HEARING LOSS

S. KIM · 2026 · Case ID: A26040067

DENIED

Summary

The veteran, who served from October 1995 to September 2003, appeals the denial of service connection for right ear hearing loss and a compensable rating for left ear hearing loss. The Board denied service connection for right ear hearing loss, finding that while in-service noise exposure was conceded and VA examination in January 2025 revealed right ear hearing loss, the subsequent addendum opinion in March 2025, based on separation audiometric results, concluded no significant threshold shift for the right ear in service. The Board gave more weight to the addendum opinion, finding the veteran's lay testimony regarding hearing loss diagnosis and severity was not competent medical evidence, and the evidence weighed against a service connection. The Board also denied an increased rating for left ear hearing loss, noting that while the Veteran reported difficulty hearing in background noise, the audiometric testing indicated only Level I hearing loss in the left ear, which, according to the rating schedule, does not warrant a higher rating. The Board found the medical evidence of record more probative than the Veteran's subjective complaints regarding the severity of his hearing loss.

Rationale

Service treatment records silent for diagnosis or complaints related to right ear hearing loss.; In-service audiometric testing did not reveal hearing loss for VA purposes.; Addendum opinion based on separation audiogram concluded no significant threshold shift for the right ear in service.; Board gave more probative value to the addendum opinion over the initial favorable opinion based on inaccurate facts.; Veteran's lay testimony regarding diagnosis and severity of hearing loss was not competent medical evidence.

Special Benefit

NO SPECIAL BENEFIT

Docket No.

251104-612022

Full Decision Text

Citation Nr: A26040067
Decision Date: 04/29/26 Archive Date: 04/29/26

DOCKET NO. 251104-612022
DATE: April 29, 2026

ORDER

Entitlement to service connection for right ear hearing loss is denied.

Entitlement to a compensable rating for left ear hearing loss is denied.

FINDINGS OF FACT

1. The competent and credible evidence of record persuasively weighs against finding that right ear hearing loss manifested during active-duty service or within one year thereafter or is related to an in-service injury or disease. The evidence is not in approximate balance.

2. The competent and credible evidence of record persuasively weighs against finding the Veteran's left hearing loss was manifested by worse than a Level I hearing loss in the left ear. The evidence is not in approximate balance.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for right ear hearing loss have not been met. 38 U.S.C. §§ 1110, 1101, 1112, 1113, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.385.

2. The criteria for entitlement to a compensable rating for left ear hearing loss have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.321, 4.1, 4.7, 4.85, 4.86, diagnostic code (DC) 6100.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from October 1995 to September 2003.

These matters are before the?Board of Veterans' Appeals?(Board) on appeal of a March 2025 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In the November 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 March 2025 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.

1. Entitlement to service connection for right ear hearing loss is denied.

The Veteran contends that he has right ear hearing loss which is related to in-service noise exposure. The Veteran was granted service connection for left ear hearing loss in a March 2025 rating decision, but the same decision denied service connection for right ear hearing loss.

Service connection is established on a direct basis when there is competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. 38 U.S.C. § 1110; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303 (a), (d).

Certain chronic diseases, including sensorineural hearing loss 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; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

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 at 500,
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; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

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 at 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies at 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. Even though disabling hearing loss is not demonstrated at separation, a veteran may, nevertheless, establish service connection for a current hearing disability by submitting evidence that a current disability is related to service. Hensley v. Brown, 5 Vet. App. 155 (1993). If the positive and negative evidence is in approximate balance, the claimant receives the benefit of the doubt. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

If the positive and negative evidence is in approximate balance, the claimant receives the benefit of the doubt. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021.

Service treatment records are silent for diagnosis or complaints related to right ear hearing loss. In-service audiometric testing does not reveal hearing loss for VA purposes at any time during active-duty service. In-service noise exposure is conceded based on the Veteran's military occupational specialty of short range air defense.

On VA examination in January 2025, audiological testing revealed right ear hearing loss for VA purposes. The Veteran described a subjective onset of hearing loss during active-duty service. The examiner initially opined that both right and left ear hearing loss were related to in-service noise exposure, noting that the Veteran's hearing loss was "consistent with noise induced hearing loss" and "beyond the normal progression for age." She further noted that she found no separation audiogram, so there was "no evidence to confirm or deny a significant shift in hearing thresholds or auditory damage from conceded noise."

In March 2025, VA requested an addendum medical opinion from the January 2025 examiner, informing her that the service treatment records did contain a separation audiogram and providing her with the results thereof. Based on those audiometric results, the examiner concluded that while left ear hearing loss was service-related, right ear hearing loss was not. The examiner reasoned that the service treatment records revealed no significant threshold shift for the right ear. The examiner explained that in the absence of a right ear threshold shift in service, there was no evidence of permanent auditory damage on active-duty service, despite the conceded noise exposure.

