported by well-reasoned rationale. Factors for assessing the probative value of a medical opinion include the thoroughness and detail of the opinion. Prejean v. West, 13 Vet. App. 444, 448-9 (2000). A medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008).

Low prob
related to service.

Low probative value is afforded to the December 2019 opinion as the examiner erred in finding that the 2018 report of tinnitus was outside service. A medical opinion based upon an inaccurate factual premise has no probative value. Reonal v. Brown, 5 Vet. App. 458, 461 (1993). The examiner's error is unsurprising, the Veteran's service as a dual service technician is incredibly uncommon, and it is not immediately clear by the record without an understanding of what a dual service technician means.

As the probative evidence of record is in the Veteran's favor, the Board finds that the criteria for the claim of entitlement to service connection for tinnitus have been met, and the appeal is granted.

2. Entitlement to service connection for cervical spine degenerative arthritis

3. Entitlement to service connection for thoracic strain

4. Entitlement to service connection for right upper extremity radiculopathy

5. Entitlement to service connection for right knee degenerative arthritis and chondromalacia patella

6. Entitlement to service connection for left knee degenerative arthritis and chondromalacia patella

7. Entitlement to service connection for right ankle tarsal tunnel syndrome

8. Entitlement to service connection for left ankle ganglion cyst and ruptured saphenous vein

9. Entitlement to service connection for left great toe matrixectomy, with left medial foot scar

The Veteran alleges that these conditions began during service and have existed since that time.

First, the Board finds, with the exception of the right ankle, that there is a current disability. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). The Veteran underwent VA examinations in October 2019 where the examiner confirmed diagnoses of degenerative arthritis of the cervical spine, radiculopathy of the right upper extremity, thoracic strain, bilateral degenerative of the knees, bilateral chondromalacia patella, left ankle ganglionic cyst and ruptured saphenous vein, matrixectomy left great toe, and left medial foot scar.

Regarding the Veteran's claimed right ankle tarsal tunnel syndrome, the examiner found no current diagnosis. Importantly, where pain alone results in functional impairment of earning capacity, even if there is no identified underlying diagnosis, it can constitute a disability. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). However, upon examination, the Veteran denied any pain, and had no functional loss of the right ankle. The Board acknowledges notations of tarsal tunnel syndrome in his STRs; however, service connection requires a current diagnosis. Accordingly, with the exception of the right ankle, the first element of service connection is met.

Second, the Board finds that there was an in-service event, injury or disease. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). October 2018 STRs noted neck pain and right arm pain, and a reversal of the curvature of the cervical spine. September 2010 STRs indicated a report of back pain. October 2018 STRs indicated thoracic pain after elk hunting. Knee pain was noted in October 2008, April 2012, October 2014, and November 2014. STRs in February 2016, August 2016, and November 2016 indicated ankle pain, with diagnoses to include ankle joint capsulitis, possible nerve entrapment, possible tarsal tunnel syndrome, ganglion cyst, ligament tear, and mild strain.

At the September 2024 Board hearing, the Veteran testified that his musculoskeletal conditions were primarily related to lifting heavy metals on the flight line, wearing a heavy welding mask, running, and physical training. Regarding the toe, the Veteran admitted that he had his toenail removed prior to service, but that it continued to cause problems due to regular running, and restrictive safety toe boots, so it was permanently removed. The Board finds
and November 2014. STRs in February 2016, August 2016, and November 2016 indicated ankle pain, with diagnoses to include ankle joint capsulitis, possible nerve entrapment, possible tarsal tunnel syndrome, ganglion cyst, ligament tear, and mild strain.

At the September 2024 Board hearing, the Veteran testified that his musculoskeletal conditions were primarily related to lifting heavy metals on the flight line, wearing a heavy welding mask, running, and physical training. Regarding the toe, the Veteran admitted that he had his toenail removed prior to service, but that it continued to cause problems due to regular running, and restrictive safety toe boots, so it was permanently removed. The Board finds the Veteran's statements competent as they are capable of lay observation. 38?U.S.C. §?1154(a); Washington, 19 Vet. App. at 368. Further, these statements have been corroborated by the STRs. Caluza, 7 Vet. App. at 511. Accordingly, the second element of service connection is met.

Third, the Board finds that the evidence of record does support a finding that the these conditions are related to active service.

The Board observes that although the AOJ afforded the Veteran VA examinations, they did not obtain any nexus opinions for these claimed conditions. Given the Veteran's complicated service status, rather than remanding for opinions, the Board will not further delay adjudication of these claims. The Veteran's credible lay testimony was readily corroborated by his STRs. Notably, he submitted his claim within one year of separation from service. The Veteran has also submitted several statements in support of his claim from his wife, and fellow servicemembers who attested to seeing the Veteran struggle with these conditions from service.

Accordingly, the criteria for the claims of entitlement to service connection for disabilities of the cervical spine, thoracic spine, radiculopathy of the right upper extremity, bilateral knees, left ankle, left great toe, and foot scar have been met, and that extent, the appeal is granted.

However, the criteria for the claim of entitlement to service connection for the right ankle have not been met, and to that extent, the appeal is denied.

In reaching this decision the Board considered the doctrine of reasonable doubt. In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence persuasively favors the claim or is in approximate balance, with the Veteran prevailing in either event, or whether the evidence persuasively weighs against the claim, in which case the claim is denied. In other words, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (2021). Here, however, as the evidence is persuasively against the claim and the positive and negative evidence is not in approximate balance, the doctrine is not for application. Id.

Thomas L. English

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Rogos, J.

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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