TINNITUS

LESLEY A. REIN · 2026 · Case ID: A26040501

GRANTED

Summary

The Veteran, who served in the U.S. Army Reserves from February 1975 to March 1984, appeals the denial of service connection for tinnitus. The Veteran claims her tinnitus began in 1975 during basic training due to exposure to loud noise on the rifle range, despite wearing hearing protection. Her service records indicate her MOS was Administrative Specialist, which typically involves low noise exposure, and her service treatment records (STRs) were silent for tinnitus complaints or diagnosis during service. However, she has service connection for right ear hearing loss due to acoustic trauma. The case presents conflicting medical opinions. A March 2023 VA examination found the tinnitus was at least as likely as not caused by military noise exposure, citing permanent hearing threshold shifts and medical research linking noise exposure to tinnitus. Another March 2023 VA examination noted contradictory findings regarding tinnitus presence and found the condition less likely than not related to service, primarily due to the lack of documented tinnitus in service records and the low-noise MOS. The Board found the latter opinion inadequate because it failed to address the Veteran's credible reports of noise exposure, the finding of acoustic trauma for hearing loss, and the first examiner's favorable nexus opinion. The Board found the first March 2023 VA opinion more persuasive, concluding the evidence was in approximate balance. Applying the benefit of the doubt, service connection for tinnitus was granted.

Rationale

Conflicting medical opinions regarding etiology; Board found May 2023 VA opinion inadequate; March 2023 VA opinion persuasive due to favorable nexus and objective findings; Benefit of the doubt applied due to approximate balance of evidence

Service Branch

ARMY RESERVES

Special Benefit

NO SPECIAL BENEFIT

Docket No.

230710-360192

Full Decision Text

Citation Nr: A26040501
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 230710-360192
DATE: April 30, 2026

ORDER

Entitlement to service connection for tinnitus is granted.

FINDING OF FACT

Resolving all reasonable doubt in favor of the Veteran, the positive and negative evidence is in approximate balance that her currently diagnosed tinnitus is etiologically related to her military noise exposure.

CONCLUSION OF LAW

The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the U.S. Army Reserves from February 1975 to March 1984.

The rating decision on appeal was issued in June 2023 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the July 10, 2023 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) (NOD), the Veteran elected the Hearing docket. Therefore, the Board may only consider the evidence of record at the time of the June 2023 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or her representative 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 before the scheduled hearing, or (2) more than 90 days after the scheduled hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302, 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.

The Veteran testified before the undersigned Veterans Law Judge at a January 2026 Virtual hearing. A transcript of this hearing is of record.

Service Connection

1. Entitlement to service connection for tinnitus

The Veteran asserts that her tinnitus was caused by her in-service noise exposure. Specifically, the Veteran reports being exposed to loud noise at the rifle range during summer camp training in the 1970's. She said that she first noticed the ringing in her ears on the rifle range. The Veteran was provided hearing protection, but she indicated that she could still hear while using the hearing protection. Her tinnitus reportedly continued since it started and occurred all the time. Following service, the Veteran said that she worked in an insurance company at a desk for the entire time. She also worked part-time at a craft store. She denied having any post-service noise exposure. See January 2026 Board hearing transcript.

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, service connection requires: (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. See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). 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).

Only "veterans" are entitled to VA compensation. 38 U.S.C. § 1131. The term "veteran" means a person who served in the active military, naval, air, or space service, and who was discharged or released therefrom under conditions other than dishonorable. 38 U.S.C
1163, 1166-67 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). 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).

