HEARING LOSS

CORY M. PICTON · 2026 · Case ID: A26038404

MIXED

Summary

The Veteran served on active duty from April 2019 to August 2019. The Veteran appeals the denial of service connection for several conditions, including bilateral hearing loss, tinea pedis, rhinitis, sinusitis, bronchitis, a non-specific respiratory condition, migraines, right ankle condition, right shoulder condition, left knee condition, and bilateral plantar fasciitis. The Board denied service connection for hearing loss, tinea pedis, rhinitis, sinusitis, bronchitis, and a non-specific respiratory condition, finding that the Veteran did not have a current diagnosis for these conditions or that the criteria for service connection were not met. The Board remanded the claims for tinnitus, an acquired psychiatric disorder, right ankle condition, right shoulder condition, left knee condition, bilateral plantar fasciitis, and migraines. The remand for tinnitus was due to inadequate nexus opinions from VA examiners, which were conclusory and failed to adequately address the evidence or interpret relevant literature. The Board also noted that the Veteran's active duty service was confirmed, but periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) required verification. The Board could not consider evidence submitted after the AOJ decision for the denied claims but indicated such evidence would be considered by the AOJ on remand for the remanded claims.

Rationale

No current diagnosis of hearing loss; Criteria for service connection not met

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250317-547742

Full Decision Text

Citation Nr: A26038404
Decision Date: 04/23/26 Archive Date: 04/23/26

DOCKET NO. 250317-547742
DATE: April 23, 2026

ORDER

Entitlement to service connection for bilateral hearing loss is denied.

Entitlement to service connection for tinea pedis is denied.

Entitlement to service connection for rhinitis is denied.

Entitlement to service connection for sinusitis is denied.

Entitlement to service connection for bronchitis is denied.

Entitlement to service connection for non-specific respiratory condition is denied.

REMANDED

Entitlement to service connection for tinnitus is remanded.

Entitlement to service connection for an?acquired psychiatric is remanded.

Entitlement to service connection for right ankle condition is remanded.

Entitlement to service connection for right shoulder condition is remanded.

Entitlement to service connection for left knee condition is remanded.

Entitlement to service connection for bilateral plantar fasciitis is remanded.

Entitlement to service connection for migraines is remanded.

FINDINGS OF FACT

1. The Veteran does not have hearing loss for VA purposes.

2. The Veteran does not have a current diagnosis of tinea pedis.

3. The Veteran does not have a current diagnosis of rhinitis.

4. The Veteran does not have a current diagnosis of sinusitis.

5. The Veteran does not have a current diagnosis of bronchitis.

6. The Veteran does not have a current diagnosis of any respiratory condition or symptoms of a non-specific respiratory condition.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for hearing loss have not been met. 38 C.F.R. §§ 3.307 (a)(3), 3.309(a), 3.385.

2. The criteria for service connection for tinea pedis have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for rhinitis have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for service connection for sinusitis have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

5. The criteria for service connection for bronchitis have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

6. The criteria for service connection for non-specific respiratory condition have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active service from April 2019 to August 2019.

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 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

This appeal concerns several issues which were adjudicated in multiple rating decisions by the AOJ. As noted above, the review period for each issue is determined based on the date of the rating decision that adjudicated the issue. Accordingly, the Board notes the appropriate rating decisions for each issue.

In a March 2025 rating decision, the AOJ denied service connection for an acquired psychiatric disorder.

In a January 2025 rating decision, the AOJ denied service connection for migraines, right shoulder condition and tinnitus.

In a May 2024 rating decision, the AOJ denied service connection for bronchitis, non-specific respiratory condition, rhinitis and sinusitis.

In a September 2023 rating decision, the AOJ denied service connection for bilateral hearing loss, left knee condition and right ankle condition.

The Board notes that the September 2023 and May 2024 rating decisions were subject to higher level review. The higher level for rating decision considered the evidence of record at the time of the prior decision. If evidence was submitted during the period after the AOJ issued the prior decision, which was subsequently subject to higher-level review
5 rating decision, the AOJ denied service connection for migraines, right shoulder condition and tinnitus.

