TINNITUS

Summary

The veteran, who served from February 1977 to August 1987, appeals the denial of service connection for bilateral hearing loss (BHL) and the dismissal of his claim for tinnitus. The veteran also sought service connection for right hand and right wrist disabilities, alleging an in-service injury on November 1, 1977, when a first sergeant struck his right hand and wrist with a metal rod. The veteran reported fearing retaliation if he reported the incident and received no medical attention. The Board noted that the VA examiner diagnosed a right hand disability with functional loss and pain, and a chronic right wrist sprain, but opined negatively on service connection, citing a lack of chronicity in service treatment records. The Board found the VA examiner's opinion inadequate, as it conflated continuity of symptoms with continuity of care and failed to recognize that pain alone can constitute a disability. Crucially, private medical records from July 2025, submitted within the appeal window, revealed significant old injuries to the Veteran's right hand and wrist, including scaphoid fracture, narrowing of the radiocarpal joint, and DISI instability, which the private orthopedist linked to the in-service incident. A fellow veteran's statement corroborated the in-service assault. The Board found the private opinion probative and the lay statements credible, granting service connection for the right hand disability (including the thumb) and the right wrist sprain. The tinnitus claim was dismissed as moot because service connection had already been granted with the maximum rating. For BHL, the Veteran's December 2024 VA audiology exam showed puretone thresholds and word discrimination scores that did not meet the regulatory definition of a hearing loss disability. An earlier August 2021 audiogram also did not meet the criteria. The Board found the Veteran's hearing loss had not reached the required level of severity, denying the claim.

Rationale

Service connection for tinnitus granted in January 2026 rating decision; Maximum disability rating granted effective August 8, 2023; No case or controversy before the Board

Full Decision Text

Citation Nr: A26040148
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 251223-632816
DATE: April 29, 2026

ORDER

Entitlement to service connection for tinnitus is dismissed.

Entitlement to service connection for right hand disability, to include the thumb, is granted.

Entitlement to service connection for right wrist sprain is granted.

Entitlement to service connection for bilateral hearing loss (BHL) is denied.

FINDINGS OF FACT

1. The Veteran has been granted service connection for tinnitus and is at the maximum schedular rating from August 8, 2023.

2. The probative evidence relates the Veteran's right hand disability to include the thumb, to military service.

3. The probative evidence relates the Veteran's right wrist sprain to military service.

4. The Veteran has not had a diagnosis of a hearing loss disability that meets regulatory requirements during or near in time to the appeal.

CONCLUSIONS OF LAW

1. The criteria for dismissal of entitlement to service connection for tinnitus have been met.  38 U.S.C. § 7105; 38 C.F.R. § 20.104.

2. The criteria for entitlement to service connection for right hand disability, to include the thumb, have been met.  §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for entitlement to service connection for right wrist sprain have been met.  §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for entitlement to service connection for BHL have not been met.  38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from February 1977 to August 1987.  This matter comes to the Board of Veterans' Appeals (Board) on appeal from a January 2025 rating decision from a Department of Veteran Affairs (VA) Regional Office (RO) under the modernized appeals system known as the Appeals Modernization Act (AMA).

In December 2025, the Veteran submitted a VA Form 10182 and requested the AMA Evidence Submission docket.  Under AMA, the Veteran can submit additional evidence within 90 days of this election.  Under the rules of the AMA, the Board may only consider the evidence of record at the time of the Agency of Original Jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the VA Form 10182.  38 C.F.R. § 20.303.  The Board cannot consider (1) evidence submitted during the period after the AOJ issued the decision on appeal and before the VA Form 10182 was received, or (2) evidence submitted more than 90 days after the VA Form 10182 was received.  38 C.F.R. § 20.303.

As a matter of procedural history, the Board notes the January 2025 rating decision on appeal denied service connection for posttraumatic stress disorder (PTSD).  On December 3, 2025, before VA received the Veteran's December 23, 2025 VA Form 10182, VA received the Veteran's supplemental claim for entitlement to service connection for tinnitus and PTSD.  A January 2026 rating decision granted entitlement to service connection for tinnitus with a 10 percent disability rating, effective August 8, 2023, and deferred a decision on entitlement to compensation for PTSD.  As such, the AOJ has not completed adjudication on the claim of PTSD, which means the matter is not before the Board.  

1. Entitlement to service connection for tinnitus. 

As explained above, the Veteran was granted entitlement to service connection for tinnitus in a January 2026 rating decision, with a 10 percent disability rating, effective August 8, 2023.  

As the maximum disability rating has been granted since August 8, 2023, the date of receipt of the Veteran's intent to file, there remains no case or controversy before the Board. Accordingly, the appeal as to the claim for entitlement to service connection for tinnitus is dismissed as moot.

