PERIPHERAL NERVE CONDITIONS

Summary

The veteran, who served in the United States Army from July 1979 to April 1989, appeals the denial of service connection for radiculopathy, lower left extremity (claimed as chronic sciatica, left side) as secondary to his service-connected lumbosacral strain with degenerative arthritis, and the continued denial of service connection for bilateral hearing loss. The Board granted service connection for radiculopathy, lower left extremity, finding that the Veteran's service-connected back condition proximately caused the radiculopathy. This decision was based on a review of treatment records indicating radiculopathy and sciatica, coupled with the fact that the Veteran is service-connected for a back condition and right lower extremity radiculopathy. The Board found the VA examinations inadequate for failing to address causation and reconcile contrary medical evidence, and resolved reasonable doubt in the Veteran's favor. For bilateral hearing loss, the Board granted service connection on a presumptive basis. The Veteran has a service occupation (Personnel Management Specialist) where hazardous military noise exposure is conceded, and has demonstrated continuous symptoms of hearing loss and tinnitus since service separation, meeting the criteria for presumptive service connection under 38 C.F.R. § 3.303(b).

Rationale

Service-connected lumbosacral strain with degenerative arthritis; Medical treatment records indicate radiculopathy and sciatica; VA examinations inadequate for causation and contrary evidence; Resolving reasonable doubt in Veteran's favor

Full Decision Text

Citation Nr: A26040550
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 250604-551457
DATE: April 30, 2026

ORDER

Entitlement to service connection for radiculopathy, lower left extremity (claimed as chronic sciatica, left side) as secondary to the service-connected lumbosacral strain with degenerative arthritis is granted.

Entitlement to service connection for bilateral hearing loss is granted.

FINDINGS OF FACT

1. Resolving reasonable doubt in the Veteran's favor, he has radiculopathy, lower left extremity (claimed as chronic sciatica, left side) that is at least as likely as not proximately caused by his service-connected lumbosacral strain with degenerative arthritis.

2. Resolving reasonable doubt in the Veteran's favor, his bilateral hearing loss is etiologically related to acoustic trauma sustained in active service.

CONCLUSIONS OF LAW

1. The criteria for radiculopathy, lower left extremity (claimed as chronic sciatica, left side) secondary to service-connected lumbosacral strain with degenerative arthritis have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.310(a)

2. The criteria for establishing entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran had honorable active-duty service with the United States Army from July 1979 to April 1989.

This matter is before the Board of Veterans' Appeals (Board) on appeal from January and April 2025 rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO), that as relevant here, denied the claim for service connection for radiculopathy, lower left extremity (claimed as chronic sciatica, left side), and continued the prior denial of service connection for bilateral hearing loss.

The rating decisions on appeal were issued in January and April 2025 and constitute initial decisions; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In March 2025, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of entitlement to service connection for bilateral hearing loss, then most recently addressed in an August 2019 rating decision. In April 2025, the RO issued the supplemental claim decision on appeal, which found that new and relevant evidence had been received and denied the claim on the merits based on the evidence of record at the time of that decision. Accordingly, the Board will proceed to address the claim on the merits. See 38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c).

In June 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 January and April 2025 rating decisions on appeal. 38 C.F.R. § 20.301. Any evidence submitted after the RO rating decisions on appeal may not 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 claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included following this decision. 

Secondary service connection for left lower extremity sciatica (radiculopathy)

Service connection may be established on a secondary basis for disability that is proximately due to or the result of a service-connected disease or injury.  See 38 C.F.R. § 3.310. Generally, to establish entitlement to service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) probative evidence establishing a link between the service-connected disability and the current disability.  See Wallin v. West, 11 Vet. App. 509, 512 (1998).

The requirement of a current disability is "satisfied when a claimant has a
 connection for left lower extremity sciatica (radiculopathy)

Service connection may be established on a secondary basis for disability that is proximately due to or the result of a service-connected disease or injury.  See 38 C.F.R. § 3.310. Generally, to establish entitlement to service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) probative evidence establishing a link between the service-connected disability and the current disability.  See Wallin v. West, 11 Vet. App. 509, 512 (1998).

The requirement of a current disability is "satisfied when a claimant has a disability at the time a claim for VA disability compensation is filed or during the pendency of that claim." See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).  In evaluating the evidence, the Board must assess the credibility and weight given to evidence. Davidson v. Shinseki, 581 F. 3d 1313 (Fed. Cir. 2009). The Veteran is competent to report symptoms and experiences observable by his senses. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits.  Davidson, 581 F.3d at 1316.

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant.  38 U.S.C. § 5107(b); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021); 38 C.F.R. § 4.3.

