TINNITUS

KRISTI L. GUNN · 2026 · Case ID: A26039171

MIXED

Summary

The veteran, who served from September 2006 to April 2008, appeals the denial of service connection for left ear hearing loss and the grant of service connection for tinnitus. The Board found that the veteran's tinnitus is at least as likely as not related to service, granting service connection. This decision was based on the veteran's testimony of tinnitus onset during service, continued symptoms, and exposure to loud noise on the flight line, which the Board considered to be in approximate balance with the VA examiner's inability to provide a definitive opinion due to incomplete records. Applying the benefit of the doubt, service connection for tinnitus was granted. For the left ear hearing loss claim, the Board denied service connection, finding that the veteran did not meet the regulatory criteria for hearing loss disability based on the VA audiological examination, which showed normal hearing in the left ear. Although noise exposure was conceded, the lack of a diagnosed hearing loss disability prevented a grant. The Board found the evidence weighed against the claim, making the benefit of the doubt doctrine inapplicable. The claim for right ear hearing loss was remanded due to a duty to assist error, as the prior VA opinion was inadequate and did not address the nexus to service, failing to consider pre-service hearing loss appropriately. The case will be remanded for a new, adequate opinion on the right ear hearing loss claim.

Rationale

Tinnitus capable of lay observation; Noise exposure conceded; Approximate balance of evidence; Benefit of the doubt resolved in veteran's favor

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210902-183955

Full Decision Text

Citation Nr: A26039171
Decision Date: 04/27/26 Archive Date: 04/27/26

DOCKET NO. 210902-183955
DATE: April 27, 2026

ORDER

Entitlement to service connection for tinnitus is granted.

Entitlement to service connection for hearing loss of the left ear is denied.

REMANDED

Entitlement to service connection for hearing loss of the right ear is remanded.

FINDINGS OF FACT

1. Resolving reasonable doubt in the Veteran's favor, tinnitus is as least as likely as not related to in-service hazardous noise exposure.

2. The evidence of record persuasively weighs against finding that the Veteran has had left ear hearing loss for VA purposes at any time during or approximate to the pendency of the claim.

CONCLUSIONS OF LAW

1. The criteria for service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for entitlement to service connection for left ear hearing loss have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.385.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active military service from September 2006 to April 2008.

This matter comes before the Board of Veterans' Appeals (Board) from a March 2021 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

In the September 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on June 18, 2025.

Therefore, the Board may only consider the evidence of record at the time of the March 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or attorney at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], 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 right ear hearing loss, 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

A veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1110.

Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called "nexus" requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

According to the United States Court of Appeals for the Federal Circuit in Lynch v. McDonough, 999 F.3d 1391 (Fed. Cir. 2021), the proper standard of review is whether the factors are in an "approximate balance." Lynch held that the veteran is entitled to the benefit of the doubt when the evidence is in an approximate balance, i.e., nearly equal and does not require the evidence to be in exact equipoise. Id.

1. Service connection for tinnitus is granted.

After a review of the entire evidentiary record and in light of the applicable legal criteria, the Board aff
381 F.3d 1163, 1167 (Fed. Cir. 2004).

1. Service connection for tinnitus is granted.

After a review of the entire evidentiary record and in light of the applicable legal criteria, the Board affords the Veteran reasonable doubt and grants service connection for tinnitus.

With regard to a present disability, in Charles v. Principi, 16 Vet. App. 370, 374-375 (2002), the United States Court of Appeals for Veterans Claims (Court) held that tinnitus is a condition which is capable of lay observation. The Veteran has reported ringing in her ears that began in service. As such, the first element of service connection is met.

With regard to an in-service injury, the AOJ made a favorable finding in the March 2021 rating decision conceding noise exposure. Further, the Veteran testified having duties on the flight line without hearing protection for long shifts. See June 2025 Hearing Transcript. Therefore, exposure to acoustic trauma and the second element of service connection has been conceded.

As for the third element of service connection, evidence of a nexus between the Veteran's tinnitus and service, the record consists of an opinion by a VA examiner in September 2020. The examiner found that an etiology opinion for tinnitus could not be provided without resorting to speculation because complete records were not found.

