HEARING LOSS

RAY BARTO SLABBEKORN, JR. · 2026 · Case ID: A26040518

GRANTED

Summary

The veteran, who served in the U.S. Army from March 1974 to January 1975, appeals the denial of service connection for bilateral hearing loss and tinnitus. The veteran claims these conditions resulted from firing an M16 rifle during service. The Board found that the veteran has a current bilateral sensorineural hearing loss and continuity of symptomatology since service, thus granting service connection. Although the VA examiner provided a negative nexus opinion for hearing loss, citing the separation examination showing normal hearing and the Institute of Medicine report's findings on delayed onset hearing loss, the Board found the examiner's reliance on the report to be flawed due to its qualifying aspects. The Board also noted the veteran's lay testimony regarding hearing loss symptoms beginning in service and continuing to the present, and the discrepancy with the separation exam, affording the veteran the benefit of the doubt. For tinnitus, the Board also found service connection warranted. While the VA examiner provided negative nexus opinions, the Board noted the examiner conceded tinnitus onset since service, supporting a grant based on continuity of symptomatology. The Board found the evidence weighed in favor of the claim, granting service connection for both bilateral hearing loss and tinnitus.

Rationale

Current bilateral sensorineural hearing loss established.; Continuity of symptomatology since service.; Negative VA nexus opinion afforded low probative weight due to flawed reasoning and contradictory aspects of cited IOM report.; Benefit of the doubt afforded due to discrepancy between separation exam and service onset of symptoms.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

260112-627505

Full Decision Text

Citation Nr: A26040518
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 260112-627505
DATE: April 30, 2026

ORDER

Entitlement to service connection for bilateral hearing loss is granted.

Entitlement to service connection for tinnitus is granted.

FINDINGS OF FACT

1. The Veteran has a current bilateral sensorineural hearing loss disability and continuity of symptomatology is shown

2. The Veteran has tinnitus that is due to in-service noise exposure.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for bilateral hearing loss are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385.

2. The criteria for entitlement to service connection for tinnitus are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from March 1974 to January 1975.

The veteran filed an original disability claim for service connection for hearing loss and tinnitus on November 20, 2025. A Department of Veterans Affairs (VA) Regional Office (RO) originally denied the Veteran's claims in a January 2026 rating decision because these disabilities neither occurred in nor were caused by service.

In January 2026, the Veteran submitted a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), electing the Evidence Submission option. As an appeal in which the appellant requested, on the Notice of Disagreement, an opportunity to submit additional evidence without a Board hearing, the Board's decision is based on a review of the evidence of record at the time of the decision on the issues on appeal and evidence submitted by the appellant or his representative with the Notice of Disagreement or within 90 days following receipt of the Notice of Disagreement. 38 C.F.R. § 20.303.

There isn't evidence in the Veteran's claims file that arrived there after the decision on appeal during a period when the Board could not consider it.

The Board notes that the time to modify the Veteran's notice of disagreement (NOD) under 38 C.F.R. § 20.202 (c)(2) has not yet expired. Williams v. McDonough, 37 Vet. App. 305, 307 (2024) (because [38 C.F.R. § 20.202 (c)(2)] gives a claimant the later of one year from the date that the RO mails notice of the decision or 60 days from when the Board receives the Notice of Disagreement (NOD) to change the NOD and select a different lane, the Board ordinarily may not decide an appeal before this time period is up). However, the Veteran waived his right to request a different Board review. See Notice of Disagreement; Clark v. O'Rourke, 30 Vet. App. 92, 97-98 (2018) (allowing waiver of a right to a particular time period for submission of evidence to be waived if there is "a voluntary, knowing, and intentional waiver of that right"); Bolds v. McDonough, 37 Vet. App. 359, 365 (2024) (parties "are generally permitted to waive the application of statutes intended for their benefit" unless there is a specific prohibition against doing so (quoting Janssen v. Principi, 15 Vet. App. 370, 374 (2001)). Therefore, the Board finds it proper to forgo the requirement that it hold a decision until the period to request to switch dockets elapses.

Factual history

On the authorized audiological evaluation in February 1974 pure tone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 10 10 0 2 15

LEFT 10 10 15 5 5

On the authorized audiological evaluation in January 1975, pure tone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 20 0 0 5 25

LEFT 15 5 5 5 5

The Veteran underwent a VA audiological examination on January
1974 pure tone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 10 10 0 2 15

LEFT 10 10 15 5 5

On the authorized audiological evaluation in January 1975, pure tone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 20 0 0 5 25

LEFT 15 5 5 5 5

The Veteran underwent a VA audiological examination on January 7, 2026. A January 2026 examiner diagnosed the Veteran with bilateral sensorineural hearing loss and recurrent tinnitus. According to the medical history, the date of onset of hearing loss was 1974. The circumstance of onset of hearing loss was during service time. Both sides were affected. The hearing loss had increased over time. The date of onset of tinnitus was 1974. The circumstance of onset of tinnitus was while on active duty the Veteran was exposed to loud noise. The reported tinnitus was constant. The side(s) affected was both. The tinnitus had increased in frequency over time.