Here, the Veteran asserts service connection for left lower extremity sciatica (radiculopathy), claiming the condition as secondary to his service-connected back condition. See September 2024 VA Form 21-526EZ.

Favorable findings in the January 2025 rating decision on appeal include that: the claimed primary disability is service connected, noting that the Veteran was granted service connection for lumbosacral strain with degenerative arthritis from April 22, 2014. The evidence of record includes treatment records dated in January, March, and June 2024, with clinical notations indicating "radiculopathy, lumbosacral DJD with radicul[opathy], past medical history significant for left-sided sciatica, and left sided sciatica". See Medical Treatment Record - Non-Government Facility received September 19, 2024, and CAPRI records received November 29, 2024. Therefore, the first criteria is met as to the claimed left lower extremity radiculopathy (left side sciatica) condition.

Next, the Veteran is service connected for lumbosacral strain with degenerative arthritis from April 2014, and right lower extremity radiculopathy associated with lumbosacral strain with degenerative arthritis from April 2014. See August 2025 Rating Codesheet. Accordingly, at issue is whether there is probative medical evidence establishing a link between these service-connected conditions and the Veteran's left lower extremity sciatica (radiculopathy).

The Veteran has maintained that his service-connected back condition has resulted in the left lower extremity radiculopathy condition. See September 2024 VA Form 21-526EZ, Fully Developed Claim (Compensation). 

In December 2024 VA Examination for Back (Thoracolumbar Spine) Disability Benefits Questionnaire (DBQ), the examiner noted that "all available records were reviewed and findings considered when completing [the] DBQ." The examiner reported that the back condition onset in 1982 and has progressed/worsened since onset. It was noted that the Veteran could not sit or stand for a long period of time and had difficulty bending. Results of a July 2015 MRI of the Lumbar Spine was noted to indicate "multilevel ligament flava/facet arthropathy and mild degenerative disease spine, with mild canal narrowing and mild neural foraminal narrowing." The examiner noted that the Veteran had "pain in the low back". A December 2024, VA examination DBQ for peripheral nerves conditions concluded that there is "no objective evidence found on exam or of record to support a diagnosis for the claimed CHRONIC SCIATICA LEFT SIDE at this time." The examiner fails to confirm any diagnosis related to lower extremity radiculopathy despite the fact that the Veteran was service connected for right lower extremity rad
 long period of time and had difficulty bending. Results of a July 2015 MRI of the Lumbar Spine was noted to indicate "multilevel ligament flava/facet arthropathy and mild degenerative disease spine, with mild canal narrowing and mild neural foraminal narrowing." The examiner noted that the Veteran had "pain in the low back". A December 2024, VA examination DBQ for peripheral nerves conditions concluded that there is "no objective evidence found on exam or of record to support a diagnosis for the claimed CHRONIC SCIATICA LEFT SIDE at this time." The examiner fails to confirm any diagnosis related to lower extremity radiculopathy despite the fact that the Veteran was service connected for right lower extremity radiculopathy as of April 22, 2014. The DBQ also fails to reconcile clinical reports referenced above, received in September and November 2024, indicating "radiculopathy, lumbosacral DJD with radicul[opathy], past medical history significant for left-sided sciatica, and left sided sciatica". No corresponding medical opinion was provided other than the conclusion that "no diagnosis rendered for the claimed chronic sciatica, left side, therefore no opinion indicated."

While there is no other VA etiology opinion of record addressing the Veteran's claimed left sided sciatica, the December 2024 VA examinations do not adequately address the causation element of secondary service connection as to the claimed condition and fails to address the contrary medical evidence of record as noted above. Instead, the VA examiner simply concluded without explanation that "there was no objective evidence of the claimed condition". See Atencio v. O'Rourke, 30 Vet. App. 74, 90-91 (2018) (holding that whether a service-connected condition caused or whether it aggravated a veteran's current disability are independent inquiries and an examiner's failure to treat these questions separately renders the opinion inadequate). As such, with respect to the claimed left sided sciatica (radiculopathy), the December 2024 VA examinations are of minimal probative value. However, the medical treatment records discussed herein and clinical notations of "radiculopathy, lumbosacral DJD with radicul[opathy], past medical history significant for left-sided sciatica, and left sided sciatica", and the fact that the Veteran is service-connected for lumbosacral strain and right lower extremity radiculopathy from April 22, 2014, all tend in favor of the claim. Additionally, the examiner noted that the primary back condition has progressed/worsened since the initial onset in service. Such findings taken together with the Veteran's reports of pain and chronic left sided sciatica, therefore, constitute competent, probative evidence tending to support an award of secondary service connection for left side sciatica (left lower extremity radiculopathy) on a causation basis. See 38 C.F.R. 