In a May 2024 rating decision, the AOJ denied service connection for bronchitis, non-specific respiratory condition, rhinitis and sinusitis.

In a September 2023 rating decision, the AOJ denied service connection for bilateral hearing loss, left knee condition and right ankle condition.

The Board notes that the September 2023 and May 2024 rating decisions were subject to higher level review. The higher level for rating decision considered the evidence of record at the time of the prior decision. If evidence was submitted during the period after the AOJ issued the prior 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, because the Board is remanding the claims of entitlement to service connection for tinnitus, an acquired psychiatric disorder, right ankle condition, right shoulder condition, left knee condition, plantar fasciitis and migraines, 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

Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease that was incurred or aggravated during active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). In general, service connection requires competent evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the two. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). When a disability is initially diagnosed after separation and not within any applicable presumptive period, service connection may be granted if all the evidence establishes that it was incurred in service. See 38 C.F.R. § 3.303 (d).

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). A layperson is competent to report on the onset and continuity of current symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a Veteran is competent to report that which he or she has personal knowledge).

If the positive and negative evidence is evenly or approximately balanced, the claimant receives the benefit of the doubt. See Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side, or another, is the benefit-of-the-doubt doctrine not for application).

In rendering a decision on appeal, the Board must analyze the credibility and probative value of all medical and lay evidence of record, account for evidence it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. 38 U.S.C. § 1154 (a); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006). Equal weight is not accorded to each piece of evidence; every item of evidence does not have the same probative value.

In this case, the Board has reviewed all the evidence of record, with an emphasis on the evidence relevant to this appeal. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that VA must review the entire record but does not have to discuss each piece of evidence). The analysis below focuses on the most salient
(Fed. Cir. 2006). Equal weight is not accorded to each piece of evidence; every item of evidence does not have the same probative value.

In this case, the Board has reviewed all the evidence of record, with an emphasis on the evidence relevant to this appeal. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that VA must review the entire record but does not have to discuss each piece of evidence). The analysis below focuses on the most salient and relevant evidence and on what this evidence shows, or fails to show, on the claims. The Veteran must not assume the Board overlooked pieces of evidence that are not explicitly discussed herein. See Timberlake v. Gober, 14 Vet. App. 122 (2000) (the law requires only that the Board address its reasons for rejecting evidence favorable to the Veteran).

1. Service connection for bilateral hearing loss.

Congress specifically limits entitlement for service-connected disease or injury to cases which result in a disability; thus, without proof of a present disability, there can be no claim. See Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

Service connection may not be established for disability due to impaired hearing unless the auditory threshold in any of the frequencies 500, 1000, 2000, 3000 or 4000 Hertz is 40 decibels or greater; or the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000or 4000 Hertz are 26 decibels or greater; or speech recognition scores using the Maryland CNC Test are less than 94 percent. (38 C.F.R. § 3.385).

The Board concludes, based on the evidence of record, that the Veteran does not have a current diagnosis of hearing loss for VA purposes 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); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); 38 C.F.R. § 3.303.

The Veteran was afforded a VA examination in February 2023, the Veteran's Maryland CNC Word List speech recognition score and pure tone thresholds, in decibels, were as follows:

HERTZ

1000 2000 3000 4000 Average CNC

LEFT 10 10 5 5 7.50 100%

RIGHT 5 5 10 5 6.25 100%

After review of the competent and probative evidence, the Board finds that service connection for hearing loss is not warranted as the Veteran does not have hearing loss for VA purposes. In particular, the record does not contain any examination which contains speech discrimination scores less than 94 percent nor any auditory thresholds in any of the frequencies of 500, 1000, 2000, 3000, or 4000 Hertz that were 40 decibels or greater or any auditory thresholds for at least three of these frequencies were not 26 decibels or greater.

The Veteran believes he has a hearing loss disability. However, this question requires objective audiological testing as defined in 38 C.F.R. § 3.385, which is outside the competence of a non-audiological expert such as the Veteran to conduct and assess. See Jandreau, 492 F.3d 1372 at 1377.

