TINNITUS

M. MILLS · 2026 · Case ID: A26038434

MIXED

Summary

The Veteran served on active duty from January 1985 to February 1986. The Veteran appeals the denial of service connection for bilateral hearing loss and a left shoulder disability, and the grant of service connection for tinnitus. The Board found that the Veteran's service treatment records and separation examination were silent regarding any complaints, diagnosis, or treatment of bilateral hearing loss or left shoulder disability. A VA examination in March 2021 diagnosed bilateral hearing loss but found no evidence linking it to service, opining it was not related to service due to lack of in-service complaints and the nature of noise-induced hearing loss. The Board found this opinion persuasive, noting the Veteran's lay opinion on etiology was nonprobative. For the left shoulder, the Board found no competent evidence of a current disability, as service records were silent, and the VA examiner noted no complaints or limitations. The Board granted service connection for tinnitus, finding it was present during service and currently, with no intercurrent cause, and that the Veteran's lay reports were credible. Service connection for bilateral hearing loss and left shoulder disability were denied due to lack of nexus and evidence of current disability, respectively.

Rationale

Tinnitus present during service and currently; No intercurrent cause identified; Veteran's reports found credible

Special Benefit

NO SPECIAL BENEFIT

Docket No.

211008-189841

Full Decision Text

Citation Nr: A26038434
Decision Date: 04/24/26 Archive Date: 04/24/26

DOCKET NO. 211008-189841
DATE: April 24, 2026

ORDER

Entitlement to service connection for tinnitus is granted.

Entitlement to service connection for bilateral hearing loss is denied.

Entitlement to service connection for a left shoulder disability is denied.

REMANDED

Entitlement to service connection for asthma is remanded.

Entitlement to service connection for asbestosis is remanded.

Entitlement to service connection for obstructive sleep apnea is remanded.

FINDINGS OF FACT

1. Tinnitus had onset during active service.

2. Bilateral hearing loss did not have onset in service, did not manifest to a compensable degree within one year of service, and is not otherwise related to service.

3. The Veteran does not have a current left shoulder disability related to service.

CONCLUSIONS OF LAW

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

2. The criteria for service connection for bilateral hearing loss are not 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 service connection for a left shoulder disability are not 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 January 1985 to February 1986.

These matters come before the Board of Veterans' Appeals (Board) on appeal from an August 2021 rating decision by a Department of Veterans Affairs (VA) regional office, which is the agency of original (AOJ).

In the October 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. On August 18, 2025, the Veteran's representative withdrew the hearing request. Therefore, the Board may only consider the evidence of record at the time of the August 2021 AOJ decision on appeal, as well as any evidence submitted by the Veteran or her representative within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 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 service connection for asthma, asbestosis, and obstructive sleep apnea, 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 for disability resulting from disease or injury incurred in or aggravated by active service. 38?U.S.C. §§?1110, 1131, 5107; 38?C.F.R. §?3.303. The three-element test for service connection requires evidence of: (1)?a current disability; (2)?in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

Certain chronic diseases, including sensorineural hearing loss and tinnitus, will be presumed related to service, absent an
injury incurred in or aggravated by active service. 38?U.S.C. §§?1110, 1131, 5107; 38?C.F.R. §?3.303. The three-element test for service connection requires evidence of: (1)?a current disability; (2)?in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

Certain chronic diseases, including sensorineural 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).

1. Entitlement to service connection for tinnitus

Tinnitus is a noise in the ears, such as ringing, buzzing, roaring, or clicking. YT v. Brown, 9 Vet. App. 195, 196 (1996). Tinnitus is the type of disability that is capable of lay observation. Charles v. Principi, 16 Vet. App. 370, 374 (2002).

In this case, the Board has no reason to doubt the Veteran's reports of experiencing tinnitus during service and presently and finds these statements credible.

As tinnitus, a chronic disease, was present during service and is present currently, and is not clearly attributable to an intercurrent cause, service connection is granted. See 38 C.F.R. §§ 3.303(b), 3.309(a); see also Fountain v. McDonald, 27 Vet. App. 258, 271 (2015); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

2. Entitlement to service connection for bilateral hearing loss

The Veteran asserts that she has bilateral hearing loss related to active service.

