HEARING LOSS

Summary

The veteran, who served in the U.S. Army from January 1984 to July 1984 and July 1986 to February 1992, appeals the denial of a compensable disability evaluation for bilateral hearing loss. The Board found that the veteran's hearing loss, as assessed by two VA examinations in January and June 2024, corresponded to Level I impairment in both ears, which is noncompensable under the rating schedule. The Board noted that while the veteran's service treatment records were not available, the audiometric results did not support a compensable rating for the period on appeal. Consequently, the claim for a compensable disability evaluation for bilateral hearing loss was denied. The case also involves multiple remanded claims for service connection, including aortic aneurysm, COPD, emphysema, hypertension, and transient ischemic attack (TIA), all related to the veteran's contention of toxic exposure risk activity (TERA) during service at Johnston Island. While the Board found the in-service TERA element was met, it determined the VA medical opinions were inadequate because they failed to adequately detail the Veteran's specific exposures and did not address all potential exposures. The case is remanded for new VA examinations to determine the etiology and nexus for these conditions.

Rationale

Audiological results from January 2024 and June 2024 examinations.; Results correspond to Level I impairment in both ears under Table IV of 38 C.F.R. § 4.85.; Intersection points under Table VII of 38 C.F.R. § 4.85 indicate a noncompensable rating.

Full Decision Text

Citation Nr: A26040538
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 250710-563821
DATE: April 30, 2026

ORDER

Entitlement to a compensable disability evaluation for bilateral hearing loss is denied.

REMANDED

Entitlement to service connection for aortic aneurysm is remanded.

Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded.

Entitlement to service connection for emphysema is remanded.

Entitlement to service connection for hypertension is remanded.

Entitlement to service connection for transient ischemic attack (TIA) (claimed as stroke) is remanded.

FINDING OF FACT

The Veteran's hearing loss is manifested by level I hearing loss in the right ear and level I hearing loss in the left ear, resulting in a noncompensable disability evaluation.

CONCLUSION OF LAW

The criteria for a compensable disability evaluation for bilateral hearing loss for the entire period on appeal have not been met. 38 U.S.C. §§ 1155, 107; 38 C.F.R. §§ 4.1, 4.7, 4.85, 4.85, Diagnostic Code 6100.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Army from January 1984 to July 1984 and from July 1986 to February 1992.

The Appeals Modernization Act (AMA) creates a new framework for Veterans dissatisfied with VA's decision on their claim to seek review. The AMA became effective on February 19, 2019. The AMA modernized review system applies to all claims for which VA issues a notice of an initial decision on or after the February 19, 2019 effective date of the modernized review system.

These matters come before the Board of Veterans' Appeals (Board) on appeal from an April 2025 Higher-Level Review decision issued by the Department of Veterans Affairs (VA) Regional Office (RO).

In the July 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) (NOD), the Veteran elected the direct review option. For the Direct Lane docket, the Board's review is limited to the evidentiary record at the time of the RO decision on appeal. See Andrews v. McDonough, 34 Vet. App. 151, (2021). 

Increased Rating

Disability ratings are determined by evaluating the extent to which a Veteran's service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing the symptomatology with the criteria set forth in the Schedule for Rating Disabilities (Rating Schedule).?38?U.S.C. §?1155;?38?C.F.R. §§?4.1, 4.2, 4.10.? 

In evaluating a disability, the Board considers the current examination reports in light of the whole recorded history to ensure that the current rating accurately reflects the severity of the condition. The Board has a duty to acknowledge and consider all regulations that are potentially applicable. Schafrath v. Derwinski, 1?Vet. App.?589 (1991). The medical, as well as industrial history is to be considered, and a full description of the effects of the disability upon ordinary activity is also required. 38?C.F.R. §§?4.1, 4.2, 4.10. 

Where there is a question as to which of 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.?See?38?C.F.R. §?4.7. Reasonable doubt regarding the degree of disability will be resolved in the Veteran's favor.?38?C.F.R. §?4.3.? Separate ratings can be assigned for separate periods of time based on facts found, a practice known as "staged" ratings.?Hart v. Mansfield, 21?Vet. App.?505.? 

When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a Veteran prevailing in either event, or the evidence is persuasively against a claim, in which case, the claim is denied.?38?U.S.C. §?5107 (b);?38?C.F.R. §?3.102.

1. Entitlement to a compensable disability evaluation for bilateral hearing loss is denied.

The Veteran is currently in receipt of a noncompensable disability evaluation for his bilateral hearing loss effective August 9, 2023,
 known as "staged" ratings.?Hart v. Mansfield, 21?Vet. App.?505.? 