Accordingly, 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 is not warranted. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. As the weight of the competent and probative evidence is against the claim, service connection for hearing loss is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Lynch, 21 F.4th at 776.

2. Service connection for tinea pedis.

3. Service connection for rhinitis.

4
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 is not warranted. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. As the weight of the competent and probative evidence is against the claim, service connection for hearing loss is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Lynch, 21 F.4th at 776.

2. Service connection for tinea pedis.

3. Service connection for rhinitis.

4. Service connection for sinusitis.

5. Service connection for bronchitis.

6. Service connection for non-specific respiratory condition.

The Veteran contends that he has tinea pedis, rhinitis, sinusitis, bronchitis, and a non-specific respiratory condition as a result of his military service. See November 2023 VA Form 21-526EZ, Fully Developed Claim.

The existence of a current disability is the cornerstone of a claim for VA compensation. 38 U.S.C. §§ 1110, 1131; Degmetich v. Brown, 104 F.3d 1328 (1997). 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," McClain v. Nicholson, 21 Vet. App. 319, 321 (2007); or "when the record contains a recent diagnosis of disability prior to... filing a claim for benefits based on that disability." Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013).

In the absence of proof of a current disability, there can be no valid claim. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

A careful and thorough review of the evidence of record reflects that the Veteran does not have a diagnosis of tinea pedis, rhinitis, sinusitis, bronchitis, and a non-specific respiratory condition, nor did he have any such diagnosis at any time during the period on appeal. There is also no evidence of record that reflects complaints or treatment of symptoms related to any of these conditions. The Board acknowledges the Veteran's assertion that he has such conditions. Nevertheless, while he is competent to report the observable physical symptoms of these disabilities, he is not competent to provide a diagnosis or medical opinion. See Barr v. Nicholson, 21 Vet. App. 303 (2007). These issues are medically complex and require specialized medical education and knowledge of the interaction between multiple systems in the body as well as the ability to interpret complicated diagnostic medical testing. See Jandreau, 492 F.3d 1372 at 1377.

In denying the Veteran's claim, the Board acknowledges that no medical opinions were obtained regarding the Veteran's claim of entitlement to service connection for tinea pedis, rhinitis, sinusitis, bronchitis, and a non-specific respiratory condition.

Under 38 U.S.C. § 5103A(d)(2), VA must provide a medical examination and/or obtain a medical opinion when there is: (1) competent evidence that the Veteran has a current disability (or persistent or recurrent symptoms of a disability); (2) evidence establishing that he suffered an event, injury or disease in service or has a disease or symptoms of a disease within a specified presumptive period; (3) an indication the current disability or symptoms may be associated with service; and (4) there is not sufficient medical evidence to make a decision. See McLendon v. Nicholson, 20 Vet. App. 79 (2006).

VA may also have duty to provide an examination under the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxins Act of 2022 (PACT Act). Pub. L. No. 117-168, 136 Stat. 1759 (2022). VA is required to provide a disability examination and/or obtain a medical opinion when a Veteran submits a claim for compensation and has (1) evidence of a disability and (2) participation in a toxic exposure risk activity (TERA), but the evidence is not sufficient to establish service connection for the disability. 38 U.S.C. § 1168(a).

Thus, whether using the McLendon or TERA standard, there must be some evidence of a current disability in order to trigger the AOJ's duty to assist by providing an examination.

Here, the
Address Comprehensive Toxins Act of 2022 (PACT Act). Pub. L. No. 117-168, 136 Stat. 1759 (2022). VA is required to provide a disability examination and/or obtain a medical opinion when a Veteran submits a claim for compensation and has (1) evidence of a disability and (2) participation in a toxic exposure risk activity (TERA), but the evidence is not sufficient to establish service connection for the disability. 38 U.S.C. § 1168(a).

Thus, whether using the McLendon or TERA standard, there must be some evidence of a current disability in order to trigger the AOJ's duty to assist by providing an examination.

Here, the Veteran has not provided evidence that he has a diagnosis of any of these conditions or that he experiences persistent or recurrent symptoms of any of the claimed conditions. Accordingly, the AOJ was not requested to provide the Veteran with a VA examination.

