KNEE IMPAIRMENT OF

CHRISTOPHER A. WENDELL · 2026 · Case ID: A26038524

DENIED

Summary

The veteran served from June 2013 to November 2016. This case involves appeals for service connection for several conditions: left knee, right knee, back, bilateral hearing loss, bruxism (claimed secondary to tinnitus), migraines (claimed secondary to tinnitus), vertigo (claimed secondary to tinnitus), anxiety (claimed secondary to tinnitus), GERD (claimed secondary to anxiety), and IBS (claimed secondary to anxiety). The Board denied all claims. For the knee and back conditions, the Board found no evidence of in-service complaints or current disability, and the VA examiner provided negative nexus opinions, citing normal evaluations in service and years of latency before complaints arose. The Board gave substantial weight to the contemporaneous STRs and the VA examiner's negative nexus opinions. For bilateral hearing loss, the Board noted the veteran's lay reports of noise exposure and hearing difficulty but found the January 2025 VA audiological examination results, which showed clinically normal hearing for VA purposes, to be the most probative evidence. The Board found no current hearing loss disability meeting VA criteria, thus denying the claim and any secondary claims related to tinnitus. For bruxism, migraines, vertigo, anxiety, GERD, and IBS, the Board denied service connection due to a lack of current diagnosed disability, which is a prerequisite for any claim, including secondary ones. The Board found the evidence persuasive against the claims, noting the remote onset of symptoms after service and the absence of current diagnoses, thus no benefit of the doubt was applied.

Rationale

STRs do not show in-service complaints or diagnosis.; 2013 VA exam showed normal evaluations.; January 2025 VA exam found clinically normal hearing acuity, no diagnosis of hearing loss.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250605-552219

Full Decision Text

Citation Nr: A26038524
Decision Date: 04/24/26 Archive Date: 04/24/26

DOCKET NO. 250605-552219
DATE: April 24, 2026

ISSUES

Entitlement to service connection for a left knee disability

Entitlement to service connection for a right knee disability

Entitlement to service connection for a back disability

Entitlement to service connection for bilateral hearing loss disability

Entitlement to service connection for bruxism, claimed as secondary to tinnitus

Entitlement to service connection for migraines, claimed as secondary to tinnitus

Entitlement to service connection for vertigo, claimed as secondary to tinnitus

Entitlement to service connection for anxiety, claimed as secondary to tinnitus

Entitlement to service connection for GERD, claimed as secondary to anxiety

Entitlement to service connection for IBS, claimed as secondary to anxiety

ORDER

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

Entitlement to service connection for a right knee disability is denied.

Entitlement to service connection for a back disability is denied.

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

Entitlement to service connection for bruxism, claimed as secondary to tinnitus is denied.

Entitlement to service connection for migraines, claimed as secondary to tinnitus is denied.

Entitlement to service connection for vertigo, claimed as secondary to tinnitus is denied.

Entitlement to service connection for anxiety, claimed as secondary to tinnitus is denied.

Entitlement to service connection for GERD, claimed as secondary to anxiety is denied.

Entitlement to service connection for IBS, claimed as secondary to anxiety is denied.

FINDINGS OF FACT

1. A left knee disability was not manifest in service or within one year of separation, and is not otherwise attributable to service.

2. A right knee disability was not manifest in service or within one year of separation, and is not otherwise attributable to service.

3. A back disability was not manifest in service or within one year of separation, and is not otherwise attributable to service.

4. The Veteran has clinically normal bilateral hearing for VA purposes.

5. The Veteran does not have currently a diagnosed bruxism disability.

6. The Veteran does not have currently diagnosed migraines.

7. The Veteran does not have a diagnosed vertigo disability.

8. The Veteran does not have a diagnosed chronic anxiety disability.

9. The Veteran does not have a diagnosed esophageal disability, including GERD.

10. The Veteran does not have diagnosed chronic IBS.

CONCLUSIONS OF LAW

1. A left knee disability was not incurred in or aggravated by service, and may not be presumed to have been incurred therein. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. A right knee disability was not incurred in or aggravated by service, and may not be presumed to have been incurred therein. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

3. A back disability was not incurred in or aggravated by service, and may not be presumed to have been incurred therein. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

4. Bilateral hearing loss disability was not incurred in or aggravated by service, and may not be presumed to have been incurred therein. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385.