Active military, naval, air, or space service includes any period of active duty for training (ACDUTRA) during which the individual concerned was disabled or died from disease or injury incurred in or aggravated in the line of duty; or any period of inactive duty training (INACDUTRA) during which the individual concerned was disabled or died from injury incurred in or aggravated in the line of duty or from an acute myocardial infarction, a cardiac arrest, or a cerebrovascular accident occurring during such training. 38 U.S.C. §§ 101(21), (24), 106; 38 C.F.R. § 3.6(a), (d). The fact that a claimant has established status as a "veteran" for other periods of service (active duty, etc.) does not obviate the need to establish that he is also a "veteran" for purposes of the period of ACDUTRA where the claim for benefits is premised on that period of ACDUTRA. Mercado-Martinez v. West, 11 Vet. App. 415, 419 (1998). However, once a claimant has achieved veteran status for a single disability incurred or aggravated during that period of ACDUTRA, that status applies to all disabilities claimed to have been incurred or aggravated during that period of ACDUTRA. Hill v. McDonald, 28 Vet. App. 243, 252 (2016).

Generally, certain presumptions that apply to periods of active duty are inapplicable to periods of ACDUTRA and INACDUTRA, such as the presumptive incurrence or aggravation of conditions that are considered chronic, per se, if initially manifested to a compensable degree (meaning to at least 10-percent disabling) within the initial post-service year, or regarding the presumptions of soundness and aggravation. See Smith v. Shinseki, 24 Vet. App. 40 (2010). However, where VA determines that a claimant has established veteran status for a period of ACDUTRA by establishing service connection for one disability, the claimant may take advantage of the presumption of aggravation for other preexisting disabilities claimed to have been aggravated during the same period of ACDUTRA. Hill v. McDonald, 28 Vet. App. 243, 246 (2016).

In determining whether service connection is warranted, the Board shall consider the benefit-of-the-doubt doctrine. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The claimant is entitled to the benefit-of-the-doubt when the competing evidence is in "approximate balance" or "nearly equal." That is, exact equipoise is not required to trigger the favorable benefit-of-the-doubt rule. Lynch v. McDonough, 21 F.4th 776, 781 (Fed. Cir. 2021) (en banc).

The question before the Board is whether the Veteran's tinnitus was etiologically related to her military service. Based on a careful review of all the subjective and clinical evidence, and resolving all reasonable doubt in favor of the Veteran, the Board finds that service connection for tinnitus is warranted.

Preliminarily, the Board notes that the Veteran's Army Reserve service from February 1975 to March 1984 is now considered active service based on the grant of service connection for right ear hearing loss that was incurred in the line of duty during that period of service. See April 2023 Deferred Rating Decision.

The Veteran's service records show that her military occupational specialty (MOS) was Administrative Specialist, which has a low probability of noise exposure. See Duty MOS listing. However, the Veteran has been awarded service connection for right ear hearing loss based on in-service exposure to acoustic trauma, and she credibly testified that she was exposed to loud noise on the
Board finds that service connection for tinnitus is warranted.

The Veteran's service records show that her military occupational specialty (MOS) was Administrative Specialist, which has a low probability of noise exposure. See Duty MOS listing. However, the Veteran has been awarded service connection for right ear hearing loss based on in-service exposure to acoustic trauma, and she credibly testified that she was exposed to loud noise on the rifle range during summer training. Thus, based on the circumstances of the Veteran's service, the Board finds that she was exposed to hazardous noise during active service.

The Veteran's available service treatment records (STRs) document that she entered Army Reserve service with normal ears - general and drums clinical evaluations. See January 1975 enlistment examination. At a March 1983 quadrennial physical, the Veteran had normal ears -general and drums clinical evaluations, and she affirmatively denied having any ear, nose, or throat trouble.

At a March 2023 VA audiological examination, the Veteran reported having military noise exposure from her exposure to firearms, the firing range, and heavy equipment. Her tinnitus reportedly began in 1975 during basic training and was constant bilaterally with worsening ringing in her right ear. The March 2023 VA examiner opined that the Veteran's tinnitus was at least as likely as not caused by or a result of military noise exposure. In providing a rationale, the March 2023 VA examiner found that the Veteran's STRs indicated a significant permanent shift in hearing thresholds from entrance to separation which was indicative of possible damage to the auditory system from conceded noise on active duty. The March 2023 VA examiner noted the Veteran's report of onset of tinnitus during basic training in 1975 and her exposure to weapons and the firing range. Thus, the March 2023 VA examiner concluded that the relationship between noise exposure, auditory damage and tinnitus is documented in the research and the objective evidence supports a nexus of auditory damage.