In sum, the persuasive evidence of record is against the Veteran's claims; the evidence is not in approximate balance, and the benefit of the doubt rule is inapplicable. Thus, entitlement to service connection for tinea pedis, rhinitis, sinusitis, bronchitis, and a non-specific respiratory condition are denied.

REASONS FOR REMAND

Initially, the Board notes that in addition to his active service, the record establishes that the Veteran had various periods of periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA). See June 2023 Service Record. While the record confirms his active service, the record does not confirm any period of ACDUTRA and INACDUTRA. The AOJ must attempt to verify all of the Veteran's periods of active duty, ACDUTRA, and INACDUTRA service.

1. Service connection for tinnitus

The Veteran was afforded a VA examination in February 2023. At the examination the Veteran stated that his tinnitus started six months after basic training. The examiner provided a negative nexus opinion. The examiner reasoned that the Veteran's hearing evaluation indicated normal peripheral hearing thresholds in both ears. See February 2023 VA Examination. The examiner did not provide any other rationale or further explain his rationale. The examiner did not provide any further reasoning for this finding. Consequently, this rationale is too conclusory and is therefore inadequate. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A] medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions").

The AOJ obtained a second opinion regarding direct service connection. The Veteran was afforded another VA examination in October 2024. The Veteran reported that his tinnitus started in December 2019. The examiner stated "[a]lthough the Veteran reports onset of tinnitus in December 2019, he denied the presence of tinnitus on Annual Periodic Health Assessments in December 2019, November 2020, & November 2021. It was first documented on Hearing Conservation Data in December 2022." The examiner then stated that current literature does not support late onset noise-induced tinnitus. In support of this, the examiner cited a Institute of Medicine (ION) 2006 report which concluded that there was no scientific basis to conclude that tinnitus directly attributable to noise exposure will develop long after noise exposure. See October 2024 VA Examination.

The Board finds the October 2024 opinion is also inadequate as it does not provide an adequate rationale. Specifically, the 2006 IOM report itself states that there is no sufficient scientific basis for the existence of delayed onset hearing loss, but also goes on to say that "[t]here is not sufficient evidence from longitudinal studies in laboratory animals or humans to determine whether permanent noise-induced hearing loss can develop much later in one's lifetime, long after the cessation of that noise exposure" and that "definitive studies to address this issue have not been performed." Noise and Military Service: Implications for Hearing Loss and Tinnitus, IOM (2006). On remand, understanding and interpreting the contradictory or qualifying aspects of the 2006 IOM study is required from the medical expert who wrote the opinion or from another source. McCray v. Wilkie, 31 Vet. App. 243, 249 (2019).

For these reasons, the Board concludes that the opinions of record do not provide an adequate rationale regarding whether the Veteran's tinnitus had its onset in service or is otherwise related to service. Consequently, the Board finds the medical evidence insufficient to make a fully informed decision on the issue and the AOJ's failure to obtain an addendum opinion for clarification amounts to a pre-decisional duty to assist error that must be corrected. 38 C.F.R.
). On remand, understanding and interpreting the contradictory or qualifying aspects of the 2006 IOM study is required from the medical expert who wrote the opinion or from another source. McCray v. Wilkie, 31 Vet. App. 243, 249 (2019).

For these reasons, the Board concludes that the opinions of record do not provide an adequate rationale regarding whether the Veteran's tinnitus had its onset in service or is otherwise related to service. Consequently, the Board finds the medical evidence insufficient to make a fully informed decision on the issue and the AOJ's failure to obtain an addendum opinion for clarification amounts to a pre-decisional duty to assist error that must be corrected. 38 C.F.R. § 3.159. Accordingly, entitlement to service connection for tinnitus is remanded.

2. Service connection for an?acquired psychiatric disorder.

3. Service connection for right ankle condition.

The Veteran contends that he has a mental health condition and a right ankle condition as a result of his military service. See November 2022 VA Form 21-526EZ, Fully Developed Claim

Initially, the Veteran filed a claim for service connection for a mental health condition. A review of the record confirms that the Veteran has been diagnosed with anxiety, depression and a trauma-and stressor related or posttraumatic stress disorder. Accordingly, the Board has recharacterized his claim as an?acquired psychiatric disorder. See Clemons v. Shinseki,?23?Vet. App.?1?(2009) (holding that the scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by the description, reported symptoms, and the record).