5. Bruxism was not incurred in or aggravated by service, may not be presumed to have been incurred therein, and is not proximately due to, the result of, or aggravated by service-connected disease or injury. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310; Brammer v. Derw
; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385.

6. Migraines were not incurred in or aggravated by service, may not be presumed to have been incurred therein, and are not proximately due to, the result of, or aggravated by service-connected disease or injury. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310; Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

7. Vertigo was not incurred in or aggravated by service, may not be presumed to have been incurred therein, and is not proximately due to, the result of, or aggravated by service-connected disease or injury. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310; Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

8. Anxiety was not incurred in or aggravated by service, may not be presumed to have been incurred therein, and is not proximately due to, the result of, or aggravated by service-connected disease or injury. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310; Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

9. An esophageal disability, including GERD, was not incurred in or aggravated by service, may not be presumed to have been incurred therein, and is not proximately due to, the result of, or aggravated by service-connected disease or injury. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310; Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

10. IBS was not incurred in or aggravated by service, may not be presumed to have been incurred therein, and is not proximately due to, the result of, or aggravated by service-connected disease or injury. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310; Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from June 2013 to November 2016.

This matter is before the Board of Veterans Appeals (Board) on appeal from a March 2025 Appeals Modernization Act (AMA) rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The rating decision considered the evidence of record on that date. The Veteran timely appealed this decision to the Board by requesting the AMA Direct Review docket for a reevaluation of the evidence considered by the Agency of Original Jurisdiction (AOJ). In the AMA decision, the Agency of Original Jurisdiction (AOJ) made binding favorable findings. See 38 C.F.R. § 3.104(c
CONCLUSIONS

The Veteran served on active duty from June 2013 to November 2016.

Duties to Notify and Assist

The Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5102, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a).

In the June 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) (NOD), the Veteran elected the Direct Review option; 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. The Veteran declined a Board hearing. The Veteran handwrote the issues, some claimed as secondary to tinnitus and anxiety. The Board sympathetically considered the Veteran's contentions as a pro se appellant. Should the Veteran elect to appoint a representative, he is advised that he may submit a VA Form 21-22, Appointment of Veterans Service Organization as Claimant's Representative.

The Veteran in this case has not referred to any deficiencies in either the duties to notify or assist; therefore, the Board may proceed to the merits of the claim. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015, cert denied, U.S.C. Oct. 3, 2016) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board....to search the record and address procedural arguments when the [appellant] fails to raise them before the Board"); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to an appellant's failure to raise a duty to assist argument before the Board).

The Board has reviewed all of the evidence in the Veteran's claims file. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the Veteran or obtained on his behalf be discussed in detail. Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the claims file shows, or fails to show, with respect to the claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-130 (2000).

SERVICE CONNECTION

To establish service connection a Veteran must generally 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." Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d).

For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "Chronic." When the disease identity is established (leprosy, tuberculosis, multiple sclerosis, etc.), there is no requirement of evidentiary showing of continuity. Continuity of symptomatology is required only where the condition noted during service (or in the presumptive period) is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a
. § 3.303 (d).

Except as provided in § 3.300(c), disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. 38 C.F.R. § 3.310 (a). Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected. However, VA will not concede that a nonservice-connected disease or injury was aggravated by a service-connected disease or injury unless the baseline level of severity of the nonservice-connected disease or injury is established by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the nonservice-connected disease or injury. 38 C.F.R. § 3.310 (b).

We note that arthritis is a chronic disease, and as such, additional presumptive theories of entitlement are relevant in addition to direct service connection. See 38 C.F.R. §§ 3.303, 3.307, 3.309. Under 38 C.F.R. § 3.303 (b), service connection may be established by demonstrating continuity of symptomatology. Continuity may be established if a claimant can demonstrate (1) that a condition was "noted" during service; (2) evidence of post-service continuity of the same symptomatology; and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. The provisions of 38 C.F.R. § 3.303 (b) only apply to diseases recognized by VA as "chronic." See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013); 38 C.F.R. §§ 3.303 (b), 3.309(a). Chronic diseases that become manifest to a degree of 10 percent or more within one year of termination of active duty may be presumed to have been incurred in service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309.

VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154 (a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).

Lay evidence cannot be determined not credible merely because it is unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). However, the lack of contemporaneous medical evidence can be considered and weighed against a Veteran's lay statements. Id. The Board, as fact finder, is obligated to, and fully justified in, determining whether lay evidence is credible in and of itself, i.e., because of possible bias, conflicting statements, etc. Id. Further, a negative inference may be drawn from the absence of complaints for an extended period. See Maxson v. West, 12 Vet. App. 453, 459 (1999), aff'd sub nom. Maxson
. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). However, the lack of contemporaneous medical evidence can be considered and weighed against a Veteran's lay statements. Id. The Board, as fact finder, is obligated to, and fully justified in, determining whether lay evidence is credible in and of itself, i.e., because of possible bias, conflicting statements, etc. Id. Further, a negative inference may be drawn from the absence of complaints for an extended period. See Maxson v. West, 12 Vet. App. 453, 459 (1999), aff'd sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000).

1. Entitlement to service connection for a left knee, right knee, and back disabilities

By way of background, the Service Treatment Records (STRs) do not include any signs, symptoms, or complaints of knee or back pain at separation. The Report of Medical Examination from 2013 disclosed clinically normal evaluations of the lower extremities, feet, neurologic system, and spine, other musculoskeletal system.

Next, the Veteran was afforded a pair of January 2025 VA Knee and Back examinations with Disability Benefits Questionnaires (DBQs) and medical opinions, received by VA in February 2025. The VA examiner performed a physical examination and reviewed the entire claims file. The VA examiner reached negative nexus opinions. The VA examiner reasoned in part, "Per review of all potentially relevant evidence including the VA suggested records below, provider finds that all findings do not establish service connection or chronicity of care for the diagnosed lumbar strain and bilateral knee strain during or since service. The report of medical examination dated 1/12/2013 indicated no back or knee issues. No mention of back or knee issues. As such, a nexus can't be established."

Next, the March 2025 rating decision favorably found current disability diagnosed on VA examination, but no nexus to service. Additional records are substantially the same.

The Veteran contends that he is entitled to service connection for left knee, right knee, and back disabilities. In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to provide "evidence not requiring that the proponent have specialized education, training, or experience." 38 C.F.R. § 3.159 (a)(2). "Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person." See id. A layperson is also competent to report on the onset and continuity of their current symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a veteran is competent to report on that of which he or she has personal knowledge). When considering whether lay evidence is competent, the Board must determine, on a case-by-case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007).

Here, the most probative evidence is the contemporaneous treatment records, including the STRs, and the medical opinion of the VA examiner. First, the STRs do not show any knee or back disability, including any neurological manifestations. Years later, the Veteran filed the instant claims with complaints of knee and back pain. The Board assigns substantial probative weight to the contemporaneous treatment records.

Second, the Board also assigns substantial probative weight to the comprehensive medical opinions of the VA examiner. The VA examiner reviewed the entire claims file, and provided detailed reasons and bases in support of a negative nexus opinions. The VA examiner rendered negative nexus opinions implicitly encompassing all theories of direct and presumptive service connection for both knees and the back. The negative nexus opinions are supported by the objective evidence in the claims file, as cited to by the VA examiner. The VA examiner highlighted "Service treatment records do not support a chronic diagnosis, disability pattern or chronicity of care regarding the claimed condition while on active duty." Therefore, the Board assigns substantial probative weight to the negative nexus opinions of the 2025 VA examiner.

Regarding direct and presumptive service connection, the Board finds that the Veteran did not have the characteristic manifestations necessary to identify the disease entities in service. The claimed disabilities were not manifest in service or within one year
opinions. The VA examiner rendered negative nexus opinions implicitly encompassing all theories of direct and presumptive service connection for both knees and the back. The negative nexus opinions are supported by the objective evidence in the claims file, as cited to by the VA examiner. The VA examiner highlighted "Service treatment records do not support a chronic diagnosis, disability pattern or chronicity of care regarding the claimed condition while on active duty." Therefore, the Board assigns substantial probative weight to the negative nexus opinions of the 2025 VA examiner.

