HEARING LOSS

KRISTIN HADDOCK · 2026 · Case ID: A26038837

DENIED

Summary

The veteran, who served in the U.S. Army from August 1975 to August 1978, appeals the denial of service connection for bilateral hearing loss. The Board acknowledged the veteran's conceded exposure to hazardous noise during service, consistent with his MOS as a Field Artillery Firefinder Radar Operator. The Board also acknowledged the veteran has a present bilateral hearing loss, meeting VA's definition. However, the Board found the evidence persuasively weighed against service connection. The veteran's service treatment records showed normal hearing at enlistment and separation, with no complaints or treatment for hearing loss during service. The earliest audiological evidence of hearing loss appeared many years after service. The Board found the veteran's assertions of in-service onset and worsening hearing loss inconsistent with medical records and not credible. While a July 2009 VA record noted noise trauma "may be related" to hearing loss, the Board found this insufficient to establish nexus, citing case law rejecting mere possibilities. Two VA contract audiological examiners provided opinions stating the hearing loss was less likely than not related to military noise exposure, citing normal audiograms at separation, lack of objective evidence of acoustic trauma, and the need for a specific nexus to military noise rather than other etiologies. These opinions were given substantial probative weight due to their rationale and consistency with the record. The Board concluded that the evidence was against a nexus, and as the evidence was not in approximate balance, the benefit of the doubt doctrine was not applicable. Service connection for bilateral hearing loss was therefore denied.

Rationale

Service treatment records showed normal hearing at enlistment and separation.; Earliest audiological evidence of hearing loss appeared many years after service.; VA examiners opined hearing loss was less likely than not related to military noise exposure.; No objective evidence of acoustic trauma from military noise exposure.; Veteran's assertions of in-service onset and worsening hearing loss were inconsistent with medical records and not credible.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210914-185246

Full Decision Text

Citation Nr: A26038837
Decision Date: 04/27/26 Archive Date: 04/27/26

DOCKET NO. 210914-185246
DATE: April 27, 2026

ORDER

Entitlement to service connection for bilateral hearing loss is denied.

FINDING OF FACT

The evidence of record persuasively weighs against finding that the Veteran's present bilateral hearing loss disability had its onset during service or is otherwise etiologically related to acoustic trauma sustained in service, or that it manifested to a compensable degree within a year of the Veteran's separation from service.

CONCLUSION OF LAW

The criteria for service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1112, 1131, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.385.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Army from August 1975 to August 1978.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from an August 2021 rating decision issued by a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). On the NOD received in September 2021, the Veteran elected the hearing docket. He testified at a Board hearing in May 2025, and the transcript of the hearing is of record. Therefore, the Board may only consider the evidence on file at the time of the rating decision on appeal and within 90 days following the date of the hearing. 38 C.F.R. § 20.302.

Service Connection

I. Law and Regulations

Service connection will be granted if the evidence demonstrates that current disability resulted from an injury suffered or disease contracted in active military, naval, or air service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service injury or disease; and (3) a relationship between the two. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Consistent with this framework, service connection is warranted for a disease first diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

Certain chronic diseases are subject to a grant of service connection on a presumptive basis when present to a compensable degree within the first post-service year, to include organic diseases of the nervous system. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. Hearing loss is classified as an organic disease of the nervous system. Fountain v. McDonald, 27 Vet. App. 258, 271 (2015).

Evidence of continuity of symptomatology from the time of service until the present is required where the chronicity of a chronic condition manifested during service either has not been established or might reasonably be questioned. 38 C.F.R. § 3.303(b); see Fountain, 27 Vet. App. at 263-64; see also Walker v. Shinseki, 708 F.3d 1331, 1340 (Fed. Cir. 2013) (holding that only conditions listed as chronic diseases in 38 C.F.R. § 3.309(a) may be considered for service connection under 38 C.F.R. § 3.303(b)).

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, 4000 Hertz (Hz) 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.

II. Pertinent Facts

Service treatment records include a July 1975 enlistment examination showing hearing thresholds in the right ear of 30, 15, 15 and 15 and in the left ear of 15, 15, 15, and 15 at 500, 1000, 2000 and 4000 Hertz, respectively. The Veteran's June 1978 ETS
least three of the frequencies 500, 1000, 2000, 3000, 4000 Hertz (Hz) 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.

