TINNITUS

DAVID H. ROBERTSON · 2026 · Case ID: A26039639

MIXED

Summary

The Veteran, who served in the U.S. Marine Corps from March 2013 to March 2018, appeals a May 2024 rating decision. The Veteran sought service connection for tinnitus, bilateral hearing loss, and bilateral pes planus (flatfoot). The Board granted service connection for tinnitus, finding that the Veteran's military occupational specialty as a flight equipment technician and multi-system aviation repairer made noise exposure probable. A February 2024 VA audiological examination indicated normal hearing thresholds and speech recognition scores, leading the Board to deny service connection for bilateral hearing loss, as the objective criteria in 38 C.F.R. § 3.385 were not met. The Veteran's lay testimony regarding hearing loss was considered competent for reporting symptoms but not for diagnosis or nexus. Service connection for bilateral pes planus was denied because while the Veteran was diagnosed with the condition in February 2024, service records were silent regarding any complaints, diagnosis, or treatment during service, and the separation examination noted normal feet. The VA examiner opined that the pes planus was less likely than not related to service. The Board found no probative evidence linking the pes planus to service. The claims for tinea pedis (athlete's foot) and lumbosacral strain were remanded due to pre-decisional duty to assist errors. For tinea pedis, the AOJ only requested a TERA opinion, not a direct service connection opinion. For lumbosacral strain, the VA examiner's opinion was inadequate as it did not adequately address the Veteran's disclosure of a pre-service back injury.

Rationale

VA examiner opined tinnitus is at least as likely as not caused by military noise exposure; Examiner rationale: noise exposure affects outer hair cell function, causing subjective ringing; Veteran's lay testimony regarding tinnitus is competent

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250410-537819

Full Decision Text

Citation Nr: A26039639
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 250410-537819
DATE: April 28, 2026

ORDER

Service connection for tinnitus is granted.

Service connection for bilateral hearing loss is denied.

Service connection for bilateral pes planus (claimed as flatfoot) is denied.

REMANDED

Entitlement to service connection for tinea pedis (claimed as athlete's foot) is remanded.

Entitlement to service connection for lumbosacral strain is remanded.

FINDINGS OF FACT

1. The probative medical evidence of record reflects that the Veteran's tinnitus is etiologically linked to hazardous noise exposure during service.

2. The probative medical evidence of record reflects that the Veteran does not have bilateral hearing loss for VA purposes.

3. The probative medical evidence of record reflects that the Veteran's bilateral pes planus is not etiologically related to active service.

CONCLUSIONS OF LAW

1. The criteria for service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 5107, 7104; 38 C.F.R. §§ 3.102, 3.303.

2. The criteria for service connection for bilateral hearing loss have not been met. 38 U.S.C. §§ 1110, 5107, 7104; 38 C.F.R. §§ 3.102, 3.303, 3.385.

3. The criteria for service connection for bilateral pes planus (claimed as flatfoot) have not been met. 38 U.S.C. §§ 1110, 5107, 7104; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Marine Corps from March 2013 to March 2018.

This matter comes before the Board of Veterans' Appeals (Board) on appeal of a May 2024 rating decision issued by a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) under the Appeals Modernization Act (AMA).

In the April 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket.

Therefore, the Board may only consider the evidence of record at the time of the May 2024 agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the AOJ decision on appeal cannot be considered by the Board. 38 C.F.R. §§ 20.300, 20.301, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

However, because the Board is remanding the claims of entitlement to service connection for tinea pedis and lumbosacral strain, 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).

Legal Authority Service Connection

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). "To establish a right to compensation for a present disability, a veteran must 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 - the so-called 'nexus' requirement." Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Certain chronic diseases 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
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." Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Certain chronic diseases 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). In an October 4, 1995, opinion, VA's Under Secretary for Health determined that it was appropriate to consider high frequency sensorineural hearing loss an organic disease of the nervous system and therefore a presumptive disability.

Hearing loss as a disability for VA disability compensation purposes is governed by 38 C.F.R. § 3.385. Impaired hearing will be considered to be a disability for VA purposes when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 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. See 38 C.F.R. § 3.385.