At a subsequent March 2023 VA audiological examination, which was conducted by a different audiologist, the Veteran reported her military noise exposure and her post-service occupation working in an insurance office. She denied having any recreational noise exposure. The March 2023 VA examiner noted that the Veteran denied having recurrent tinnitus.

In a May 2023 VA opinion, the VA examiner opined that the Veteran's tinnitus was less likely than not incurred in or caused by military service. In providing a rationale, the May 2023 VA examiner noted that the VA audiologist noted that the Veteran had constant tinnitus during her first VA examination and then during the second VA examination, the VA audiologist noted that the Veteran did not have recurrent tinnitus. The May 2023 VA examiner stated that the Veteran's MOS had a low probability of hazardous noise exposure and that her claims file was silent for complaints, diagnosis, or treatment of tinnitus during service. The May 2023 VA examiner concluded that because the Veteran's claims file was silent for a diagnosis of tinnitus during service, her tinnitus was less likely than not related to service.

The Board recognizes that the record includes conflicting medical opinions regarding the etiology of the Veteran's tinnitus. With regard to the medical opinions obtained, as with all types of evidence, it is the Board's responsibility to weigh the conflicting medical evidence to reach a conclusion as to the ultimate grant of service connection. Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). The Board may favor the opinion of one competent medical expert over another if its statement of reasons and bases is adequate to support that decision. Owens v. Brown, 7 Vet. App. 429, 433 (1995). Stated another way, the Board decides, in the first instance, which of the competing medical opinions or examination reports is more probative of the medical question at issue. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 300 (2008).

The Board finds that the May 2023 VA opinion is inadequate to decide the claim. Although the Veteran's MOS has a low probability of noise exposure, the May 2023 VA examiner did not address the Veteran's report of noise exposure during summer training from the firing range or the finding of acoustic trauma during service which was sufficient to establish service connection for right ear hearing loss. Nor did the May 2023 VA examiner discuss the March 2023 VA examiner's finding that the Veteran had significant permanent hearing threshold shifts from entrance to separation, which was indicative of auditory damage. Finally, the May 2023 VA examiner indicated the contradictory notations by the two March 2023 VA examiners regarding whether the Veteran had tinnitus; however, the May 2023 VA examiner did not address the first March 2023 VA examiner's favorable nexus opinion. Rather, the May 2023 VA examiner relied solely on the lack of a documented diagnosis during service for finding no nexus between the Veteran's tinnitus and military service. For the above reasons, the Board cannot rely on the opinion to decide the claim. See Barr. v. Nicholson, 21 Vet. App. 303 (2007).

By contrast, the Board finds that the first March 2023 VA examiner provides the most persuasive evidence regarding the etiology of the Veteran's tinnitus. On that basis, the first March 2023 VA examiner provided an opinion, which was based on a consideration of the Veteran's lay reports regarding the onset of her tinnitus, the continuity of her tinnitus symptoms, and the nature of her military and post-service noise exposure. The March 2023 VA examiner also supported her opinion with a discussion of objective findings during service indicating auditory damage as well as medical research on the relationship between noise exposure, auditory damage, and tinnitus. Accordingly, the Board concludes that the positive and negative evidence is in approximate balance that the Veteran's currently diagnosed tinnitus is etiologically related to her military noise exposure.

In summary, resolving all reasonable doubt in favor of the Veteran, service connection for tinnitus is warranted. Therefore, the Veteran's service connection claim for tinnitus must be granted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

LESLEY A. REIN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Journet Shaw, 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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