II. Pertinent Facts

Service treatment records include a July 1975 enlistment examination showing hearing thresholds in the right ear of 30, 15, 15 and 15 and in the left ear of 15, 15, 15, and 15 at 500, 1000, 2000 and 4000 Hertz, respectively. The Veteran's June 1978 ETS (Expiration of Term of Service) examination report shows hearing thresholds in the right and left ears of 10 decibels at 500, 1000, 2000, 3000 and 4000 Hz.

An April 2001 VA primary care physician assistant note does not show hearing loss in the problem list and notes the Veteran did not have hearing loss. A May 2003 VA physician note also does not include hearing loss as an active problem and shows the Veteran had normal hearing ability to the whispered voice.

A July 2009 VA physician note shows that hearing loss was present with the Veteran being made nervous at times when people yelled at him in order for him to comprehend their communication. He was assessed as having hearing loss. He was noted to have been exposed to noise trauma while in artillery assignment in service which "may be related to his hearing loss." The record notes that the Veteran was proceeding with filing a claim for hearing loss to further evaluate this concern. Findings revealed that tympanic membranes were normal bilaterally and the Veteran had normal hearing ability to the whispered voice.

A VA problem list in May 2010 includes hearing loss.

A VA medical opinion was requested in May 2010 to address a possible nexus between the Veteran's claimed hearing loss disability and service. With respect to physical findings, the examiner noted that pure tones were significantly elevated compared to speech recognition reception thresholds and were not considered adequate for rating. After reviewing the Veteran's claims file and noting his normal audiogram at separation, the examiner opined that the Veteran's hearing loss was not caused by military noise exposure. She explained that literature does not support delayed onset hearing loss from noise exposure.

A May 2012 VA primary care record shows that the Veteran had normal hearing to the whispered voice, and a May 2013 VA primary care nurse note shows that the Veteran did not have gross hearing loss. An April 2014 VA primary care nurse note shows that the Veteran denied changes to his hearing, and a March 2016 treatment record similarly shows he had no decreased hearing.

An April 2016 VA behavioral health record contains the Veteran's report that he had difficulties with his hearing the week before which came on all of a sudden and he requested an appointment with his primary care provider. A May 2016 primary care record shows that the Veteran had wax build up in his right ear. This record also shows that he reported improved hearing after his ear canals were irrigated.

A March 2019 substance abuse (SATP) note shows the Veteran's last examination was in 2016, and he had some problems with his left ear.

A May 2019 VA audiology record shows that the Veteran had normal hearing sensitivity in the right ear and a severe to profound mixed hearing loss in the left ear. His hearing history shows he had three years of noncombat noise exposure in the military and 10 years as a chemical plant worker and was enrolled in a hearing conservation program.

A July 2019 VA otolaryngological record contains a provisional diagnosis of mixed conductive and sensorineural hearing loss, unilateral, left ear with restricted hearing on the contralateral side. The onset was noted to be days and even possibly weeks.

A November 2019 VA Ear, Nose and Throat (ENT) telephone note from the otolaryngology clinic shows that the results of a mastoid computed tomography scan were discussed with the Veteran and that he may benefit from myringotomy. The examiner said that he reiterated to the Veteran that this was not a new finding and was chronic in nature.

A February 2020 VA ENT clinic note from the otolaryngology clinic shows the Veteran had hearing loss bilaterally and he was cleared for hearing aids.

In March 2021, the Veteran underwent a VA audiological assessment. Examination findings revealed that the Veteran's right ear was unremarkable. Regarding his left ear, there was an appearance of a small attic retraction pocket and the appearance of amber-colored fluid in the "ME" space. Right ear results were noted to be consistent with normal middle ear pressure and TM (tympanic membrane) mobility, and left ear results were consistent with middle ear dysfunction/pathology. Pure tone threshold results revealed that the right ear was within normal limits with exception of moderate likely sensorineural hearing loss at 6000 Hertz only, and moderate to severe mixed hearing loss in the left ear. The actual audiological results are not included in the report. Speech recognition results revealed 94% in the right ear at 60 decibel hearing loss and 90% in the left ear at 80 decibel hearing loss. The examiner noted that the Veteran presented with primarily conductive left ear hearing loss, flat tympanogram, and appearance of left "ME" effusion.