When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with a Veteran prevailing in either event, or the evidence is persuasively against a claim, in which case, the claim is denied.?38?U.S.C. §?5107 (b);?38?C.F.R. §?3.102.

1. Entitlement to a compensable disability evaluation for bilateral hearing loss is denied.

The Veteran is currently in receipt of a noncompensable disability evaluation for his bilateral hearing loss effective August 9, 2023, under Diagnostic Code 6100. 

In evaluating service-connected hearing loss, disability ratings are derived by a mechanical application of the rating schedule to the numeric designations assigned after audiometric evaluations are performed. Lindenmann v. Principi, 3 Vet. App. 345, 349 (1992). Evaluations of bilateral hearing loss range from noncompensable to 100 percent based on an organic impairment of hearing acuity, as measured by controlled speech discrimination tests in conjunction with the average hearing threshold, as measured by puretone audiometric tests in the frequencies of 1000, 2000, 3000, and 4000 cycles per second. The rating schedule establishes 11 auditory acuity Levels designated from Level I for essentially normal hearing through Level XI for profound deafness.

VA audiological evaluations are conducted using a controlled speech discrimination test together with the results of puretone audiometry tests. The vertical line in Table VI (printed in 38 C.F.R. § 4.85) represents nine categories of decibel I loss based on the puretone audiometry test. The numeric designation of impaired hearing (Levels I through XI) is determined for each ear by intersecting the vertical row appropriate for the percentage of discrimination and the horizontal column appropriate to puretone decibel loss. The percentage evaluation is found from Table VII (in 38 C.F.R. § 4.85 and the statement of the case) by intersecting the vertical column appropriate for the numeric designation for the ear having the better hearing acuity and the horizontal row appropriate for the numeric designation of the level for the ear having the poorer hearing acuity. For example, if the better ear had a numeric designation of Level "V," and the poorer ear had a numeric designation of Level "VII," the percentage evaluation is 30 percent. 38 C.F.R. § 4.85.

Regulations also provide that in cases of exceptional hearing loss, i.e., when the puretone threshold at each of the four specified frequencies (1,000, 2,000, 3,000, and 4,000 hertz) is 55 decibels or more, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or Table VIA, whichever results in the higher numeral. Each ear will be evaluated separately. 38 C.F.R. § 4.85 (a). The provisions of 38 C.F.R. § 4.86(b) further provide that when the puretone threshold is 30 decibels or less at 1,000 hertz and 70 decibels or more at 2,000 hertz, the rating specialist will determine the Roman numeral designation for hearing impairment from either Table VI or VIA, whichever results in the higher numeral. That numeral will then be evaluated to the next higher Roman numeral.

The Veteran was afforded a VA examination in January 2024 to assess his bilateral hearing loss. At that time, the Veteran's puretone thresholds were as follows:

Hertz 	1000	2000	3000	4000

Right Ear 	20	15	40	50

Left Ear 	15	20	50	55

The pure tone average was 31 in the right ear and 35 in the left ear. Maryland CNC speech recognition scores were 94 percent on the right and 98 percent on the left. The Veteran was assessed with bilateral sensorineural hearing loss in the frequency range of 500 - 4000 Hz, and in the frequency range of 6000 Hz or higher.

The Veteran was afforded a second VA examination in June 2024 to assess his bilateral hearing loss. At that time, the Veteran's puretone thresholds were as follows:

Hertz 	1000	2000	3000	4000

Right Ear 	25	25	40	50

Left Ear 	15	30	55	60

The pure tone average was 35 in the right ear and 40 in the left ear. Maryland CNC speech recognition scores were 100 percent on the right and 98 percent on the left. The Veteran was assessed
 with bilateral sensorineural hearing loss in the frequency range of 500 - 4000 Hz, and in the frequency range of 6000 Hz or higher.

The Veteran was afforded a second VA examination in June 2024 to assess his bilateral hearing loss. At that time, the Veteran's puretone thresholds were as follows:

Hertz 	1000	2000	3000	4000

Right Ear 	25	25	40	50

Left Ear 	15	30	55	60

The pure tone average was 35 in the right ear and 40 in the left ear. Maryland CNC speech recognition scores were 100 percent on the right and 98 percent on the left. The Veteran was assessed with bilateral sensorineural hearing loss in the frequency range of 500 - 4000 Hz, and in the frequency range of 6000 Hz or higher.

Based upon the results of audiological testing, the Veteran is not entitled to a compensable disability evaluation for his bilateral hearing loss.