On the authorized audiological evaluation in the January 2026 VA examination pure tone thresholds, in decibels, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 20 20 45 60 70

LEFT 30 30 60 70 75

Speech audiometry revealed speech recognition ability of 94 percent in the right ear and of 94 in the left ear. The January 2026 examiner opined that it was not at least as likely as not that the Veteran's hearing loss was caused by or a result of an event, injury, and/or disease incurred during military service. The January 2026 examiner reasoned that the separation examination dated January 1975 revealed hearing within normal limits. There was no report of complaint/treatment for hearing decrease in STRs or at separation, according to the January 2026 examiner. Although noise exposure was conceded and the relationship of noise, auditory damage and hearing loss was well-established, auditory damage and hearing loss were not conceded based on noise alone. The January 2026 examiner reasoned that the American College of Occupational and Environmental Medicine stated that there was insufficient evidence that noise-induced hearing loss progresses after hazardous noise exposure ceases, based on human and animal data reviewed by the National Academies; more recent rodent synaptopathy findings warranted caution but did not demonstrate delayed threshold decline in humans (Mirza et al., 2018). The January 2026 examiner reasoned that according to the Institute of Medicine Study (2005), "Noise and Military Service" Implications for Hearing Loss and Tinnitus" current knowledge of cochlear pathology did not provide sufficient scientific basis for the existence of delayed onset hearing loss. There must be a nexus of auditory damage to relate current hearing loss to military noise and not another etiology. The evidence was against a nexus in this case, concluded the January 2026 examiner.

The January 2026 examiner also provided negative direct and secondary service connection opinions for tinnitus. The January 2026 examiner opined that the Veteran's tinnitus was not at least as likely as not a symptom associated with hearing loss. The January 2026 examiner reasoned that there is no mention of tinnitus during or soon after active duty in the veteran's medical file. The January 2026 examiner reasoned that the Veteran had no other diagnosis that would be a likely nexus for tinnitus, such as Meniere's disease, TBI, or acoustic neuroma. Then, the January 2026 examiner concluded that, therefore, it was more likely than not that Veteran's tinnitus was due to hearing loss.

The January 2026 examiner opined that the Veteran's tinnitus was not at least as likely as not caused by or a result of military noise exposure. The January 2026 examiner reasoned that the Veteran's separation examination dated January 1975 revealed hearing within normal limits. The HUNT Study, a large population-based analysis, found no association between occupational noise exposure and tinnitus among individuals with normal hearing thresholds; only those with elevated thresholds showed a statistically significant association (Moulag et al., 2024). There was no report of complaint/treatment for hearing decrease in STRs or at separation. Exams and STRs were silent for tinnitus. While it is possible that noise exposure might contribute to tinnitus, there was no evidence of any diagnosis, or treatment for tinnitus or any
innitus was not at least as likely as not caused by or a result of military noise exposure. The January 2026 examiner reasoned that the Veteran's separation examination dated January 1975 revealed hearing within normal limits. The HUNT Study, a large population-based analysis, found no association between occupational noise exposure and tinnitus among individuals with normal hearing thresholds; only those with elevated thresholds showed a statistically significant association (Moulag et al., 2024). There was no report of complaint/treatment for hearing decrease in STRs or at separation. Exams and STRs were silent for tinnitus. While it is possible that noise exposure might contribute to tinnitus, there was no evidence of any diagnosis, or treatment for tinnitus or any other ear related symptoms, reasoned the January 2026 examiner. Although noise exposure was conceded and the relationship between noise exposure and tinnitus had been established in some cases, tinnitus was not conceded based on potential noise exposure alone. The evidence was against a nexus in this case; therefore, it was less likely than not that tinnitus was due to noise exposure, concluded the January 2026 examiner.

Law

VA grants service connection for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (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).

The existence of a current disability is the cornerstone of a claim for VA disability compensation. See Degmetich v. Brown, 104 F.3d 1328, 1332 (1997) (holding that interpretation of sections 1110 and 1131 of the statute as requiring the existence of a present disability for VA compensation purposes cannot be considered arbitrary). Evidence must at least show the appellant has the disability for which benefits are being claimed, else, there can be no valid claim because, for all intents and purposes, there is no present disability to in turn relate or attribute to his military service. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). A current disability means a disability shown by competent and credible (i.e., probative) evidence to exist. Chelte v. Brown, 10 Vet. App. 268 (1997). Pain alone, without an accompanying diagnosis of a present disease, can qualify as a disability if it reaches the level of a functional impairment of earning capacity. Saunders v. Wilkie, 886 F.3d 1356, 1367-69 (Fed. Cir. 2018).

For VA compensation purposes, a hearing loss disability exists where auditory thresholds equal or exceed 40 decibels at any of the frequencies of 500, 1000, 2000, 3000, or 4000 hertz; or equal or exceed 26 decibels at any three of those frequencies; or where speech recognition by Maryland CNC testing is less than 94 percent. See 38 C.F.R. § 3.385.