An April 2021 VA referral record shows that the Veteran was requesting referral for evaluation and potential treatment for left ear essentially conductive hearing loss. His chief complaint was a long history of ear infections dating back to childhood. On examination the Veteran presented with a flat tympanogram, appearance of "ME" effusion, and moderate to severe mixed hearing loss. His right ear was noted to be essentially normal with exception of hearing loss at 6000 Hertz only.

On file is a May 2021 private audiogram in graph form noting the Veteran had a mild high frequency sensorineural hearing loss in the right ear, with excellent speech discrimination, and moderate to moderately severe mixed hearing loss in the left ear, with fair speech discrimination.

A VA contract audiological examination report in August 2021 shows that the Veteran had pure tone hearing threshold levels of 35, 30, 35, 50 and 45 decibels in the right ear and 70, 65, 65, 75 and 85 decibels in the left ear at 500, 1000, 2000, 3000 and 4000 Hertz, respectively. Speech discrimination scores using the Maryland CNC Word List were 94% in each ear. The Veteran was diagnosed as having sensorineural hearing loss in the right ear and mixed hearing loss in the left ear. The examiner opined that the Veteran's hearing loss was less likely than not related to military noise exposure. She noted there was no significant permanent shift in hearing thresholds beyond test variability from service entrance to service separation, which she said was objective evidence there was no permanent auditory damage on active duty from the conceded noise exposure. She also noted there was no report of complaint or treatment for hearing loss in the service treatment records or at separation. She said while noise exposure is conceded and the relationship of noise, auditory damage and hearing loss is well established, auditory damage and hearing loss are not conceded based on noise alone. She explained there must be a nexus of auditory damage to relate current hearing loss to military noise exposure and not another etiology.

The Veteran reported in the NOD in September 2021 that his post service employment with a chemical company involved loading and unloading trucks in a mostly noise free environment.

The Veteran testified in May 2025 that he was exposed to loud noise in service on a daily basis from rifles and machine guns. He also testified that his hearing problems began in service and have progressively worsened.

III. Analysis

VA has conceded as a favorable finding that the Veteran was exposed to hazardous noise in service. See 38 C.F.R. § 3.104(c). This is based on his assertions of exposure to loud noise from rifles and machine guns which is consistent with his military occupational specialty (MOS) of Field Artillery Fire finder Radar Operator which has a high probability for hazardous noise exposure.

VA made an additional favorable finding that the Veteran has a present bilateral hearing loss disability as claimed. In this regard, an August 2021 VA contract examination report shows the Veteran has hearing loss in both ears that meets VA's definition of hearing loss. 38 C.F.R. § 3.385.

Also, while the Veteran reported that his medical history includes multiple ear infections as a child, he is presumed sound with respect to his hearing at service entry. 38 U.S.C. § 1111. In this regard, there are no records indicating hearing problems prior to service and the Veteran's enlistment
military occupational specialty (MOS) of Field Artillery Fire finder Radar Operator which has a high probability for hazardous noise exposure.

Also, while the Veteran reported that his medical history includes multiple ear infections as a child, he is presumed sound with respect to his hearing at service entry. 38 U.S.C. § 1111. In this regard, there are no records indicating hearing problems prior to service and the Veteran's enlistment examination report in July 1975 shows that he did not meet VA's definition of hearing impairment as defined under 38 C.F.R. § 3.385.

As noted above, the Veteran's service treatment records do not show complaints or treatment for hearing loss and in fact show that he had normal hearing at his separation examination in June 1978. Moreover, the earliest audiological evidence of hearing loss is not until many years after service, in July 2009, when a VA examiner assessed the Veteran as having hearing loss. There are simply no documented complaints of hearing loss prior to this date. In fact, VA primary care records in April 2001 and May 2003 show that the Veteran did not have hearing loss. Thus, while consideration has been given to the Veteran's assertions that the onset of his hearing loss was in service and has continued to date, the Board finds that these assertions are inconsistent with his medical records both in service and after service and are therefore not deemed credible, so they are of no probative value.