Regarding direct and presumptive service connection, the Board finds that the Veteran did not have the characteristic manifestations necessary to identify the disease entities in service. The claimed disabilities were not manifest in service or within one year from separation, and are not otherwise attributable to service. There is no probative evidence to the contrary. In addition, the Board finds that while competent to report by a physician that he has a diagnosis of bilateral knee strain and lumbsacral strain, the Veteran's own lay opinion regarding identifying a chronic disease pales in probative weight when compared to the objective medical evidence of record. Additional causal evidence against the claims, and while not dispositive, is the lapse of so many years between discharge and the first documented reports of a chronic condition many years after discharge. This multi-year gap after service provides highly probative evidence against the claim. See Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000).

An alternative method of establishing the second and third Shedden element, under 38 C.F.R. § 3.303 (b), is through a demonstration of continuity of symptomatology if the disability claimed qualifies as a chronic disease listed in 38 C.F.R. § 3.309 (a). Consideration of entitlement to service connection via the demonstration of continuity of symptomatology is applicable in the present case. However, the most probative evidence in the contemporaneous treatment records and VA medical opinion does not demonstrate such continuity. The VA examiner described the Veteran's medical history showing the remote onset of the claimed disease entities years after separation. Therefore, the Board finds that service connection on a direct and presumptive basis for knee and back disabilities is not warranted.

The Board also considered the Veteran's lay statements to the extent that he is competent to relate current pain in the knees and back. However, they are outweighed by the medical evidence of record. In this regard, the Board has specifically considered that Saunders clarified that evidence of pain alone which results in functional impairment, even if there is no identified underlying diagnosis, can constitute a disability. See Saunders v. Wilkie, 886 F.3d 1356 (2018). The United States Court of Appeals for the Federal Circuit (Federal Circuit) found that the term "disability" as used in 38 U.S.C. § 1110 "refers to the functional impairment of earning capacity, not the underlying cause of said disability," and held that "pain alone can serve as a functional impairment and therefore qualify as a disability." The Board observes that Saunders does not eliminate the need for underlying pathology, disease, or injury (also sometimes called a diagnosis).

Later, in Wait v. Wilkie, the United States Court of Appeals for Veterans Claims (Court) addressed the question of what is necessary for a claimant to demonstrate that his or her pain or other symptoms cause "functional impairment of earning capacity," and therefore meet the current disability requirement under Saunders. See Wait v. Wilkie, 33 Vet. App. 8 (2020). The Court held that, to meet the current disability requirement under Saunders, "there must be competent evidence specific to the claimant tending to show that his or her impairment rises to a level to affect earning capacity, which may include showing manifestations of a similar severity, frequency, and duration as those VA has determined by regulation would cause impaired earning capacity in an average person." The Court clarified that the Board must make the factual determination whether the appellant's manifestations rise to the level of a functional impairment in earning capacity.

Additionally, the Board observes that Saunders was in the context of the musculoskeletal system, though it does not explicitly hold that it is limited to such circumstances. Regardless, there is no additional functional impairment due to pain alone as is addressed by Saunders related to service. It follows that the weight of the evidence is against any indication of a relationship to service for any neurological manifestations of a knee or back disability. Therefore, even after considering Saunders, service connection for knee and back disabilities is not warranted.

In sum, the Board assigns the most probative weight to the contemporaneous medical records, including the STRs, and the findings of the VA examiner. The VA examiner reviewed the STRs, treatment records, and considered the Veteran's lay history. The VA examiner rendered negative nexus opinions for all theories of entitlement. The Board finds this to be the most probative evidence of record. The Board has considered direct service connection and theories of both a chronic disease manifesting within one year from separation and continuity of symptomatology where applicable. 38 C.F.R. §§ 3.303, 3.307, 3.309. The most probative evidence establishes the remote onset of any knee and back impairment. Additionally, the Board considered Saunders for all theories of entitlement. There is no probative evidence to the contrary. There is no doubt to resolve. Therefore, service connection for left knee, right knee, and back disabilities is not warranted.