§ 3.310(a); Wallin, 11 Vet. App. at 512.

Arguably, at this point, the Board could remand the claim of service connection for radiculopathy, lower left extremity (claimed as chronic sciatica, left side) for further VA examination or opinion. However, such a request could be construed as obtaining additional evidence for the sole purpose of denying the claim, which is impermissible. 38 C.F.R. § 3.304(c) ("The development of evidence in connection with claims for service connection will be accomplished when deemed necessary but it should not be undertaken when evidence present is sufficient for this determination"); Andrews v. McDonough, 34 Vet. App. 216, 225 (2021) ("Remand is inappropriate where the predominant purpose is not to allow the Board to make a fully informed decision unencumbered by error but to allow VA to obtain more evidence so that it can properly deny the claim").

Looking at the approximate balance of the evidence as a whole and resolving reasonable doubt in the Veteran's favor, the Board finds that the relevant, probative evidence of record tends to support the finding that the Veteran's radiculopathy, lower left extremity (claimed as chronic sciatica, left side) is proximately due to his service-connected lumbosacral strain on a causation basis. Thus, resolving reasonable doubt in favor of the Veteran, the Board finds that secondary service connection for radiculopathy, lower left extremity (claimed as chronic sciatica, left side) is warranted, and the issue is granted. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.310(a); Lynch, 21 F.4th 776.

Service connection for bilateral hearing loss

Service connection may be granted for any injury or disease diagnosed after discharge, when all the evidence, including
opathy, lower left extremity (claimed as chronic sciatica, left side) is proximately due to his service-connected lumbosacral strain on a causation basis. Thus, resolving reasonable doubt in favor of the Veteran, the Board finds that secondary service connection for radiculopathy, lower left extremity (claimed as chronic sciatica, left side) is warranted, and the issue is granted. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102, 3.310(a); Lynch, 21 F.4th 776.

Service connection for bilateral hearing loss

Service connection may be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). Generally, to establish service connection, 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." Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

In addition, for certain chronic diseases, such as hearing loss, a presumption of service connection arises if the chronic disease was shown as chronic in service; manifested to a compensable degree within one year following discharge from service; or was noted in service with continuity of symptomatology since service. 38 U.S.C. §§ 1112, 1113, 1131, 1133, 1137; 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

In rendering a decision on appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the veteran. See Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994). Board determinations with respect to the weight and credibility of evidence are factual determinations going to the probative value of the evidence. Layno v. Brown, 6 Vet. App. 465, 469 (1994). Equal weight is not accorded to each piece of evidence contained in the record; not every item of evidence has the same probative value.

Competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno, 6 Vet. App. at 465. Lay statements may serve to support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability or symptoms of disability subject to lay observation. 38 C.F.R. § 3.159; see Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007).

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

Turning to the case, the Veteran seeks entitlement to service connection for bilateral hearing loss. He has maintained that his bilateral hearing loss was caused by in-service acoustic trauma. See March 2019, VA Form 21-526EZ. The Board acknowledges that the Veteran is already service connected for tinnitus effective September 13, 2024, and that the RO previously determined that the tinnitus was established as directly related to the Veteran's military service. See February 2025 rating decision.

Hearing loss and tinnitus are recognized by VA as "chronic diseases" under 38 C.F.R. § 3.309(a); therefore, the presumptive provisions of 38 C.F.R. §§ 3.303(b), 3.307, and 3.309 apply. Walker, 708 F.3d 1335-1337; Fountain v. McDonald, 27 Vet. App. 258 (2015).

Favorable findings from April 2025, rating decision on appeal include that
innitus effective September 13, 2024, and that the RO previously determined that the tinnitus was established as directly related to the Veteran's military service. See February 2025 rating decision.

Hearing loss and tinnitus are recognized by VA as "chronic diseases" under 38 C.F.R. § 3.309(a); therefore, the presumptive provisions of 38 C.F.R. §§ 3.303(b), 3.307, and 3.309 apply. Walker, 708 F.3d 1335-1337; Fountain v. McDonald, 27 Vet. App. 258 (2015).

Favorable findings from April 2025, rating decision on appeal include that: the Veteran has been diagnosed with a disability, noting May 2019 and February 2025, VA examinations show diagnosis of bilateral hearing loss; the evidence shows that a qualifying event, injury, or disease had its onset during the Veteran's service, noting DD Form 214 shows military occupational specialty (MOS) as a Personnel Management Specialist, in which hazardous military noise exposure is conceded. Under the AMA, the Board is bound by favorable findings by the RO in the absence of evidence of clear and unmistakable error. See 38 C.F.R. § 3.104(c). Therefore, the first and second elements of service connection have been met.