Thus, as the Veteran's hearing loss is not shown to have been present during service or in the first year after separation of service in either ear, and continuity of symptomatology leading to a diagnosis of hearing loss is not shown by the weight of the evidence, in-service incurrence of right and/or left ear hearing loss cannot be presumed. 38 C.F.R. §§ 3.307, 3.309(a).

The above notwithstanding, a claimant may establish direct service connection for a hearing disability initially manifest several years after separation based on evidence showing that the current hearing loss is causally related to injury or disease suffered in service. See Hensley v. Brown, 5 Vet. App. 155 (1993). As noted, the Veteran in this case attributes his hearing loss to his conceded noise exposure in service. However, the only probative nexus evidence on file militates against the Veteran's claim. In this regard, a VA contract audiological examiner in May 2010 opined that the Veteran's hearing loss was not caused by military noise exposure. The examiner noted the Veteran had a normal audiogram at separation and that literature does not support delayed onset hearing loss from noise exposure. An August 2021 VA contract audiological examiner similarly opined that the Veteran's hearing loss is not at least as likely as not caused by or a result of an event in military service. This examiner noted that the Veteran's hearing was normal on his entrance exam with the exception of pure tone threshold level of 30 decibels at 500 Hertz in the right ear at service entry, and normal hearing in each ear (10 decibels from 500 to 4000 Hz) at service separation, with no changes in his hearing thresholds. She also noted there is no objective evidence of acoustic trauma due to military noise exposure. She explained that although noise exposure is conceded, and the relationship between noise exposure, auditory damage and hearing loss is well-established in medical literature, auditory damage and hearing loss are not conceded based on noise alone. She said there must be a nexus of auditory damage to relate current hearing loss to military noise and not another etiology. She concluded that in this case the evidence was against a nexus, therefore, it was less likely than not that the hearing loss was related to military noise exposure.

Both VA contract examiners based their opinion on their review of the Veteran's claims file and pertinent medical literature with consideration of the Veteran's reported history. Moreover, the examiners supported their opinion with specific rationale that is consistent with the evidence of record. Consequently, their opinions are entitled to substantial probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Furthermore, there is no contrary medical opinion evidence on file.

While the Board acknowledges the July 2009 VA record noting that the Veteran was exposed to noise trauma in his assignment to the artillery and "this may be related to his hearing loss", the Veterans' Court has repeatedly and consistently rejected medical opinions raising only a possibility of medical nexus as being insufficient to establish nexus. See McLendon
and pertinent medical literature with consideration of the Veteran's reported history. Moreover, the examiners supported their opinion with specific rationale that is consistent with the evidence of record. Consequently, their opinions are entitled to substantial probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Furthermore, there is no contrary medical opinion evidence on file.

While the Board acknowledges the July 2009 VA record noting that the Veteran was exposed to noise trauma in his assignment to the artillery and "this may be related to his hearing loss", the Veterans' Court has repeatedly and consistently rejected medical opinions raising only a possibility of medical nexus as being insufficient to establish nexus. See McLendon v. Nicholson, 20 Vet. App. 79, 85 (2006); Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992) (general and inconclusive statement about the possibility of a link between current disability and service injury is insufficient). In short, this opinion merely raises the possibility of a nexus between the Veteran's inservice noise exposure and service and is insufficient to establish such a nexus for service connection purposes.

Regarding the Veteran's opinion that his hearing loss is related to inservice noise exposure, this opinion is not considered competent evidence in this instance since such an opinion requires specialized knowledge and testing to understand the complex nature of the body systems. The Veteran in this case has not indicated that he has such specialized knowledge. See Jandreau v. Nicholson, 492 F.3d 1372, 1377, n. 4 (Fed. Cir. 2007).

In conclusion, given the audiological opinions above, and the lack of any probative evidence to the contrary, the Board finds that the evidence of record is persuasively against finding that the Veteran's bilateral hearing loss diagnosed as right sensorineural hearing loss and left mixed hearing loss is related to service. In reaching this conclusion, the Board has considered the applicability of the benefit of the doubt doctrine; however, as the evidence is persuasively against this claim and is not in approximate balance, that doctrine is not applicable in the instant appeal and the claim for service connection for bilateral hearing loss must be denied. 38 U.S.C. § 5107 (b); Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir 2021).

Kristin Haddock

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board A. Shawkey, Counsel

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

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