2. Entitlement to service connection for right hand disability, to include the thumb.

3. Entitlement to service connection for right wrist sprain.

The Veteran seeks service connection for right hand and right wrist disabilities.  Specifically, he contends that during service,
 the Veteran was granted entitlement to service connection for tinnitus in a January 2026 rating decision, with a 10 percent disability rating, effective August 8, 2023.  

As the maximum disability rating has been granted since August 8, 2023, the date of receipt of the Veteran's intent to file, there remains no case or controversy before the Board. Accordingly, the appeal as to the claim for entitlement to service connection for tinnitus is dismissed as moot.

2. Entitlement to service connection for right hand disability, to include the thumb.

3. Entitlement to service connection for right wrist sprain.

The Veteran seeks service connection for right hand and right wrist disabilities.  Specifically, he contends that during service, on November 1, 1977, a first sergeant in his battalion struck his right hand and wrist with a metal rod; that he was told not to report this incident; that he feared for his life and suffered with no medical attention and was forced to heal without proper treatment; that he was 19 years old and frightened to death, and; that he feared that if he went to sick call, he would be killed, because the first sergeant was very foolish and vicious.  See December 2023, Statement in Support of Claim for PTSD.  

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service.  38 U.S.C. §§ 1131, 5107; 38 C.F.R. § 3.303.  Generally, service connection requires three elements: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Shedden v. Principi, 381 F.3d. 1163, 1166-67 (Fed. Cir. 2004).  Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

In deciding the Veteran's claim, the 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 the persuasive evidence is against the claim, in which case the claim is denied.  38 U.S.S. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990).  When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant.

In December 2024, the Veteran was afforded a VA medical examination to ascertain the nature and etiology of a right hand disability.  The examiner diagnosed the Veteran with a right hand disability, to include the thumb, and a chronic right wrist sprain.  The Board notes the diagnosis of a right hand disability is not a specific medical diagnosis.  However, the examiner also opined the Veteran has functional loss or functional impairment, as he has pain on the right hand and thumb with pushing, pulling, and lifting.  

Notably, evidence of pain alone which results in functional impairment, even if there is no identified underlying diagnosis, can constitute a disability. See Saunders v. Wilkie, 886 F.3d 1356 (2018). The United States Court of Appeals for the Federal Circuit (Federal Circuit) found that 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."  

To provide additional context to the Veteran's right hand disability, in December 2025, which is within the appropriate evidence window, the Veteran submitted private medical treatment records.  There is documentation of a July 9, 2025 orthopedic consultation, where x-rays were taken of the Veteran's right hand and wrist.  The private medical treatment record documents the result of the x-rays as metacarpals and phalanges are fully normal.  The two rows of the proximal and second row of the wrist show significant perturbation in the AP film.  There does look to be some waste of scaphoid fracture with subsequent deformity.  There is extreme narrowing of the radiocarpal joint and there is less than .5mm of space at one spot.  The general scalloped appearance of the distal radius is preserved.  The lunate looks to have been injured, as well, and possibly angulated, which is confirmed on the lateral film.  There appears to be a modest DISI instability present in this.  There are no other fractures,
 record documents the result of the x-rays as metacarpals and phalanges are fully normal.  The two rows of the proximal and second row of the wrist show significant perturbation in the AP film.  There does look to be some waste of scaphoid fracture with subsequent deformity.  There is extreme narrowing of the radiocarpal joint and there is less than .5mm of space at one spot.  The general scalloped appearance of the distal radius is preserved.  The lunate looks to have been injured, as well, and possibly angulated, which is confirmed on the lateral film.  There appears to be a modest DISI instability present in this.  There are no other fractures, dislocations, cystic, lytic, or acute bony, or soft tissue pathology.  There are multiple osteophytes and joint space narrowing in these two carpal rows.  This is quite complex, old, and such an archaic injury in presentation.  See VBMS, document labeled STR- Medical, receipt date 12/23/2025, page 26 of 60.  Given the aforementioned functional loss and impairment noted by the December 2024 VA medical examiner, in addition to the archaic injury noted from the aforementioned x-rays, the Board notes there is evidence of pain that causes impairment in earning capacity. 

The Veteran's service treatment records (STRs) are silent for documentation or complaints of the right hand and right wrist.

In December 2025, the Veteran submitted a statement from a fellow veteran, whom he served with, K.A.  Specifically, K.A. confirmed that on or about November 1, 1977, their battalion was doing a road march, when a first sergeant took his clearing rod and wacked the Veteran across his right hand.  The Veteran yelled out in agony and everyone was stunned and nearly stopped marching.  The first sergeant said to keep moving and marching.  K.A. provided context that a clearing rod is a component of a small arms repair kit.  K.A. added that the Veteran has complained how he experiences flare-ups and excruciating pain from time to time.  The Board finds the Veteran and K.A. competent and credible to report their military experience.