For?the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 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.

The absence of in-service evidence of hearing loss is not fatal to a claim for service connection. Ledford v. Derwinski, 3 Vet. App. 87, 89?(1992). Evidence of a current hearing loss disability (i.e., meeting the requirements of 38 C.F.R. § 3.385) and a medically sound basis for attributing such disability to service may serve as a basis for a grant of service connection for hearing loss. Hensley v. Brown, 5 Vet. App. 155, 159?(1993).

To establish service connection, the Veteran is not obliged to show that her hearing loss was present during active military service. However, if there is insufficient evidence to establish that a claimed chronic disability was present during service, the evidence must establish a nexus between her current disability and her in-service exposure to loud noise. Godfrey v. Derwinski,?2 Vet. App. 352?(1992).

The question for the Board is whether the Veteran has a current hearing loss disability that began during service or is related to an in-service injury, event, or disease.

The Veteran's service treatment records reflect there were no complaints, diagnosis, or treatment of bilateral hearing loss. Hearing tests administered during service did not indicate hearing loss for VA purposes. As such, the Board must determine whether the Veteran's hearing loss is otherwise related to service.

The question for the Board is whether the Veteran has a current hearing loss disability that began during service or is related to an in-service injury, event, or disease.

The Veteran underwent VA examination in connection with this claim in March 2021. 07/28/2021 C&P Examination. The examiner diagnosed bilateral hearing loss and noted the Veteran's service as a boatswain's mate put her at a high risk of noise exposure, but opined that there was no evidence to indicate the condition was the result of an event, disease, or injury in service. The examiner noted that evidence from several studies is sufficient to conclude that the most pronounced effects of noise-induced hearing loss would occur immediately following exposure, with recovery to stable thresholds within 30 days. The examiner further indicated that available anatomical and physiological evidence suggested that post-exposure hearing loss was not likely. As there was insufficient evidence to suggest that permanent hearing loss could develop much later in one's lifetime, long after the cessation of noise exposure, the examiner opined that the Veteran's hearing loss was not related to service.

While the Veteran may believe that her current hearing loss disability is related to exposure to noise in service, she is not competent to offer opinions as to the etiology of hearing loss, as medical expertise is required. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). In that regard, the question of causation involves a medical subject concerning an internal physical process extending beyond an immediately observable cause-and-effect relationship. As such, the question of etiology in this case may not be competently addressed by lay evidence, and the Veteran's own opinion is nonprobative evidence.

There is no competent evidence of a nexus between the hearing loss disability and service to weigh against the VA medical opinion. Thus, the Board finds that the evidence persuasively weighs against finding a nexus between the bilateral hearing loss disability and exposure to noise in service.

The presumptive service connection provisions of?38 C.F.R. § 3.309(b) based on chronic in-service symptoms and continuous post-service symptoms apply to hearing loss. However, here, there is no competent evidence of continuity of symptomatology. The service treatment records do not show complaints of hearing loss in service, and the Veteran's hearing was assessed as normal. As a result, service connection for a hearing loss disability cannot be presumed, as there is no competent evidence of a hearing loss disability within one year following service or of continued symptomatology since service.

For?the above reasons, the evidence weighs persuasively against a finding that service connection for a hearing loss disability is warranted. Accordingly, there is no benefit of the doubt to resolve in the Veteran's favor, and the claim for service connection for bilateral hearing loss is denied. 38 U.S.C. §?5107; 38 C.F.R. §?3.102.

3. Entitlement to service connection for a left shoulder disability

The Veteran asserts that she has a left shoulder disability related to service.

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

The Board concludes that the evidence weighs persuasively against a finding that the Veteran has had a left shoulder disability any time during the pendency of the claims or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

Service treatment records do not reflect treatment for a left shoulder disability; a Report of Medical History and Report of Medical Examination completed upon the Veteran's separation from service are similarly silent. 01/14/2021 STR - Medical. In July 1985, the Veteran complained of bilateral scapular pain, more severe on the right side, but no shoulder pain. Id.