In addition, certain chronic diseases, such as organic disease of the nervous system (including sensorineural hearing loss and tinnitus), may be presumed to have been incurred in, or aggravated by, service if the disease becomes manifest to a compensable degree within one year of separation from qualifying military service. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. Additionally, service connection on the basis of continuity of symptomatology can be established for the chronic diseases specified at 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

1. Entitlement to service connection for hearing loss

The Veteran asserts that he has hearing loss that resulted from firing and becoming a sharpshooter with the M16 during his active service. See November 2025 VA Form 21-526EZ Application for Disability Compensation and Related Compensation Benefits. The Board finds that the Veteran has a current bilateral sensorineural hearing loss disability and continuity of symptomatology is shown. As such, the criteria for entitlement to service connection for bilateral hearing loss are met.

The RO found the Veteran has a current disability. See January 2026 Rating Decision. He was diagnosed with sensorineural
. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

1. Entitlement to service connection for hearing loss

The RO found the Veteran has a current disability. See January 2026 Rating Decision. He was diagnosed with sensorineural hearing loss in both ears during the January 2026 VA examination. Auditory thresholds exceeded 40 decibels at multiple frequencies. See 38 C.F.R. § 3.385. The Board is bound by these favorable findings.

Second, the Veteran has noise exposure during service based on his military occupational specialty and his statement about firing M16s, which is consistent with the facts and circumstances of service.

Third, the January 2026 VA examination medical history section summarizes that the Veteran's hearing loss began in service and progressively worsened since. The January 2026 examiner provided a negative nexus opinion based in part on Institute of Medicine report, "Noise and Military Service: Implications for Hearing Loss and Tinnitus", that did not support the existence of delayed onset hearing loss. The Board notes that the IOM report contains qualifying or contradictory aspects within its text. For example, it concludes there was no sufficient scientific basis for the existence of delayed onset hearing loss, yet also indicates that there was insufficient evidence from studies to determine whether permanent noise-induced hearing loss could develop later in life, long after the noise exposure, and that definitive studies on the issue have not been performed. As a result, the Board considered whether the apparent qualifiers or contradictions within the text diminish the probative value of the VA opinion evidence or render the opinion inadequate. McCray v. Wilkie, 31 Vet. App. 243 (2019). The Board finds they do.

Per the Court in McCray "a medical text's qualifying or contradictory aspects" is only one factor on a non-exhaustive list that is relevant to the Board's evaluation of the probative value and adequacy of a medical opinion. Id. at 257. Here, the January 2026 examiner relied on the findings of the report to provide a negative nexus opinion. As such, the January 2026 opinion is afforded low probative weight.

Here, the competent and credible lay evidence establishes that the Veteran's symptoms of hearing loss began in service and have continued to the present. Although there is no probative medical or audiological opinion in favor of the claim, the opinions against the claim do not establish that the Veteran's hearing loss is due to a post-service cause. Thus, based on the evidence of continuity of symptomatology since service, the criteria for entitlement to service connection for bilateral hearing loss are met and the appeal as to this issue is granted.

The Board acknowledges that in a report of medical history completed at separation, the Veteran denied hearing loss. The January 2026 examiner cited to the lack of hearing loss in service. Such is fundamentally flawed reasoning without greater context. See Hensley v. Brown, 5 Vet. App. 155, 159 (1993). However, as the January 2026 exam indicated that Veteran's symptoms initially manifested in service, this discrepancy may be due to his initial failure to recognize the presence of impairment. The Board affords the Veteran the benefit of the doubt in this regard. Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021); see also Ortiz v. Principi, 274 F. 3d 1361 (Fed. Cir. 2001). The claim is granted.

2. Entitlement to service connection for tinnitus

The Veteran asserts that he has tinnitus that resulted from firing and becoming a sharpshooter with the M16 during his active service. See November 2025 VA Form 21-526EZ Application for Disability Compensation and Related Compensation Benefits. The Board finds that the Veteran has tinnitus that is due to in-service noise exposure. As such, the criteria for entitlement to service connection for tinnitus are met.

The RO found the Veteran has a current disability. See January 2026 Rating Decision. He was diagnosed with recurrent tinnitus during the January 2026 VA examination. The Board is bound by these favorable findings.

The Veteran has noise exposure during service based on his military occupational specialty and his statement about firing M16s, which is consistent with the
innitus that resulted from firing and becoming a sharpshooter with the M16 during his active service. See November 2025 VA Form 21-526EZ Application for Disability Compensation and Related Compensation Benefits. The Board finds that the Veteran has tinnitus that is due to in-service noise exposure. As such, the criteria for entitlement to service connection for tinnitus are met.

The Veteran has noise exposure during service based on his military occupational specialty and his statement about firing M16s, which is consistent with the facts and circumstances of service.

The January 2026 examiner provided negative nexus opinions. However, the evidence weighs in favor of the claim. Although the January 2026 examiner opined against the claim, the examiner conceded the presence of tinnitus since service, which supports an award of service connection based on continuity of symptomatology. Thus, as the evidence is in favor of the claim, the criteria for entitlement to service connection for tinnitus are met and the appeal as to this issue is granted.

RAY BARTO SLABBEKORN, JR.

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Koottappillil, Arun X.

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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