At the January 2024 examination, the Veteran's audiological results correspond to Level I for his right ear and level I for his left ear under Table IV of 38 C.F.R. § 4.85. The intersection points for Level I (right) and Level I (left) under Table VII of 38 C.F.R. § 4.85 shows that the Veteran's hearing loss corresponds to a noncompensable disability rating.

At the June 2024 examination, the Veteran's audiological results correspond to Level I for his right ear and level I for his left ear under Table IV of 38 C.F.R. § 4.85. The intersection points for Level I (right) and Level I (left) under Table VII of 38 C.F.R. § 4.85 shows that the Veteran's hearing loss corresponds to a noncompensable disability rating.

Thus, the audiometric evidence of record does not support a finding of entitlement to a compensable disability evaluation for the entire period on appeal.

The Board is sympathetic to the Veteran's claims. However, the auditory threshold and speech discrimination evidence provided to the Board do not demonstrate that the Veteran's hearing loss warrants a compensable disability evaluation for his bilateral hearing loss. Accordingly, the Veterans claim is denied.

REASONS FOR REMAND

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38?U.S.C. §?1110; 38?C.F.R. §?3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (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-the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 38 F.3d 1163, 1167 (Fed. Cir. 2004)). The absence of any one element will result in the denial of service connection.

Service connection may also be granted on a presumptive basis for certain diseases, to include diabetes mellitus, if a veteran was exposed to an herbicide agent during active military service and it manifests to a compensable degree at any time after separation from service. 38 U.S.C. § 1116(a)(2); 38 C.F.R. § 3.307(a)(6)(ii); National Defense Authorization Act for Fiscal Year 2021, Pub. L. No. 116-283,134 Stat. 3388 (2021); Blue Water Navy Vietnam Veterans Act of 2019, Pub. L. No. 116-23, 133 Stat 966 (2019); Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act) was enacted. Pub. L. No. 117-168, 136 Stat. 1759 (2022).

In August 2022, the PACT Act was enacted. In pertinent part, the PACT Act amended 38 U.S.C. § 1116 by expanding the eligibility for presumptive service connection due to herbicide agent exposure. Under the PACT Act, effective no earlier than August 10, 2022, veterans who served on Johnston Atoll or on a ship that called at Johnston Atoll during the period beginning on January 1, 1972, and ending on September 30, 1977, are now presumed to have been exposed to herbicide agents as a result of that service. 38 C.F
. L. No. 117-168, 136 Stat. 1759 (2022).

In August 2022, the PACT Act was enacted. In pertinent part, the PACT Act amended 38 U.S.C. § 1116 by expanding the eligibility for presumptive service connection due to herbicide agent exposure. Under the PACT Act, effective no earlier than August 10, 2022, veterans who served on Johnston Atoll or on a ship that called at Johnston Atoll during the period beginning on January 1, 1972, and ending on September 30, 1977, are now presumed to have been exposed to herbicide agents as a result of that service. 38 C.F.R. § 3.307(a)(6); PACT Act of 2022.

Under the AMA, the Board must remand a claim to correct an error by AOJ to satisfy its duty to assist the Veteran under 38?U.S.C. §?5103A, if the error occurred prior to the AOJ decision on appeal. 38?U.S.C. §?5103A (f)(2)(A); 38?C.F.R. §?20.802 (a). The Board may also remand a claim to correct any other AOJ error "in satisfying a regulatory or statutory duty, if correction of the error would have a reasonable possibility of aiding in substantiating" the claim. 38?C.F.R. §?20.802 (a).

1. Entitlement to service connection for aortic aneurysm is remanded.

2. Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded.

3. Entitlement to service connection for emphysema is remanded.

4. Entitlement to service connection for hypertension is remanded.

5. Entitlement to service connection for transient ischemic attack (TIA) (claimed as stroke) is remanded.

The Veteran contends that he has an aortic aneurysm, COPD, emphysema, hypertension, and a stroke related to his active-duty service.

With respect to current disability, the May 2024 rating decision made favorable findings that the Veteran has a current diagnosis of an aortic aneurysm, COPD, emphysema, hypertension, and a stroke. The Board is bound by these favorable findings. 38 U.S.C. § 5104(b)(4); 5104A; 38 C.F.R. § 20.801(a).