There are no post-service medical treatment records associated with the claims file. The Veteran did not submit any private treatment records in connection with these claims. The VA Form 21-526EZ that the Veteran filed to initiate this claim in April 2020 clearly provided her with notice of the action to take if she wished for VA to assist her in obtaining any outstanding medical records. 04/29/2020 VA 21-526EZ. To date, the Veteran has not provided a release
the Veteran's separation from service are similarly silent. 01/14/2021 STR - Medical. In July 1985, the Veteran complained of bilateral scapular pain, more severe on the right side, but no shoulder pain. Id.

There are no post-service medical treatment records associated with the claims file. The Veteran did not submit any private treatment records in connection with these claims. The VA Form 21-526EZ that the Veteran filed to initiate this claim in April 2020 clearly provided her with notice of the action to take if she wished for VA to assist her in obtaining any outstanding medical records. 04/29/2020 VA 21-526EZ. To date, the Veteran has not provided a release for any medical treatment records. Moreover, it appears that the Veteran has not been treated by VA. 03/23/2021 CAPRI.

The Board has also considered Saunders v. Wilkie,?886 F.3d 1356?(Fed. Cir. 2018), in which the Federal Circuit held 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." Id. at 1367-69. However, the Veteran has made no statements regarding pain or functional impairment related to the left shoulder beyond the bare assertion of entitlement to service connection.

The Veteran was afforded a VA examination in connection with this claim in March 2021, at which time the examiner diagnosed a right shoulder disability only. 03/18/2021 C&P Examination. The examiner noted no left shoulder complaints, and range of motion of the left shoulder was normal.

Accordingly, as the Board finds there is no competent evidence of a current left shoulder disability, to include functional impairment due to pain or other symptoms, the evidence weighs persuasively against the claim. As such, there is no doubt to resolve in the Veteran's favor and service connection for a left shoulder disability is denied. 38 U.S.C. §?5107; 38 C.F.R. §?3.102.

REASONS FOR REMAND

1. Entitlement to service connection for asthma

2. Entitlement to service connection for asbestosis

3. Entitlement to service connection for obstructive sleep apnea

The Veteran asserts that she developed respiratory disabilities, including asthma, asbestosis, and obstructive sleep apnea, during service. Alternatively, she contends that she developed these disabilities as a result of exposure to toxins in service, including asbestos, cleaning fluids, and "other chemicals."

It does not appear that development has been conducted to determine whether the Veteran engaged in toxic exposure risk activities (TERA) during active service; a TERA memorandum has not been prepared in the Veteran's case. As a result, to ensure the Veteran is provided every opportunity to establish her claims, as well as compliance with the most current guidance regarding VA's duties under the Sergeant First Class SFC Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act, the Board finds these matters should be remanded so that a TERA memorandum may be prepared to assess whether further development is required under the PACT Act.

With regard to asthma, the Board notes that a VA opinion was provided in April 2021. The examiner opined that, while the Veteran reported the onset of difficulty breathing in service, her current asthma was less likely than not incurred in service due to a lack of evidence corroborating her respiratory symptoms and lack of documentation on the separation examination. The mere lack of documented symptoms or treatment in service may not serve as the sole basis for a negative nexus opinion. Accordingly, whether or not the TERA memorandum indicates that the Veteran did, in fact, participate in TERA, a new opinion should be provided regarding asthma.

The matters are REMANDED for the following actions:

1. Prepare a TERA memorandum to assess whether the Veteran participated in TERA during active service as a result of her military occupational specialties (MOS) and/or any other garrison exposures. The memorandum should address the Veteran's claimed exposure to asbestos, cleaning fluids, and other chemicals. Conduct any additional development indicated.

2. After the above development is completed, the claims file should be sent to an appropriate examiner to offer an opinion as to whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the current asthma had onset during service or is otherwise related to an in-service injury, event, or disease, to include any TERA.

In offering the opinion, the examiner is asked to consider the Veteran's competent lay statements regarding the onset and course of her symptoms.

The need for an examination is left to the discretion of the examiner. A rationale for all opinions offered is requested as adjudicators are precluded from making any

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