TINNITUS

T. BERRY · 2026 · Case ID: A26039681

GRANTED

Summary

The veteran, who served from May 2009 to June 2010, including service in Iraq and Kuwait during the Persian Gulf War, appeals the June 2021 rating decision concerning service connection for tinnitus and irritable bowel syndrome (IBS). The veteran claims tinnitus is due to in-service acoustic trauma, though service records are silent and the VA examiner opined it was less likely than not service-related due to a lack of documented complaints and normal hearing post-service. However, the Board found the veteran's lay statements credible regarding noise exposure and the onset of tinnitus, and with the benefit of the doubt, granted service connection for tinnitus. For IBS, the veteran claimed it began in Iraq in 2009, a period and location qualifying for Persian Gulf War presumptions. The VA examiner confirmed IBS and found the veteran's explanation for not seeking treatment until 2021 credible, despite the long gap. The Board granted service connection for IBS on a presumptive basis, noting the qualifying service and the confirmed diagnosis within the relevant timeframe. Service connection for tinnitus and IBS were both granted.

Rationale

Veteran has current tinnitus; In-service noise exposure presumed; Benefit of the doubt applied due to approximate balance of evidence

Special Benefit

NO SPECIAL BENEFIT

Docket No.

211028-194146

Full Decision Text

Citation Nr: A26039681
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 211028-194146
DATE: April 28, 2026

ORDER

Entitlement to service connection for tinnitus is granted.

Entitlement to service connection for irritable bowel syndrome (IBS) is granted.

FINDINGS OF FACT

1. The Veteran was exposed to hazardous noise during military service.

2. The Veteran is competent to report that he has experienced ringing in his ears since service.

3. The Veteran's irritable bowel syndrome is a medically unexplained chronic multi-symptom illness (MUCMI) of an unknown origin.

4. The Veteran served in the Southwest Asia theater of operations during the Persian Gulf War and has a current diagnosis of irritable bowel syndrome that has manifested to a compensable degree.

CONCLUSIONS OF LAW

1. Resolving reasonable doubt in the Veteran's favor, the criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for entitlement to service connection for IBS are met. 38 U.S.C. §§ 1110, 1117, 1118, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.317.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had active duty service from May 2009 to June 2010.

The rating decision on appeal was issued in June 2021 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the October 28, 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. On June 5, 2025, the Veteran withdrew the hearing request. Therefore, the Board may only consider the evidence of record at the time of the June 2021 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran, or representative, within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 20.801.

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

Service Connection

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(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." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)).

Service connection for certain chronic diseases, including tinnitus, may be presumed if they are manifested to a compensable degree within one year following the date of separation from active service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309.

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 diagnosis including the word "chronic." Continuity of symptomatology is required where the condition noted during service is not, in fact, shown to be chronic or when the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in-service is not adequately supported then a showing of continuity of symptomatology after discharge from service is required to support the claim. 38 C.F.R. § 3.303(b). But to establish entitlement to service connection based on continuity of symptomatology, the claimant must have one of the "chronic" diseases specifically enumerated in 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information and lay and medical evidence of record in a case and when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

Entitlement to service connection for tinnitus

Essentially, the Veteran contends that his tinnitus is due to acoustic trauma experienced in-service. See February 2021 VA 21-526EZ, Fully Developed Claim (Compensation); October 2021 VA Form 10182 Notice of Disagreement; and July 2025 VA Form 20-10208, Document/Evidence Submission.

For the reasons stated below, the Board finds that service connection for tinnitus is warranted.

Initially, the Board notes that the Veteran's service records are silent as to any complaints of or treatment for tinnitus. Military noise exposure associated with his Military Occupational Specialty (MOS) as a carpentry and masonry specialist has been presumed.

The only favorable findings from the June 2021 rating decision on appeal are that the Veteran has been diagnosed with the disability of tinnitus and that hazardous noise exposure is presumed due to his MOS.

The Veteran received a VA audiological examination in May 2021. The Veteran said that his tinnitus began in Iraq. He reported constant, high-pitched, buzzing tinnitus that sometimes gives him headaches and makes it difficult to sleep. The Veteran stated that his condition has worsened. After examining the Veteran and reviewing his electronic claims file, the VA examiner determined that the Veteran's tinnitus is less likely than not related to service. The examiner explained that while the Veteran reported tinnitus that began during his deployment and his MOS has a high probability of noise exposure, he denied ringing in his ears during the post-deployment health assessment. Furthermore, the Veteran had no documented complaints of tinnitus for more than 10 years after service, his hearing is currently normal, and there were no threshold shifts during service. Therefore, a nexus to service, including hazardous noise exposure, is not established.

