HEARING LOSS

MELANIE J. MANN · 2026 · Case ID: A26040801

MIXED

Summary

The veteran, who served in the Navy from January 1995 to September 1998, appeals the denial of service connection for bilateral hearing loss, a left knee scar, a skin disability, and traumatic brain injury (TBI) residuals. The veteran also sought an increased rating for tinnitus and service connection for pseudofolliculitis barbae, which were dismissed as withdrawn. The Board denied service connection for hearing loss, finding that the veteran's audiometric results did not meet VA criteria for hearing loss, despite the veteran's testimony of hearing difficulties and a noted threshold shift in service. The Board denied service connection for a left knee scar, noting insufficient evidence to confirm its existence or relation to service, despite the veteran's testimony of an in-service motor vehicle accident. Service connection for a skin disability was denied as the VA examiner found no current diagnosis, and the veteran's testimony about eczema was not supported by medical evidence. The TBI claim was denied due to a lack of competent medical evidence establishing a diagnosis or nexus to service, despite the veteran's report of an in-service accident and possible head trauma. The Board remanded the claim for service connection for a low back disability, as the service treatment records indicated an in-service back strain and the veteran reported current arthritis, necessitating a VA examination to clarify the nexus.

Rationale

No hearing loss disability for VA purposes per 38 C.F.R. § 3.385.; Audiometric thresholds and speech recognition scores did not meet VA criteria.; In-service audiogram showed normal hearing, despite Veteran's testimony.

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

200814-104040

Full Decision Text

Citation Nr: A26040801
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 200814-104040
DATE: April 30, 2026

ORDER

Entitlement to service connection for bilateral hearing loss is denied.

Entitlement to service connection for a left knee scar is denied.

Entitlement to service connection for a skin disability is denied.

Entitlement to service connection for traumatic brain injury (TBI) is denied.

Entitlement to an increased disability rating for tinnitus is dismissed.

Entitlement to service connection for pseudofolliculitis barbae is dismissed.

REMANDED

Entitlement to service connection for a low back disability is remanded.

FINDINGS OF FACT

1. The Veteran does not have a hearing disability for VA purposes.

2. The Veteran did not have a left knee scar related to service.

3. The Veteran does not have a skin disability related to service.

4. The Veteran does not have a TBI related to service.

5. On May 3, 2024, prior to the promulgation of a decision in the appeal, the Veteran requested to withdraw the issue of entitlement to an increased disability rating for tinnitus.

6. On May 3, 2024, prior to the promulgation of a decision in the appeal, the Veteran requested to withdraw the issue of entitlement to service connection for pseudofolliculitis barbae.

CONCLUSIONS OF LAW

1. The criteria for service connection for hearing loss are not met. 38 U.S.C. §§ 1110, 1112, 1113, 1137, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.306, 3.307, 3.309, 3.385.

2. The criteria for service connection for a left knee scar are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304.

3. The criteria for service connection for a skin disability are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304.

4. The criteria for service connection for a TBI are not met. 38 U.S.C. §§ 1101, 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304.

5. The criteria for withdrawal of the issue of entitlement to an increased disability rating for tinnitus are met. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

6. The criteria for withdrawal of the issue of entitlement to service connection for pseudofolliculitis barbae are met. 38 U.S.C. § 7105; 38 C.F.R. § 20.205.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from January 1995 to September 1998.

The rating decision on appeal was issued in May 2020 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In the August 2020 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on May 3, 2024.

Therefore, the Board may only consider the evidence of record at the time of the March 2020 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or 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 prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

Regarding the claims that were denied, if the Veteran would like VA to consider any evidence
of record at the time of the March 2020 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or 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 prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

Regarding the claims that were denied, 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 claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Regarding the claim of entitlement to service connection with a back disability, because the Board is remanding that issue, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

1. Entitlement to service connection for bilateral hearing loss is denied.

The Veteran seeks service connection for bilateral hearing loss.

Service connection may be granted 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).

Certain chronic diseases will be presumed related to service if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service, with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

The threshold for normal hearing is from 0 to 20 decibels, and higher threshold levels indicate some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993). For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability 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.

The Veteran underwent a VA examination in March 2020. The Veteran's Puretone thresholds bilaterally in all of the frequencies 500, 1000, 2000, 3000, 4000 Hertz were 20 decibels or less, and speech recognition scores using the Maryland CNC test were greater than 94 percent. Thus, the Veteran does not have a hearing loss disability for VA purposes in either ear. 38 C.F.R. § 3.385.

At the hearing, the Veteran's representative argued that, while the Veteran was stationed on the U.S.S. Ticonderoga, he was exposed to loud noises. The Veteran testified that, while he can hear sounds, he is unable to hear what people say sometimes, regardless of whether there is any background noise. He further testified that he did not have hearing loss before service, and that he lives with it now by learning how to mitigate his inability to understand people when they speak.

At the Veteran's April 1994 entrance examination, the Veteran reported that he had hearing loss, but the audiogram
the Veteran does not have a hearing loss disability for VA purposes in either ear. 38 C.F.R. § 3.385.