2. Entitlement to service connection for bilateral hearing loss disability

The determination of whether a Veteran has a hearing loss disability is governed by 38 C.F.R. § 3.385. 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.

In addition to dictating objective test results, a VA audiologist must fully describe the functional effects caused by a hearing disability in his or her final report. Martinak v. Nicholson, 21 Vet. App. 447, 455 (2007).

By way of background, after filing his service connection claims, the Veteran was afforded a January 2025 VA audiological examination. On the authorized audiological evaluation, pure tone thresholds, in decibels, were as follow:

HERTZ

500 1000 2000 3000 4000

RIGHT 5 5 5 5 20

LEFT 10 5 0 5 5

The average decibel loss is 8.75 in the right ear. The average decibel loss is 3.75 in the left ear. Speech audiometry revealed speech recognition ability of 100 percent in the right ear and of 100 percent in the left ear. The VA examiner opined that use of the word recognition score was appropriate for this Veteran. The VA examiner opined that the test results are valid for rating purposes. In summary, the VA examiner found normal hearing for VA purposes in both the right and left ears. For both ears, the VA examiner indicated in the negative for an etiology opinion because the Veteran did not have a diagnosis of hearing loss for VA purposes.

Next, the March 2025 rating decision did not find sensorineural hearing loss for VA purposes. 38 C.F.R. § 3.385. The RO still conceded, "Your military occupation as a Patriot launching station enhanced operator/maintainer allows the VA to concede acoustic trauma." There was still no disability and no nexus.

The Veteran contends that he was exposed to noise in service, and that he is entitled to service connection for bilateral hearing loss disability, to include consideration of secondary service connection to tinnitus.

The Veteran is competent to provide evidence of that which he experiences, including a history of noise exposure in service and difficulty hearing. Layno v. Brown, 6 Vet. App. 465, 469 (1994). However, his lay reports regarding the onset and etiology of his claimed hearing loss are outweighed by the more probative objective medical evidence.

The most probative evidence is the clinically normal findings from the January 2025 VA examination. The VA examiner elicited a lay history from the Veteran, reviewed the entire claims file, and performed
he was exposed to noise in service, and that he is entitled to service connection for bilateral hearing loss disability, to include consideration of secondary service connection to tinnitus.

The most probative evidence is the clinically normal findings from the January 2025 VA examination. The VA examiner elicited a lay history from the Veteran, reviewed the entire claims file, and performed an audiometric examination. The VA examiner indicated clinically normal hearing acuity in both ears for VA purposes. In other words, under the governing regulation, the Veteran's measured hearing acuity in decibels and Maryland CNC test still did not rise to the accepted level for hearing loss disability for VA purposes. 38 C.F.R. § 3.385. In particular, none of the frequencies were greater than 20 decibels for either ear. The speech recognition scores were more than 100 percent. The Board assigns the most probative weight to the findings of the January 2025 VA examiner.

Here, the Board finds that the most recent January 2025 VA audiometric examination results do not establish bilateral hearing loss meeting the definition as required by VA. 38 C.F.R. § 3.385. The Board acknowledges the Veteran's sincere belief that he is entitled to service connection for bilateral hearing loss disability. However, the most probative evidence in the VA audiometric testing results demonstrates that he still does not have hearing loss disability for VA purposes in either ear. The Veteran has been afforded an examination to support his contentions. Regarding the arguments in the NOD of secondary service connection to tinnitus, even under Hensley, there must be current disability for VA purposes. VA is bound by the rating criteria in 38 C.F.R. § 3.385. There is no doubt to resolve. Therefore, service connection for bilateral hearing loss disability is not warranted.

3. Entitlement to service connection for bruxism, migraines, vertigo, anxiety, GERD, and IBS.

By way of background, the Service Treatment Records (STRs) do not show any signs, symptoms, or complaints of bruxism, migraines, vertigo, anxiety, GERD, or IBS. Years later, the March 2025 rating decision did not accept any of these diagnosed disabilities. The RO reminded the Veteran, "The evidence does not show a current diagnosed disability. (38 CFR 3.159, 38 CFR 3.303)." Months later, the June 2025 Notice of Disagreement (NOD) does not identify any evidence or suggest why the Board should reach an outcome different than that already reached by the RO based on no current disability. Additional treatment records are substantially the same.