Pertinent to a claim for service connection, such a determination requires a finding of a current disability that is related to an injury or disease in service. Watson v. Brown, 4 Vet. App. 309 (1993); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). Under applicable regulation, the term "disability" means impairment in earning capacity resulting from diseases and injuries and their residual conditions. 38 C.F.R. § 4.1; see also Hunt v. Derwinski, 1 Vet. App. 292, 296 (1991); Allen v. Brown, 7 Vet. App. 439 (1995); Saunders v. Wilkie, 886 F.3d 1356 (Fed. Cir. 2018) (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.").

In McClain v. Nicholson, 21 Vet. App. 319, 321 (2007), the Court held that the requirement of the existence of a current disability is satisfied when a claimant has a disability at the time he files his claim for service connection or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim. However, in Romanowsky v. Shinseki, 26 Vet. App. 289 (2013), the Court held that when the record contains a recent diagnosis of disability prior to a claimant filing a claim for benefits based on that disability, the report of diagnosis is relevant evidence that the Board must address in determining whether a current disability existed at the time the claim was filed or during its pendency.

In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

1. Service connection for tinnitus is granted.

2. Service connection for bilateral hearing loss is denied.

The Veteran contends that he has bilateral hearing loss due
the claim was filed or during its pendency.

1. Service connection for tinnitus is granted.

2. Service connection for bilateral hearing loss is denied.

The Veteran contends that he has bilateral hearing loss due to working on and around loud military jets which also caused ringing in his ears.

The Veteran's DD214 reflects that he was a flight equipment technician and multi-system aviation repairer in the U.S. Marine Corps. In the May 2024 rating decision, VA has conceded that the Veteran's military occupational specialty (MOS) is probable for military noise exposure.

Associated with the claim for service connection, the Veteran underwent a VA audiological evaluation in February 2024. On the authorized audiological evaluation, pure tone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 15 15 10 5 10

LEFT 15 15 15 10 10

Speech audiometry revealed speech recognition ability of 96 percent in both the right and left ear. The examiner determined that the Veteran has normal hearing in both the right and left ear.

As the auditory threshold for any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is not 40 decibels or greater; nor is the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz 26 decibels or greater; nor is the Veteran's speech recognition scores using the Maryland CNC Test less than 94 percent, the Veteran does not have hearing loss for VA purposes. 38 C.F.R. § 3.385. As such, the first element of service connection has not been met with regard to bilateral hearing loss.

However, during the audiology exam, the Veteran was diagnosed with bilateral tinnitus or ringing in the ears. The Veteran reported that it started during service in 2016 while working around aircraft and has been intermittent, occurring approximately twice per month for seconds to minutes at a time.

The VA examiner opined that it is at least as likely as not that the Veteran's tinnitus is caused by or a result of military noise exposure. As rationale, the examiner explained that exposure to noise can affect outer hair cell function by sheering off sensitive stereocilia which typically results in subjective ringing in the ears.

In this case, the Veteran does not presently have bilateral hearing loss for VA purposes. However, the Veteran does have bilateral tinnitus which the probative medical evidence of record reflects is etiologically related to service.

The board has considered the Veteran's lay statements asserting that he has hearing loss caused by service. The Veteran is competent to report on symptoms he experiences as they come to him through his senses, such as ringing in the ears and difficulty hearing. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). In limited situations, lay evidence may be competent and sufficient to establish a diagnosis of a condition when (1) a lay person is competent to identify the medical condition (noting that sometimes the lay person will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer), (2) the lay person is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. See Jandreau v. Nicholson, supra. Similarly, laypersons are competent to diagnose and provide nexus opinions to some extent, where the diagnosis or opinion is not of a complex nature. Id., see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).

However, while the Veteran may subjectively believe that he has bilateral hearing loss that was caused by military service, he is not competent to provide a diagnosis or nexus opinion regarding these issues. The issues are medically complex and outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to make such a determination. See Jandreau v. Nicholson, supra; see also Kahana v. Shinseki, 24 Vet
persons are competent to diagnose and provide nexus opinions to some extent, where the diagnosis or opinion is not of a complex nature. Id., see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).

However, while the Veteran may subjectively believe that he has bilateral hearing loss that was caused by military service, he is not competent to provide a diagnosis or nexus opinion regarding these issues. The issues are medically complex and outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to make such a determination. See Jandreau v. Nicholson, supra; see also Kahana v. Shinseki, 24 Vet. App. 428 (2011). Furthermore, the audiological standards for hearing loss to be recognizable as a disability for VA compensation purposes is rigidly defined by the criteria in 38 C.F.R. § 3.385. If test results do not meet those minimum objective criteria, as in this case, then the first element of service connection is not met.