A verified stressor is not required for an acquired psychiatric disability other than posttraumatic stress disorder and no verified stressor required when a disability first manifested during service.

The Veteran has not been afforded a VA examination for either condition. However, the Veteran has been diagnosed with an acquired psychiatric disorder and a right ankle sprain. Furthermore, the record contains evidence establishing an "in-service event, injury or disease. Specifically, the Veteran makes statements regarding the events that occurred in service and the subsequent impacts that he believes it has had on his mental health. See September 2024 VA Form 21-0781, Statement in Support of Claim for PTSD. The record also contains a buddy statement regarding the onset of the Veteran's acquired psychiatric disorder. See September 2024 VA Form 21-10210, Lay Witness Statement. Regarding the claimed ankle injury, the record contains a sick call slip that establishes that the Veteran sought medical treatment for a foot injury. See January 2023 JLV/MTF, page 10.

Accordingly, The Board finds that the Veteran's acquired psychiatric disorder and right ankle sprain may be related to service. Thus, the low McLendon threshold has been met and the AOJ should have obtained the proper VA examination for each condition.

Therefore, the Board finds that a pre-decisional duty-to-assist error has occurred in that a medical examination and opinion should have been obtained to determine the nature and etiology of the Veteran's acquired psychiatric disorder and right ankle sprain. Accordingly, a remand is necessary.

4. Service connection for right shoulder condition.

The Veteran filed a claim for right shoulder condition. See November 2022 VA Form 21-526EZ, Fully Developed Claim.

The Veteran was afforded a VA examination in March 2023. The examiner found that the Veteran does not have a current diagnosis associated with the claim condition. However, the examiner provided a positive nexus opinion. The examiner stated "the claimed condition of right shoulder spasm is at least likely as not to have incurred in the basic training injury and has not improved despite maximal outpatient conservative therapy." See March 2023 VA Examination.

The Veteran was afforded a second VA examination in November 2024. This time, the Veteran was diagnosed with strain of muscle and tendon of back wall of thorax, sequela. The examiner provided a negative nexus opinion. The examiner concluded that the claimed condition was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness. The examiner did not provide an opinion regarding direct service connection.

For the following reasons, the Board finds that a remand is necessary. First, the Board finds conflicting information regarding the Veteran's currently diagnosed right shoulder conditions. The March 2023 examiner found no shoulder conditions. Subsequently, the same examiner provided a positive nexus for right shoulder spasms. However, the Veteran was not diagnosed with right shoulder spasms. Thereafter, the November 2024 examiner diagnosed the Veteran with strain of muscle and tendon of back wall of thorax, sequela. Consequently, clarification is needed regarding all of the Veteran's currently diagnosed right shoulder conditions.

Second, the record is unclear
natural progression by an in-service injury, event, or illness. The examiner did not provide an opinion regarding direct service connection.

Second, the record is unclear regarding when the Veteran's shoulder condition first began. The November 2024 examiner determined that the condition pre-existed service. Specifically, the examiner stated "Veteran states he had no known shoulder injury prior to service. Reports that he played baseball when he was 7 years old but did not have a shoulder injury/condition resulting from this. Entrance exam is not available in claims file. Therefore, the claimed condition was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness". However, at the March 2023 and November 2024 examinations the Veteran stated that his shoulder was first injured during basic training. The Board notes a medical slip dated July 18, 2022, states that the pain started in January 2022. However, this note simply states that the current pain started in January 2022. It does not address the original injury. Accordingly, it is unclear when the injury occurred.

Third, if the condition did pre-exist military service the November 2024 opinion is still inadequate. It is not possible to determine that the Veteran's condition was clearly and unmistakably not aggravated beyond its natural progression by service if the level of severity could not be determined at entrance, as the November 2024 examiner appears to conclude. The examiner does not provide any other reasoning for this finding. See Stefl, 21 Vet. App. at 124.