The December 2024 VA medical examiner provided a negative nexus medical opinion that the Veteran's right hand disability and right wrist sprain is less likely than not incurred in or caused by the claimed in-service injury, event, or illness.  The examiner explained that the Veteran was diagnosed with a right hand strain after he was assaulted by a colleague while in service, and that the STRs show a complaint of assault, but no chronicity linked to treatment.  The Board notes the examiner is conflating two issues.  It is continuous symptoms, not continuous complaints or treatment for them, that the VA regulation requires. See Wilson v. Derwinski, 2 Vet. App. 16, 19 (1991). Furthermore, although the VA medical examiner diagnosed the Veteran with a chronic right wrist sprain, a right hand disability is not a chronic disability per 38 C.F.R. § 3.309 that is supported by reports of continuous symptoms.  Thus, the Board finds the December 2024 medical opinion to be inadequate given that the VA examiner impermissibly equated "chronicity of care" with "continuity of symptoms", and only the latter is required by 38 C.F.R. § 3.303(b). See also Savage v. Gober, 10 Vet. App. 488, 496 (1997).    

As previously explained, in December 2025, the Veteran submitted private medical treatment records, which included a July 9, 2025 orthopedic consultation.  The orthopedist noted the Veteran's report of suffering an injury in the military in November 1977; that the mechanism of injury was a metal rod impact to the dorsum of the right hand and wrist; that there have been no previous or subsequent injuries or accidents to this extremity, and; they have the history of the injury and social implications as far as how it affects his life status, duties, and activities, known as ADLs (activities of daily living), and the link is related to that, as they have eliminated other potential accidents, injuries, or medical causes.  Consequently, the orthopedist opined it is more likely than not, this issue is related to the injury as described.  It is clear to the Board that the orthopedist reviewed the Veteran's medical history to the extent of finding no other injuries or incidents that would have caused the current functional impairment of the right hand and wrist.  Consequently, the Board affords the orthopedist's opinion probative weight.  

Given the aforesaid, the Board finds that the Veteran's currently diagnosed right
 as how it affects his life status, duties, and activities, known as ADLs (activities of daily living), and the link is related to that, as they have eliminated other potential accidents, injuries, or medical causes.  Consequently, the orthopedist opined it is more likely than not, this issue is related to the injury as described.  It is clear to the Board that the orthopedist reviewed the Veteran's medical history to the extent of finding no other injuries or incidents that would have caused the current functional impairment of the right hand and wrist.  Consequently, the Board affords the orthopedist's opinion probative weight.  

Given the aforesaid, the Board finds that the Veteran's currently diagnosed right hand disability is etiologically related to the in-service incurrence of being hit on the right hand and wrist by a first sergeant in his battalion, and therefore, the Board finds that service connection for the right hand, to include right thumb, and chronic right wrist sprain, is warranted.

?

4. Entitlement to service connection for BHL. 

The Veteran contends that he has a hearing loss disability that is due to his military service.

VA considers impaired hearing to be a disability for compensation purposes 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, 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.

Regarding a current diagnosis of a hearing loss disability, the Veteran underwent a VA audiology examination in December 2024.  His puretone thresholds were as follows:

Hertz	500	1000	2000	3000	4000

Right	15	25	25	25	25

Left	15	25	25	30	25

Maryland CNC word discrimination scores were 96 percent on the right, and 94 percent on the left.

These findings do not qualify as a disability for VA compensation purposes.

Notably, at no point during the appeal has the Veteran's audiological findings reached the level of severity required to be considered a "disability" for VA compensation purposes under 38 C.F.R. § 3.385.  Thus, the first element required for service connection (a current diagnosis of a disability) has not been met.

The Board notes that an audiologic report from August 31, 2021 was submitted in conjunction with the Veteran's December 2025, VA Form 10182.  See VBMS, document labeled STR- Medical, receipt date 12/23/2025, page 4 of 60.  The thresholds were as follows:

Hertz	500	1000	2000	3000	4000

Right	15	20	15	15	5

Left	10	25	15	15	5

The audiogram does not support a diagnosis of a disability of hearing loss.  Additionally, word recognition scores were also included; however, they were obtained through the NU-6 Word List, rather than through the Maryland CNC Test; therefore, they cannot be used to establish a hearing loss disability, as defined in 38 C.F.R. § 3.385.

The Board does not doubt the sincerity of the Veteran's belief that he has decreased hearing acuity, or that he had significant noise exposure in service.  However, regulation requires that compensation for hearing loss is only available once the loss reaches a prescribed level of severity, which can only be shown by objective medical testing.  In this case, the Veteran's hearing loss has not reached that level of severity.

The claim for entitlement to service connection for hearing loss is denied because the criteria set forth in 38 C.F.R. § 3.385 are not met, and therefore there is no current disability for VA compensation purposes. The existence of a current disability is the cornerstone of a claim for VA disability compensation. In the absence of evidence of a current disability there can be no valid claim. As such, the appeal is denied.

 

 

Bethany L. Buck

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	R. Smith, Associate 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.