Accordingly, service connection for bilateral hearing loss is not warranted. However, service connection for bilateral tinnitus is warranted. In reaching this decision, the Board has considered the benefit-of-the-doubt rule and finds it not applicable as the evidence is not in approximate balance. 38 U.S.C. § 5107(b) (2018); Lynch v. McDonough, supra.

3. Entitlement to service connection for bilateral pes planus (claimed as flatfoot, bilateral) is denied.

The Veteran contends that he has pes planus, or flat feet which was caused by service. Specifically, the Veteran contends that his pes planus was caused by having to wear boots every day for years. See VA Form 21-526EZ dated January 2024.

Associated with the claim, the Veteran underwent a VA examination in February 2024 to determine the nature and etiology of the claimed disability. After an in-person examination and review of the record, the VA examiner diagnosed the Veteran with pes planus. Thus, the first element of service connection has been met.

However, as to the second and third elements of in-service incurrence and nexus, service and post-service treatment records are silent for any complaints, diagnosis, or treatment of pes planus. The Veteran's separation examination dated January 2018 reflects that the Veteran had normal arches and that his feet were Asymptomatic at the time of separation. The first medical indication in the record of the Veteran complaining of or being diagnosed with pes planus was during the February 2024 VA examination.

To this regard, the VA examiner opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. As rationale, the examiner explained that there is insufficient evidence of pes planus upon separation from service; and that there are no specific complaints of foot pain or flat feet related to service.

The Board acknowledges the Veteran's lay statements and recognizes that the Veteran is competent to provide lay evidence about the symptoms he experiences as they come to him through his senses. However, while the Veteran is competent to report his current symptoms, as a lay person he does not have the education, training, or experience to diagnose or opine as to the etiology of the condition. See Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007).

After a review of the evidence of record, the Board finds that service connection is not warranted for bilateral pes planus as there is no adequate medical evidence indicating the disorder existed during service or is etiologically related to his active service. The Board finds that service connection for pes planus is not warranted on either a direct or a presumptive basis. The record contains no evidence of any such disorder in service or its onset within one year of service discharge. As noted above, the Veteran's service treatment records are negative for any complaints, treatment, or diagnosis related to pes planus.

While the Veteran may subjectively believe that his bilateral pes planus is the result of service, he is not competent to provide a diagnosis or nexus opinion regarding these issues. The issues are medically complex and outside the competence of the Veteran in this case because the record does not show that he has the skills or medical training to make such a determination. See Jandreau v. Nicholson, supra; see also Kahana v. Shinseki, 24 Vet. App. 428 (2011).

The Veteran is competent to report on factual matters of which he has first-hand knowledge, such as experiencing pain in service, reporting to sick call, being placed on limited duty, and undergoing physical therapy. See Washington v. Nicholson, supra. In limited situations, lay evidence may be competent and sufficient to establish a diagnosis of a condition when (1) a lay person is competent to identify the medical condition (noting that sometimes the lay person will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer), (2) the lay person is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. See Jandreau v. Nicholson, supra. Similarly, laypersons are competent to diagnose and provide nexus opinions to some extent, where the diagnosis or opinion is not of a complex nature. Id., see also Davidson v. Shinseki, supra. Here, the Veteran is not competent to conclude the etiology of his claimed condition.

In this case, there is no probative evidence to suggest that the Veteran's pes planus is related to service beyond the mere contention the Veteran has made. Rather, after a review of the record, in-person examination and interview of the Veteran, the VA examiner determined that the Veteran's pes planus was more likely not related to military service. Thus, there exists no probative medical evidence to support a connection between the Veteran's recently diagnosed pes planus and military service.

Accordingly, service connection for bilateral pes planus is not warranted. In reaching this decision, the Board has considered the benefit-of-the-doubt rule and finds it not applicable as the evidence is not in approximate balance. 38 U.S.C. § 5107(b) (2018); Lynch v. McDonough, supra.

REASONS FOR REMAND

1. Entitlement to service connection for tinea pedis (claimed as athlete's foot) is remanded.

2. Entitlement to service connection for lumbosacral strain is remanded.

The Veteran contends that he has athlete's foot from having to wear boots and socks for long periods of time without changing them, and a back condition from carrying heavy packs and equipment during service. See VA Form 21-526EZ dated January 2024.