As the opinions of record are inadequate, the Board finds the medical evidence insufficient to make a fully informed decision on the issue and the AOJ's failure to obtain an addendum opinion for clarification amounts to a pre-decisional duty to assist error that must be corrected. 38 C.F.R. § 3.159. Accordingly, entitlement to service connection for right shoulder condition is remanded.

5. Service connection for left knee condition.

The Veteran was afforded a VA examination in March 2023. At the examination the Veteran stated his left knee condition began in May 2019, during basic training. The Veteran stated that the condition has resulted in the same pain and that it was never below a three out of ten. The examiner diagnosed the Veteran with left knee strain and noted a date of diagnosis of June 2019. The examiner then provided a negative nexus opinion. The examiner stated "claimant left knee condition is less likely than not caused by claimed injury or event in military service. Current records do not indicated long term damage or sequalae from a documented event that occurred June 2019 during basic training camp in Missouri." See March 2023 VA Examination.

The Board notes that a "current disability" for VA purposes is any diagnosis made during the period on appeal. See McLain v Nicholson, 21 Vet. App. 319, 321 (2007) (holding that a current disability exists if the diagnosed disability is present at the time the claim is filed or during the pendency of the claim, even if the disability resolves prior to adjudication).

Here, the March 2023 examiner first noted that the Veteran has a diagnosis of left knee strain and stated a diagnosis date of June 2019. However, the examiner then stated that the Veteran's condition was not caused by the inservice injury, finding no evidence of long term damage or sequalae from a documented event that occurred June 2019 during basic training. This finding implies that the Veteran does not have a current diagnosis of right knee strain or he has a current diagnosis of right knee strain but the date of diagnosis is not June 2019.

Further adding to the confusion, the record contains private medical records concerning the Veteran's left knee pain. While seeking treatment, the Veteran reported that his left knee pain started in April 2021 due to an unknown reason. See February 2023 Medical Treatment Record - Non-Government Facility, page 10. These records contradict the Veteran's statements at the March 2023 VA examination.

Due to the conflicting information regarding the onset of the Veteran's left knee strain, it is unclear whether the Veteran has a current disability of a left knee condition that began in or is otherwise related to service. The AOJ's failure
knee strain or he has a current diagnosis of right knee strain but the date of diagnosis is not June 2019.

Due to the conflicting information regarding the onset of the Veteran's left knee strain, it is unclear whether the Veteran has a current disability of a left knee condition that began in or is otherwise related to service. The AOJ's failure to obtain an addendum opinion for clarification amounts to a pre-decisional duty to assist error that must be corrected. 38 C.F.R. § 3.159.

6. Service connection for bilateral plantar fasciitis.

A remand is warranted to ensure VA's duty to assist is satisfied as to obtaining a medical opinion when necessary to decide a claim. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159 (c)(3). Specifically, the Veteran was afforded a VA examination in June 2024. The examiner noted that the Veteran has a diagnosis of plantar fasciitis. The examiner provided an opinion the same day. However, the opinion provided was concerning entitlement to service connection for flatfeet, rather than plantar fasciitis. Accordingly, no opinion was offered as to whether or not the Veteran's plantar fasciitis was related to service.

Therefore, the Board finds that a pre-decisional duty-to-assist error has occurred in that an opinion should have been obtained to determine the nature and etiology of the Veteran's plantar fasciitis and whether it was related to service.

7. Service connection for migraines.

For the following reasons, the Board finds remand is necessary.

Where a Veteran served continuously for 90 days or more during active service, and other organic diseases of the nervous system manifest to a degree of 10 percent within one year from date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309.

Migraine headaches, as an "other organic disease of the nervous system," are an enumerated condition under 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

The Veteran was afforded a VA examination in December 2024. The Veteran reported that his migraines began as early as 2020. The examiner diagnosed the Veteran with a migraine disability. The examiner provided a negative nexus opinion. The examiner reasoned that there was not enough evidence to substantiate a claim of migraines during military service. The examiner then stated that the medical record is silent for any diagnosis of migraines or symptoms directly related to migraines during military service. Additionally, the examiner stated that the migraine symptoms were reported after military service and cannot be directly attributed to a diagnosis of migraines at this time.