The Veteran contends that he is entitled to service connection for bruxism, migraines, vertigo, anxiety, GERD, and IBS; claimed as secondary to tinnitus and anxiety. In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to provide "evidence not requiring that the proponent have specialized education, training, or experience." 38 C.F.R. § 3.159 (a)(2). "Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person." See id. A layperson is also competent to report on the onset and continuity of their current symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994) (a veteran is competent to report on that of which he or she has personal knowledge). When considering whether lay evidence is competent, the Board must determine, on a case-by-case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). The Veteran has not completely related a diagnostic impression of any of these current disabilities from a medical professional.

The Board observes that the existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110; see Degmetich v.
lay evidence is competent, the Board must determine, on a case-by-case basis, whether the Veteran's particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). The Veteran has not completely related a diagnostic impression of any of these current disabilities from a medical professional.

The Board observes that the existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110; see Degmetich v. Brown, 104 F. 3d 1328, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). 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).

Here, a grant of service connection is foreclosed for bruxism, migraines, vertigo, anxiety, GERD, and IBS because the evidence fails to disclose a competent impression of a chronic disability. This is the first element of service connection. As echoed by the RO, the evidence also does not establish that the Veteran suffered an event, injury or disease in service. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4). The Veteran has not identified any evidence suggesting the Board should reach a different outcome than the denial of benefits by the RO based on no current disability.

Concerning secondary service connection, this avenue is precluded as a matter of law because there must first be current diagnosed disability in order to consider secondary service connection. See 38 C.F.R. § 3.310; Sabonis v. Brown, 6 Vet. App. 426 (1994) (where the law is dispositive, the claim must be denied due to a lack of legal merit).

For these appeals, in the absence of proof of a present disability there can be no valid claim. Brammer, 3 Vet. App. at 225. The most persuasive evidence is the ongoing treatment records. Grants of service connection are foreclosed because the evidence fails to disclose current diagnostic impressions of the disabilities.

Additionally, the Board observes that the Veteran has not been provided with a VA examination and request for a medical opinion on the issue of direct causation for the alleged disabilities. The evidence does not establish that the Veteran suffered "an event, injury or disease in service," so it is not necessary to obtain a VA medical opinion with regard to etiology. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4). The Court of Appeals for Veterans Claims (Court) has held that VA is not required to provide a medical examination when there is no credible evidence of an event, injury, or disease in service. See Bardwell v. Shinseki, 24 Vet. App. 36 (2010). A conclusory generalized lay statement that service event or illness caused the claimant's purported disability is insufficient to require the Secretary to provide an examination. See Waters v. Shinseki, 601 F.3d 1274, 1278 (2010).

The Board has considered the Veteran's sincere belief that the benefit sought is warranted. The first documented complaints and application for service connection are several years after service. See generally Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The Board considered Saunders v. Wilkie, 886 F.3d 1356 (2018), but there still must be current disability to satisfy the first prong of service connection. Therefore, service connection for bruxism, migraines, vertigo, anxiety, GERD, and IBS is denied.

The Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record).

In reaching these conclusions, the evidence persuasively stands
Board considered Saunders v. Wilkie, 886 F.3d 1356 (2018), but there still must be current disability to satisfy the first prong of service connection. Therefore, service connection for bruxism, migraines, vertigo, anxiety, GERD, and IBS is denied.

In reaching these conclusions, the evidence persuasively stands against finding in favor of the claims in that it is not in "approximate balance" or "nearly equal" to the evidence that supports the claims. See Lynch v. McDonough, No. 20-2067 (Fed. Cir. 2021) (holding "[E]vidence is not in 'approximate balance' or 'nearly equal,' and therefore the benefit-of-the-doubt rule does not apply, when the evidence persuasively favors one side or the other.") Therefore, the service connection claims are denied.

CHRISTOPHER A. WENDELL

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board B. Bodi

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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