With regard to the Veteran's service connection claim for athlete's foot, in February 2024 the Veteran underwent a VA examination to determine the nature and etiology of the claimed disability. After an in-person examination and review of the claims filed the VA examiner returned a negative nexus opinion with regard to the Veteran's tinea pedis being related to toxic exposure risk activity (TERA) during service. An opinion regarding direct service connection was not given.

The Board notes, the Veteran's contention is that he developed athlete's foot during service due to wearing boots and socks for multiple days at a time without being able to change them. This is a direct service connection theory of entitlement, not a TERA theory of entitlement.

The Board further notes that in the January 2024 examination request, the AOJ only requested an opinion as to whether the Veteran's claimed athlete's foot was related to TERA during service. As there is no medical opinion regarding direct service connection, remand is necessary to correct a pre-decisional duty to assist error in obtaining one.

With regard to the Veteran's service connection claim for lumbosacral strain, the Veteran underwent a VA examination in February 2024. However, there appears to be a question as to whether the Veteran's claimed back condition preexisted his military service. In the January 2024 examination request, the AOJ request that the examiner return an opinion regarding aggravation of a preexisting condition. Specifically, the AOJ noted that STR's dated April 2013 reflect that the Veteran had reported that he injured his back while lifting weights just prior to going on active duty but never sought treatment. The Board notes that the Veteran's January 2013 entrance examination report is silent as to any preexisting back conditions.

The VA examiner opined that the claimed condition, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness. As rationale the examiner stated that "medical record review shows enlistment examination from January 2013 shows no preexisting back condition
the AOJ request that the examiner return an opinion regarding aggravation of a preexisting condition. Specifically, the AOJ noted that STR's dated April 2013 reflect that the Veteran had reported that he injured his back while lifting weights just prior to going on active duty but never sought treatment. The Board notes that the Veteran's January 2013 entrance examination report is silent as to any preexisting back conditions.

The Board notes that the examiner's rationale appears to determine that the Veteran did not have a preexisting back condition, and therefore, could not then be aggravated by service. However, the examiner failed to discuss the evidence in the record reflecting the Veteran's disclosure during basic training of having sustaining a back injury just prior to entering active duty.

The Board notes that the examination request clearly pointed the examiner to the evidence in the record reflecting that the Veteran injured his back lifting weights just prior to entering service. The examiner made no mention of the notation in the STR's reflecting the Veteran's prior back injury, nor did the examiner explain why such prior back injury would not be considered clear and unmistakable evidence of a preexisting condition. As such, the Board finds the opinion and rationale inadequate to adjudicate the claim.

Lastly, STR's and the Veteran's separation examination dated January 2018 clearly note that the Veteran made several complaints of back pain during service. Thus, if the Veteran's back condition did clearly and unmistakably exist prior to service, the presumption of aggravation is triggered, requiring a medical opinion as to whether such reported back pain during service indicates worsening of the disability beyond its natural progression. Such opinion must be supported by an adequate rationale.

Accordingly, remand is necessary to correct a pre-decisional duty to assist error and obtain adequate medical opinions and rationale. Upon remand, the AOJ is required to fully complete the development ordered by the Board. Stegall v. West, 11 Vet. App. 268 (1998); Ascherl v. Brown, 4 Vet. App. 371, 377 (1993).

The matters are REMANDED for the following action:

1. Send the claims file to an appropriately qualified clinician to determine the nature and etiology of the Veteran's claimed tinea pedis (athlete's foot) and lumbosacral strain. The examiner must review the claims file, including this remand, prior to rendering the opinions requested below. The need for an additional in-person examination, or interview of the Veteran is left to the discretion of the reviewing clinician.

The examiner is asked to respond to the following:

(a) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's claimed tinea pedis (athlete's foot) was incurred during service, or is otherwise etiologically related to an injury, event, or illness during service?

(b) Did the Veteran's claimed lumbosacral strain, clearly and unmistakably preexist his military service?

(c) If the Veteran's claimed lumbosacral strain did clearly and unmistakably preexist military service, was the disability clearly and unmistakably NOT aggravated beyond its natural progression by service?

(d) If the Veteran's claimed lumbosacral strain did not preexist military service, is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's claimed lumbosacral strain was incurred during service, or is otherwise etiologically related to an injury, event, or illness during service?

A rationale should be provided for any opinion offered.

If it is not possible to provide the opinion requested without speculation, the examiner must state whether this is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training).

David H. Robertson

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board R. Schulte

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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