The Board acknowledges that as an organic disease of the nervous system, sensorineural hearing loss is a disease which, if manifest to a degree of 10 percent within one year after separation from active duty, may be presumed to have been incurred in service. To the extent that the Veteran believes that right ear hearing loss began during his active-duty service or within one year thereafter, he is not competent to provide a diagnosis of hearing loss or determine that any symptoms were manifestations of a sensorineural hearing loss, or of hearing loss for VA compensation purposes generally. The diagnosis of the appellant's hearing loss is medically complex, as diagnosis of hearing loss requires knowledge of interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4. (Fed. Cir. 2007). The Veteran is not shown to possess the requisite medical experience, expertise, or training to administer and interpret audiometry testing or to provide competent medical evidence on this complex question. While the Veteran may have experienced a subjective decrease in hearing ability, it must meet the standard at 38 C.F.R. § 3.385 for VA disability benefits purposes. The Board thus gives more probative weight to the competent medical evidence of record, that being the in-service audiometric testing which shows no diagnosis of hearing loss. The available evidence thus weighs persuasively against finding manifestations sufficient to identify chronic hearing loss in active-duty service, or within one year thereafter. Thus, service connection is not warranted on a presum
. (Fed. Cir. 2007). The Veteran is not shown to possess the requisite medical experience, expertise, or training to administer and interpret audiometry testing or to provide competent medical evidence on this complex question. While the Veteran may have experienced a subjective decrease in hearing ability, it must meet the standard at 38 C.F.R. § 3.385 for VA disability benefits purposes. The Board thus gives more probative weight to the competent medical evidence of record, that being the in-service audiometric testing which shows no diagnosis of hearing loss. The available evidence thus weighs persuasively against finding manifestations sufficient to identify chronic hearing loss in active-duty service, or within one year thereafter. Thus, service connection is not warranted on a presumptive basis. 38 C.F.R. §§ 3.307, 3.309.

The Board turns to the question of whether right ear hearing loss is directly related to active-duty noise exposure. While the Veteran believes his right ear hearing loss is related to in-service noise exposure, the Veteran does not have the requisite medical experience, expertise, or training to provide a competent nexus opinion. The etiology of hearing loss is medically complex as it has multiple possible etiologies. Jandreau, 492 F.3d at 1377 n.4. The Board thus gives more probative weight to the March 2025 examiner's opinion against a relationship with in-service noise exposure.

While the January 2025 opinion was favorable, where a medical opinion is based on inaccurate facts and history, its probative value is significantly reduced. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). Here, the January 2025 medical opinion, though favorable to the claim, was based on an inaccurate factual picture as the examiner overlooked the June 2003 audiometric test results. The March 2025 opinion was rendered after the examiner took account of the June 2003 audiometric test results. Therefore, the Board attributes greater probative value to the March 2025 addendum opinion than to the January 2025 opinion.

The Board has considered the arguments provided by the representative in the January 2026 appellate brief. In relevant part, the representative asserted that "it can take longer for one ear to reflect the damage than the other." Additionally, the representative cited to medical articles, purporting to support that "initially reversible noise damage can have dramatic long-term consequences in amplifying age-related sensorineural hearing loss" and that "a single synaptopathic exposure has effects on the ear that continue long after the damaging noise has stopped." However, the representative is not shown to have the requisite medical experience, expertise, or training to provide a competent nexus opinion. Again, the etiology of hearing loss is medically complex as it has multiple possible etiologies. Jandreau, 492 F.3d at 1377 n.4. The Board thus gives more probative weight to the March 2025 examiner's opinion against a relationship with in-service noise exposure.

The Board also acknowledges that the January 2026 Appellate Brief contained hyperlinks to content that was not otherwise part of the record on appeal; however, that content was not accessed nor considered as part of the record before the Board. See Bowey v. West, 11 Vet. App. 106, 108-09 (1998) (holding that the mere reference to non-VA documents is insufficient to incorporate them into the record).

Regarding the representative's summaries of the referenced articles, medical treatise evidence can, in some circumstances, constitute competent medical evidence, especially when combined with an opinion of a medical professional. See Sacks v. West, 11 Vet. App. 314, 317 (1998); 38 C.F.R. § 3.159(a)(1). However, generic information in a medical journal or treatise is normally too general and inconclusive to constitute the sole basis for establishing a medical nexus to a disease or injury. Mattern v. West, 12 Vet. App. 222, 227 (1999); see also Wallin v. West, 11 Vet. App. 509, 514 (1998) (treatise evidence must "not simply provide speculative generic statements not relevant to the Veteran's claim.") In this case the representative's summary of the referenced articles are general and speculative in nature, do not specifically state a correlation between, and have not been specifically related to the Veteran by a medical professional. As the information provided by the representative is not specific to the facts of this case, the Board affords this evidence little probative weight. In contrast, because the March 2025 VA physician's opinion is specific to the Veteran's case, fully articulated, and supported by a well-reasoned analysis, it is entitled
); see also Wallin v. West, 11 Vet. App. 509, 514 (1998) (treatise evidence must "not simply provide speculative generic statements not relevant to the Veteran's claim.") In this case the representative's summary of the referenced articles are general and speculative in nature, do not specifically state a correlation between, and have not been specifically related to the Veteran by a medical professional. As the information provided by the representative is not specific to the facts of this case, the Board affords this evidence little probative weight. In contrast, because the March 2025 VA physician's opinion is specific to the Veteran's case, fully articulated, and supported by a well-reasoned analysis, it is entitled to much greater probative value than the representative's submissions.