The examiner's opinion appears to be based on a lack of treatment during active military service. See Dalton v. Nicholson, 21 Vet. App. 23 (2007) (An opinion based on the absence of treatment records without consideration of a Veteran's competent reports is inadequate); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (noting that Board cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence).

While the examiner acknowledged that the Veteran reported migraines after military service, the examiner seems to ignore the Veteran's statement that his migraines began within a year of military service and have continued since. Accordingly, the Board finds that the examiner did not adequately address the Veteran's symptoms.

Additionally, the Board notes that VA is required to consider all theories of entitlement to VA benefits that are either raised by the claimant or raised by the record. See Schroder v. West, 212 F.3d 1265, 1271 (Fed. Cir. 2000); Robinson v. Mansfield, 21 Vet. App. 545, 553 (2008). Here, In the December 2023 VA examination the Veteran stated that his tinnitus causes migraines. As this raises
the examiner seems to ignore the Veteran's statement that his migraines began within a year of military service and have continued since. Accordingly, the Board finds that the examiner did not adequately address the Veteran's symptoms.

Additionally, the Board notes that VA is required to consider all theories of entitlement to VA benefits that are either raised by the claimant or raised by the record. See Schroder v. West, 212 F.3d 1265, 1271 (Fed. Cir. 2000); Robinson v. Mansfield, 21 Vet. App. 545, 553 (2008). Here, In the December 2023 VA examination the Veteran stated that his tinnitus causes migraines. As this raises the theory of secondary service connection and entitlement to service connection for tinnitus is being remand. This issue is inextricably intertwined. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991).

The matters are REMANDED for the following action:

1. Verify all ACDTURA, and INACDTURA dates for his service. If necessary, a request should be made to the Defense Finance and Accounting Service (DFAS). Document all requests for information as well as all responses in the claims file.

2. Obtain an addendum opinion regarding the nature and etiology of the Veteran's tinnitus. The examiner should provide an opinion whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's tinnitus began in service or is otherwise the result of military service.

3. Schedule the Veteran for a VA examination regarding the nature and etiology of the Veteran's acquired psychiatric disorder. The examiner is asked to:

(a.) Identify any and all acquired psychiatric disorder(s).

(b.) For each diagnosed psychiatric disorder, the examiner is asked to determined is at least as likely as not (likelihood at least approximately balanced or nearly equal, if not higher) had its onset in service, or is otherwise related to his service.

4. Schedule the Veteran for VA examination to determine the nature and etiology of his right ankle condition. The examiner should provide an opinion whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's right ankle condition began in service, within one year of discharge therefrom, or is otherwise the result of military service.

5. Obtain an addendum opinion regarding the nature and etiology of the Veteran's right shoulder condition. The examiner should provide opinions on the following:

(a.) Identify any and all right shoulder conditions.

(b.) For each diagnosed condition, is there clear and unmistakable evidence that it predated service?

(c.) For each condition which the examiner determines clearly and unmistakably predated service, is there clear and unmistakable evidence it was not aggravated by service?

(d.) For each condition which did not predate service, did the disorder begin in service, or is it otherwise related to service?

The examiner is reminded 'clear and unmistakable' is evidence that cannot be misinterpreted or misunderstood; the conclusion that is undebatable.

6. Obtain an addendum opinion regarding the nature and etiology of the Veteran's planter fasciitis. The examiner should provide an opinion whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's planter fasciitis began in service, within one year of discharge therefrom, or is otherwise the result of military service.

7. Obtain an addendum opinion regarding the nature and etiology of the Veteran's migraine disability. The examiner should provide an opinion whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's migraine disability began in service, within one year of discharge therefrom, or is otherwise the result of military service.

(a.) The AOJ is required to consider all theories of entitlement to VA benefits that are either raised by the claimant or raised by the record.

Cory M. Picton

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Welch, Joshua H.

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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