With respect to in-service incurrence, the May 2024 rating decision made favorable findings regarding the aforementioned diagnoses, that the Veteran had participated in a toxic exposure risk activity (TERA). Review of the Veteran's military personnel records indicates the Veteran was stationed at Johnston Island for multiple assignments throughout his active-duty service, including two consecutive assignments at the US Chemical Activity Pacific of Johnston Island. In a February 2024 TERA memorandum, the memorandum indicated that the Veteran did not have exposure to herbicide agents, but found the Veteran was stationed at Johnston Island (Johnston Atoll) during his active-duty service; however, the February 2024 TERA memorandum failed to provide details regarding the Veteran's potential exposures. In April 2024, a second TERA memorandum was provided. The April 2024 TERA memorandum indicated that the Veteran participated in a TERA as there were chemical weapons leaks in the weapon storage area where caustic chemicals such as sodium hydroxide were used to mitigate toxic agents during clean up. The TERA memorandum also noted that larger spills of nerve and mustard agent withing the MCD at JACADS also took place. While the evidence of record clearly indicates that the Veteran participated in a TERA, the February 2024 TERA memorandum failed to provide adequate details regarding the Veteran's exposures. Accordingly, the Board finds the in-service incurrence element has been met.

The remaining question is whether there is a nexus between the Veteran's current diagnosis and in-service incurrence.

In March 2024 the Veteran was afforded VA examinations for his aortic aneurysm, COPD, emphysema, hypertension, and stroke. The Veteran reported he believed he may have been exposed to herbicide agents and additionally noted that he was stated at the Johnston Atoll stockpile weapons. In the accompanying VA medical opinions, a VA examiner opined the Veteran's aortic aneurysm, COPD, emphysema, hypertension, and stroke were less likely than not related to the Veteran's in-service TERA. The examiner indicated that herbicide agent exposure is presumptive for veterans that served at Johnston Atoll from January 1, 1972, to September 30, 1977, and that because the Veteran was not on active-duty service until 1984, his
eurysm, COPD, emphysema, hypertension, and stroke. The Veteran reported he believed he may have been exposed to herbicide agents and additionally noted that he was stated at the Johnston Atoll stockpile weapons. In the accompanying VA medical opinions, a VA examiner opined the Veteran's aortic aneurysm, COPD, emphysema, hypertension, and stroke were less likely than not related to the Veteran's in-service TERA. The examiner indicated that herbicide agent exposure is presumptive for veterans that served at Johnston Atoll from January 1, 1972, to September 30, 1977, and that because the Veteran was not on active-duty service until 1984, his diagnoses were thus unrelated to any toxic exposures in service. However, the Board finds these opinions are inadequate. As noted above, the February 2024 TERA memorandum the examiner relied upon failed to provide relevant information regarding the Veteran's exposures during active-duty service despite multiple notations within the Veteran's military personnel records. Furthermore, the examiner provided an opinion regarding herbicide agent exposure only despite no indication of herbicide agent exposure on the February 2024 TERA memorandum and additionally failed to address the Veteran's other potential exposures related to his work at stockpile weapons which he reported during the March 2024 VA examinations. The Board finds that the February 2024 TERA memorandum and subsequent March 2024 VA medical opinions are inadequate, thus constituting a pre-decisional duty to assist error. 38?C.F.R. §?20.802 (a).

The matters are REMANDED for the following action:

1. Schedule the Veteran for a VA examination to determine the nature, onset, and etiology of his aortic aneurysm, COPD, emphysema, hypertension, and stroke. Any and all studies, tests, and evaluations deemed necessary by the examiners should be performed.

The Veteran is competent to attest to observable events and symptomatology and such reports must be acknowledged and considered in formulating any opinion. If the Veteran's reports are discounted, the examiner should provide a reason for doing so.

The examiners should address the following:

(a.) Whether the Veteran's aortic aneurysm was at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) caused by the indicated toxic exposure risk activities (TERA), after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERAs of the Veteran.

(b.) Whether the Veteran's COPD was at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) caused by the indicated toxic exposure risk activities (TERA), after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERAs of the Veteran.

(c.) Whether the Veteran's emphysema was at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) caused by the indicated toxic exposure risk activities (TERA), after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERAs of the Veteran.

(d.) Whether the Veteran's hypertension was at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) caused by the indicated toxic exposure risk activities (TERA), after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERAs of the Veteran.

(e.) Whether the Veteran's stroke was at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) caused by the indicated toxic exposure risk activities (TERA), after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all TERAs of the Veteran.

The examiner must address the April 2024 TERA Memorandum associated with the file prior to the May 2024 AOJ decision on appeal which provides details regarding the Veteran's in-service TERA for each and every diagnosis listed above.

 

 

GAYLE STROMMEN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Risley, Haley

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.