Here, the evidence of record documents that the Veteran has current tinnitus inasmuch as he has credibly stated that he has ringing in his ears that began during service and continued thereafter. See July 2025 VA Form 20-10208, Document/Evidence Submission. Additionally, the May 2021 VA examiner confirmed a diagnosis of recurrent tinnitus. In-service noise exposure is presumed.

The Board notes the negative etiological opinion provided by the VA examiner of record. The Board further notes that, in this case, the Veteran himself is of the opinion that such a link exists between his current tinnitus and active service. As the Veteran has previously suggested, his tinnitus began at the same time, or shortly after, his exposure to excessive noise in service. While a lay person, he is capable of opining on medical questions that fall within the realm of common knowledge. Kahana v. Shinseki, 24 Vet. App. 428, 438 (2011). Tinnitus, or ringing in the ears, may be observed and described by a lay person. See Jandreau v. Nicholson, 492
The Board notes the negative etiological opinion provided by the VA examiner of record. The Board further notes that, in this case, the Veteran himself is of the opinion that such a link exists between his current tinnitus and active service. As the Veteran has previously suggested, his tinnitus began at the same time, or shortly after, his exposure to excessive noise in service. While a lay person, he is capable of opining on medical questions that fall within the realm of common knowledge. Kahana v. Shinseki, 24 Vet. App. 428, 438 (2011). Tinnitus, or ringing in the ears, may be observed and described by a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007).

Although there is no objective evidence to support a specific incident of acoustic trauma in-service, the Board accepts the Veteran's statements as competent and credible as to his having been exposed to noise in the military and having ringing in his ears that continued thereafter.

After reviewing the record, the Board finds that the evidence is in approximate balance. The benefit of the doubt is resolved in favor of the Veteran in this matter in granting service connection for tinnitus. 38 U.S.C. § 5107.

Entitlement to service connection for IBS

Service connection may also be granted for a Persian Gulf veteran with objective indications of a qualifying chronic undiagnosed illness or a medically unexplained chronic multi symptom illness (MUCMI). 38 U.S.C. § 1117; 38 C.F.R. § 3.317. A Persian Gulf veteran is defined as a veteran who served on active military, naval or air service in the Southwest Asia theater of operations during the Persian Gulf War. 38 C.F.R. § 3.317 (e)(1). The Southwest Asia theater of operations refers to Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations. 38 C.F.R. § 3.317(e)(2). The period of the Persian Gulf War is from August 2, 1990, through the present. See 38 C.F.R. § 3.2 (i).

Here, the Veteran served in Iraq and Kuwait during the relevant period. This service is considered a qualifying period of service for the purposes of 38 U.S.C. § 1117 and 38 C.F.R. § 3.317. See VA Memo dated January 2023.

Irritable bowel syndrome is on the list of medically unexplained chronic multi symptom illnesses that may be presumed to be service connected if manifested in active service or to a degree of 10 percent disabling prior to December 31, 2026.

The Veteran received a VA intestinal conditions examination in June 2021, wherein a diagnosis of IBS was confirmed. The Veteran reported that his IBS began in 2009 in Iraq when he began to have bowel movements after every meal. He also had periods of diarrhea and constipation with stomach pain. He said that his symptoms have persisted to the present and he currently has loose stools about 1-2 days per week with abdominal cramping, constipation, and alternating diarrhea. The Veteran stated that he did not seek treatment for IBS until approximately 2021 because he did not have a physician and was unaware of access to VA treatment. The examiner provided the following remarks:

"Although the veteran never sought medical care for his IBS from the time of separation until Jan 2021 (a period of 11 years), he states that he had no family physician and was unaware that he was eligible for care within the VA system. His explanation appears credible and therefore the absence of a nexus should not adversely impact his eligibility for service connection."

The Board finds that service connection for IBS is warranted. The Veteran had the requisite service in Southwest Asia during the Persian Gulf War era under 38 U.S.C. § 1117, as he served in Iraq and Kuwait. Furthermore, the June 2021 VA examiner diagnosed the Veteran with IBS. As such, the Veteran's IBS has been manifested to a 10 percent disabling degree prior to December 31, 2026 (during the period on appeal). Thus, service connection for IBS is warranted on a presumptive basis under 38 U.S.C. § 1117; 38 C.F.R. § 3.317.

(Continued on the next page)

T. Berry

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board M. Miller, Counsel

The Board's decision in this case is binding only with respect to the instant matter
7, as he served in Iraq and Kuwait. Furthermore, the June 2021 VA examiner diagnosed the Veteran with IBS. As such, the Veteran's IBS has been manifested to a 10 percent disabling degree prior to December 31, 2026 (during the period on appeal). Thus, service connection for IBS is warranted on a presumptive basis under 38 U.S.C. § 1117; 38 C.F.R. § 3.317.

(Continued on the next page)

T. Berry

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board M. Miller, 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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