Based on the foregoing, the Board finds that the competent and credible evidence is neither evenly nor approximately balanced as to whether service connection for right ear hearing loss is warranted. Rather, the evidence weighs persuasively against finding that right ear hearing loss manifested during active-duty service or within one year thereafter, or that right ear hearing loss is related to any in-service injury or illness. The benefit of the doubt doctrine does not apply. 38 U.S.C. § 5107 (b), Lynch, 21 F.4th 776. The claim is denied.

2. Entitlement to a compensable rating for left ear hearing loss is denied.

The Veteran contends that his left ear hearing loss is more severely disabling than contemplated by the assigned noncompensable rating.

Disability evaluations are determined by the application of the VA's Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. The percentage ratings in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1.

Where there is a question as to which of the two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7.

Evaluations of defective hearing range from noncompensable to 100 percent based on organic impairment of hearing acuity as measured by the results of a controlled Maryland CNC speech discrimination test together with the average hearing threshold level measured by pure tone audiometry tests in the frequencies of 1000, 2000, 3000, and 4000 cycles per second (Hertz). 38 C.F.R. § 4.85. To evaluate the degree of disability from defective hearing, the schedule establishes 11 auditory hearing acuity levels designated from Level I for essentially normal hearing acuity through Level XI for profound deafness. 38 C.F.R. §§ 4.85, Tables VI and VII, DC 6100. Disability ratings for hearing loss are derived from a mechanical application of the rating schedule to the numeric designations resulting from audiometric testing. See Lendenmann v. Principi, 3 Vet. App. 345 (1992).

If impaired hearing is service-connected in only one ear, in order to determine the percentage evaluation from Table VII, the non-service-connected ear will be assigned a Roman Numeral designation for hearing impairment of I, subject to the provisions of § 3.383 of this chapter. 38 C.F.R. § 4.85 (f). Table VII provides that where hearing loss in only one ear is service-connected, 10 percent is the maximum schedular rating.

On the authorized audiological evaluation in January 2025, pure tone thresholds, in decibels, were as follows:

HERTZ

1000 2000 3000 4000 AVG.

LEFT 15 20 45 40 30

Speech audiometry revealed speech recognition ability of 100 percent in the left ear. The Veteran stated that he struggled to hear conversations, especially in background noise or in groups.

Application of the findings of the October 2021 VA examination to Table VI in 38 C.F.R. § 4.85 yields a finding of Level I hearing loss in the left ear. Application of those findings to Table VII yields a 0 percent rating.

The Board has taken into consideration the Veteran's complaints regarding the impact of left ear hearing loss on his daily life. Pertinently, the Veteran reported having difficulty hearing conversations, especially in background noise or in groups. These are functional difficulties that would be expected to be caused by his recorded levels of hearing loss. See Doucette v. Shulkin, 28 Vet. App. 366 (2017) (Manifestations such as difficulty hearing speech are the types of difficulties contemplated by the schedular criteria for hearing loss.). The assignment of disability ratings for hearing impairment is primarily derived from a mechanical formula based on levels of pure tone threshold average and speech discrimination. Lendenmann, 3 Vet. App. at 349. In this case, the levels of pure tone threshold average and speech discrimination do not support the criteria for a higher rating.

Thus, the most probative medical evidence as to the severity of the Veteran's left ear hearing loss for the periods discussed herein is the VA examination of record. That examination reveals that the Veteran's hearing loss did not warrant an increased rating.

The Board acknowledges the Veteran's contention that his hearing loss is more severe than contemplated by the assigned ratings. The Board is sympathetic to the fact that the Veteran experiences hearing loss but when only one ear is service connected, the regulations require a very high level of disability for higher ratings.

As the Veteran does not have either the education or training to offer a medical opinion challenging the adequacy of the testing, and as there is no competent evidence of record to support his assertion that his hearing loss was, in fact, more severe than indicated on examination, the Veteran's assertions in this regard are not probative. See Layno v. Brown, 6 Vet. App. 465 (1994), Jandreau, 492 F. 3d 1372. The Board concludes that the medical findings on examination are of greater probative value than the Veteran's lay allegations regarding the severity of his hearing loss and that his functional impairment is adequately reflected by those medical findings.

Based on the foregoing, the Board finds that the competent and credible evidence is neither evenly nor approximately balanced as to whether entitlement to a compensable initial rating for left ear hearing loss is warranted. Rather, the evidence persuasively weighs against finding the Veteran's left ear hearing loss was manifested by worse than a Level I hearing loss. The benefit of the doubt doctrine does not apply. 38 U.S.C. § 5107 (b), Lynch, 21 F.4th 776. The claim is denied.

S. Kim

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Bametzreider, Paul

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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