As the Veteran has established a current disability and an in-service event, the dispositive issue is whether there is a relationship between the two.

In the April 2025 rating decision on appeal, the RO denied the Veteran's claim for service connection for bilateral hearing loss indicating that a link between the Veteran's medical condition and military service was not found.

The Veteran is competent to describe symptoms he experienced. Jandreau, 492 at 1376-77. The Board finds credible; the Veteran's reports that he noticed his hearing loss related symptoms within months of separation from service and that the symptoms have continued since that time. As such, the reports are probative to suggest that the Veteran's symptoms originating in service were later diagnosed as bilateral hearing loss. Moreover, hearing loss and tinnitus are the type of disability for which lay evidence can be competent to establish service connection. See Maples v. Wilkie, No. 18-2016, 2019 U.S. App. Vet. Claims LEXIS 199 (Feb. 11, 2019) (mem dec) (Falvey, J.) (lay evidence can be sufficient to support a claim for service connection for sleep [*12] apnea); Bethea v. Derwinski, 2 Vet. App. 252, 254 (1992) (single judge decisions may be relied upon for any persuasiveness or reasoning they contain). While there is an absence of complaints of or treatment for hearing loss or tinnitus for many years after the Veteran's service separation, the Board has resolved reasonable doubt in his favor and finds that he had continuous symptoms of hearing loss and tinnitus since service separation and meets the requirements of presumptive service connection under 38 C.F.R. 

§ 3.303(b).

In February 2025 VA examination DBQ for hearing loss and tinnitus, the examiner noted that hearing loss and tinnitus onset in August 1989 (less than six months after his separation from service). The examiner noted the conditions have progressed/worsened since onset. The DBQ report also indicates that the Veteran was exposed to military noise to include from "... weapons, explosives, aircraft engines, artillery, mortars, tanks, helicopters and transport trucks [] attached to [] infantry division - he was deployed ...." A corresponding medical opinion was not requested.

The record also includes a May 2019 VA examination DBQ for hearing loss and tinnitus. At that time, the examiner opined that the Veteran's hearing loss was less likely than not related to his military service. The only rationale provided is that "enlistment and separation exams both indicated hearing within normal limits with no significant threshold shifts present". The DBQ report also opined that the Veteran's diagnosed tinnitus was not related to his service. A February 2025 rating decision, however, granted the Veteran entitlement to service connection for tinnitus from September 13, 2024.

The VA DBQs of record indicated they are based on a review of the Veteran's file and medical history; however, they fail to acknowledge or comment in any way on the Veteran's lay statements regarding the onset of his tinnitus and hearing loss symptoms within the first several months of his separation from service and progression/worsening of the conditions since initial onset. In this regard, the DBQs are inadequate as there is no account for the Veteran's reports that he first noticed experiencing tinnitus and hearing loss within months of his separation from service, and thereafter the conditions worsened. Dalton v
. A February 2025 rating decision, however, granted the Veteran entitlement to service connection for tinnitus from September 13, 2024.

The VA DBQs of record indicated they are based on a review of the Veteran's file and medical history; however, they fail to acknowledge or comment in any way on the Veteran's lay statements regarding the onset of his tinnitus and hearing loss symptoms within the first several months of his separation from service and progression/worsening of the conditions since initial onset. In this regard, the DBQs are inadequate as there is no account for the Veteran's reports that he first noticed experiencing tinnitus and hearing loss within months of his separation from service, and thereafter the conditions worsened. Dalton v. Peake, 21 Vet. App. 23 (2007).

While the record does not include a medical opinion that indicates a nexus between the Veteran's hearing loss with service, the Board does not need to reach the weight assignable to any medical opinion because service connection is granted on a presumptive basis under 38 C.F.R. § 3.303(b) for the "chronic disease" of hearing loss (38 C.F.R. § 3.309(a)) based on a finding of "continuous" symptoms of hearing loss (to include tinnitus) since service rather than on the basis of direct service connection.

In sum, there is evidence of acoustic trauma in service and continuous symptoms of hearing loss and tinnitus within months of separation from service and thereafter. Accordingly, hearing loss is presumed to have been incurred in service and the appeal is granted. Because the Board is granting service connection on a presumptive basis based on continuous symptoms of hearing loss and tinnitus since service separation, all other service connection theories are rendered moot.

 

 

Christopher Seppanen

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Kelly, E. C.

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.