At the Veteran's April 1994 entrance examination, the Veteran reported that he had hearing loss, but the audiogram conducted as part of his entrance into active duty showed normal hearing bilaterally. Similarly, the Veteran's February 1976 separation examination shows normal hearing bilaterally, with the exception of an auditory threshold of 25 decibels at the 500 Hertz frequency in the left ear and an auditory threshold of 30 decibels at the 6000 Hertz frequency. The 6000 Hertz frequency is not considered for VA purposes, and, even though there is one threshold of 25 decibels at the 500 Hertz frequency, the examination results do not qualify for a finding of hearing loss for VA purposes. The Board further acknowledges that a comparison between January 1995 and March 1998 audiograms shows a significant threshold shift in service, but, even so, there are no audiometric results which show hearing loss in either ear for VA purposes. 38 C.F.R. § 3.385.

The Board finds that the medical and lay evidence does not show that the Veteran has a hearing loss disability for VA purposes. Thus, service connection must be denied.

2. Entitlement to service connection for a left knee scar is denied.

The Veteran testified that he had a scar on his left knee that he received as a result of an in-service motor vehicle accident.

The Veteran explained that he was a passenger in a car that was in a motor vehicle accident near the time that he separated from service. He explained that he sought medical treatment from a civilian doctor, but it was paid for by the government since he was still on active duty at the time of the accident. The Veteran further testified that, while the scar was "ugly," it did not cause him any pain or discomfort.

Here, there is insufficient evidence in the claims file to show that the Veteran has a knee scar. The Veteran did not supply any medical evidence, or identify any source of medical treatment, for his scar. The Veteran's April 1994 entrance examination shows a positive notation of a scar, but it does not tell where the scar was located. Nonetheless, the Veteran was found qualified to enter service in spite of the notation. The Veteran's February 1976 separation examination was negative for any identifying body marks, scars, or tattoos.

The Veteran also underwent a VA examination for a skin disability in June 2024. The examination report was received within 90 days of the May 2024 hearing and thus is available for review by the Board. The skin examination showed no scars related to any skin disability. While this examination report alone is not dispositive (as the Veteran reported that his scar was related to an injury and not a disability), the Board has considered this examination together with the other evidence in the claims file.

There are no private or VA medical records received within the relevant evidence window showing that the Veteran has a knee scar or that a knee scar is related to service.

The Board acknowledges that the Veteran testified that he had a scar related to service, but there is no available evidence showing that he has a knee scar, or that he has a knee scar related to service. Although the Veteran is competent to report lay observable symptoms, he is not competent to establish a nexus between a disability and military service. The question is medically complex, as it requires knowledge of the interaction between multiple body systems and the interpretation of complicated diagnostic medical testing. There is no evidence in the claims file showing that the Veteran has the training necessary to diagnose scar disabilities or to opine on their etiology. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).

Thus, as there is no competent medical evidence showing that the Veteran has a knee scar related to his active duty service, the evidence is persuasively against the claim, the benefit of the doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776, 777-79 (Fed. Cir. 2021). Service connection is denied for the Veteran
scar disabilities or to opine on their etiology. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).

3. Entitlement to service connection for a skin disability is denied.

The Veteran claims entitlement to a skin disability due to his service.

The Veteran testified that he suffered from eczema in boot camp, on the first day of boot camp and when his skin was exposed to chlorine, other bleach products, and paint stripping material during service. The Veteran further testified that he was given lotion during service to treat his skin.

He testified that he did not seek treatment from a dermatologist because he takes his son and daughter to a dermatologist and understands what he needs to do to treat his skin. He also reported that he has "daily eczema" across his face and feet.

There are no private or VA medical records received within the relevant evidence window showing a diagnosis or treatment of a skin disability. The Veteran underwent a VA examination in June 2024 which was received by the Board within 90 days of the hearing. The June 2024 VA examiner conducted an in-person VA examination and opined that the Veteran did not have a diagnosis for a skin disability.

The Board finds that the Veteran does not have a currently diagnosed skin condition. The Board acknowledges that the Veteran has testified about certain symptoms he perceives on his skin, but there is no evidence that the Veteran is competent to diagnose skin conditions or to opine on the etiology of any diagnosed skin disabilities. Jandreau. The only competent medical evidence before the Board is the June 2024 VA examiner's report which concluded that the Veteran did not have a skin disability.

Thus, as there is most competent medical evidence of record shows that the Veteran does not have a skin disability related to his active duty service, the evidence is persuasively against the claim, the benefit of the doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776, 777-79 (Fed. Cir. 2021). Service connection is denied for the Veteran's reported skin disability.

4. Entitlement to service connection for TBI residuals is denied.

The Veteran claims that he suffered a TBI during active duty service. He reports that he was a passenger in a motor vehicle accident and suffered a TBI as a result. He also maintains that the TBI may have resulted from five inch gun training on a naval ship.