However, the Veteran reported that tinnitus began during service and continued since then. See June 2025 Hearing Transcript. The Veteran further testified to exposure to loud noise on the flight line during service. Id. Tinnitus is a condition which is capable of lay observation. Therefore, the Board finds the evidence for and against the Veteran's claim for tinnitus is in approximate balance.

As such, the benefit of the doubt must be resolved in favor of the Veteran, and entitlement to service connection for tinnitus is warranted. 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

2. Service connection for hearing loss of the left ear is denied.

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 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 Veteran was afforded a VA audiological examination for her claim of hearing loss in September 2020. Speech audiometry revealed speech recognition ability of 100 percent in the left ear. The examiner further found normal hearing in the left ear.

Following review of the evidence, the Board finds that the criteria under 38 C.F.R. § 3.385 to consider the Veteran's left ear hearing loss to be a disability for VA purposes have not been met. The evidence does not show that the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or that the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or that speech recognition scores using the Maryland CNC test are less than 94 percent.

The Board has considered the lay evidence of record. As a layperson, the Veteran is competent to report that she experiences difficulty hearing. However, she is not competent to render a diagnosis of a left ear hearing loss disability that satisfies the regulatory criteria set forth in 38 C.F.R. § 3.385.

Finally, the Board recognizes that noise exposure has been conceded. However, the Veteran does not have a diagnosis of left ear hearing loss for VA purposes. The existence of a current disability is the cornerstone of a claim for VA disability compensation. Where the evidence does not support a finding of current disability upon which to predicate a grant of service connection, there can be no valid claim for that
CNC test are less than 94 percent.

Accordingly, the Board finds that the benefit-of-the-doubt rule is not applicable as the evidence is not in approximate balance, and entitlement to service connection for left ear hearing loss is not warranted. 38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

REASONS FOR REMAND

1. Service connection for hearing loss of the right ear is remanded.

The issue of entitlement to service connection for hearing loss is remanded to correct a duty to assist error that occurred prior to the March 2021 rating decision on appeal. The Agency of Original Jurisdiction (AOJ) obtained a September 2020 medical opinion prior to the March 2021 rating decision on appeal. However, this medical opinion is inadequate. The examiner explained that an opinion could not be obtained without resorting to speculation. The examiner further noted that hearing loss had preexisted service.

Service treatment records show that the Veteran had some hearing loss when she entered service. Despite this, the audiogram results at entry did not meet the definition of hearing loss under 38 C.F.R. § 3.385. For the purposes of hearing loss, "defects, infirmities or disorders" are limited to a hearing loss disability as defined in 38 C.F.R. § 3.385. In other words, a demonstration of less than perfect hearing at entry that does not meet VA's definition of hearing loss under VA regulations is not considered "noted" and thus the presumption of soundness applies. McKinney v. McDonald, 28 Vet. App. 15, 23 (2016). For purpose of this remand, the Veteran is presumed sound on entry. A remand is needed in order to obtain an adequate opinion. The reviewing clinician should not consider the Veteran's hearing loss prior to service but instead provide an opinion as to whether the Veteran's current hearing loss is at least as likely as not related to her military service.

The matter is REMANDED for the following action:

1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's current hearing loss of the right ear is at least as likely as not related to conceded noise exposure during service.

For purpose of this remand, the Veteran is presumed sound on entry. The reviewing clinician should not consider the Veteran's hearing loss prior to service in providing an opinion but instead provide an opinion as to whether the Veteran's current hearing loss is at least as likely as not related to her military service (including conceded noise exposure).

The Veteran's lay statements must be considered in the clinician's opinion.

Medical records submitted in August 2025 should be considered.

The opinion must include a complete rationale for all opinions expressed. If the clinician feels that a requested opinion cannot be rendered without resorting to speculation, the clinician must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e., additional facts are required, or the examiner does not have the needed knowledge or training).

KRISTI L. GUNN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board T. Samadani, 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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