The Veteran reported that he saw a civilian doctor after his motor vehicle accident and his care was paid for by the Government because he was on active duty when the accident occurred, but did not provide any records related to the doctor to show his diagnosis or treatment of TBI. Further, there is no evidence in the claims file that the Veteran identified the doctor or otherwise requested VA's assistance to obtain the civilian doctor's treatment records before the rating decision was issued.

The Veteran did not report seeking care for a TBI during service related to his five inch gun training, and his Service Treatment Records (STRs) reflect no report related to a possible TBI.

Here, there is no evidence, beyond the Veteran's testimony, that he suffered a TBI while on active duty. Although he does report that he suffers from symptoms that he believes are related to a TBI, he has not shown competent medical evidence that he has been diagnosed with a TBI.

While the Veteran sincerely believes that his reported symptoms are related to his active duty service, and in particular his in-service injuries reported, the Veteran is not competent to provide a medical nexus opinion in this case. The question is medically complex, as it requires knowledge of the interaction between multiple body systems and the interpretation of complicated diagnostic medical testing, and there is no evidence in this case that the Veteran possesses the knowledge or training required to offer a competent medical opinion. Jandreau.

The Veteran has not been provided a VA examination with respect to his claimed TBI. However, VA need not provide an examination with respect to this claim. Here, the only suggestion that the Veteran has a TBI related to service is his own bare assertion in the form of his claim and his hearing
that his reported symptoms are related to his active duty service, and in particular his in-service injuries reported, the Veteran is not competent to provide a medical nexus opinion in this case. The question is medically complex, as it requires knowledge of the interaction between multiple body systems and the interpretation of complicated diagnostic medical testing, and there is no evidence in this case that the Veteran possesses the knowledge or training required to offer a competent medical opinion. Jandreau.

The evidence is persuasively against the finding that the Veteran has a TBI or TBI residuals related to his service. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. The Board concludes that the criteria for service connection are not met. 38 C.F.R. § 3.03. Accordingly, service connection for a TBI is denied.

5. Entitlement to an increased disability rating for tinnitus is dismissed.

6. Entitlement to service connection for pseudofolliculitis barbae is dismissed.

The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.205. Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. § 20.205.

In the present case, the Veteran withdrew the issues of entitlement to service connection for pseudofolliculitis barbae and entitlement to an increased disability rating for tinnitus on the record at the hearing in this matter on March 27, 2023. The Board finds that the Veteran's withdrawal was explicit, unambiguous, and done with a full understanding of the consequences of such action on the part of the claimant. DeLisio v. Shinseki, 25 Vet. App. 45, 57 (2011); see Acree v. O'Rourke, 891 F.3d 1009, 1014 (Fed. Cir. 2018).

Hence, there remain no allegations of errors of fact or law for appellate consideration regarding those issues. Accordingly, the Board does not have jurisdiction to review the appeal of those issues and the appeal is dismissed as to the issues withdrawn by the Veteran.

REASONS FOR REMAND

Entitlement to service connection for a back disability is remanded.

Here, the Veteran's STR's show that he was diagnosed with a back strain in service. See October 1997 STR.

The Veteran testified that he hurt his back when I jumped from one platform to another on a navy vessel. He testified that his back hurt throughout service, and that he has a current diagnosis for arthritis. See Transcript, 18-19.

Here, as the Veteran's STRs show an in-service back injury and the Veteran reports a contemporaneous diagnosis, there is sufficient evidence to suggest that there is an association between the Veteran's back disability and his service. Thus, the AOJ had a duty to obtain a VA medical opinion to address the Veteran's claims, and the failure to schedule a VA examination constitutes a pre-decisional duty to assist error. McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006).

On remand, the AOJ must schedule the Veteran for a VA back examination to address the etiology of any diagnosed back disability.

The matter is REMANDED for the following action:

Schedule the Veteran for a VA examination for his claimed back disability. The examiner must review the claims file.

The examiner should identify all diagnosed back disabilities. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below.

The examiner is asked to provide a response to the following:

a) Identify all diagnosed back disabilities.

b) Did any back disability have its onset during service?

c) Is any diagnosed back disability related to service, including his documented in-service back strain?

d) If the Veteran has a diagnosis for any form of arthritis, did the disability (1) begin during active service
Veteran for a VA examination for his claimed back disability. The examiner must review the claims file.

The examiner is asked to provide a response to the following:

a) Identify all diagnosed back disabilities.

b) Did any back disability have its onset during service?

c) Is any diagnosed back disability related to service, including his documented in-service back strain?

d) If the Veteran has a diagnosis for any form of arthritis, did the disability (1) begin during active service, (2) manifest within one year after discharge from service, or (3) was it noted during service with continuity of the same symptomatology since service?

Provide a rationale to support the opinions.

In providing the requested opinion, consider the Veteran's description of the in-service injury and symptoms as well as post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of the current disability, this should be noted. Stated another way, do the Veteran's reports about the symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible?

Melanie J. Mann

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board A. Boal, 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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