HEARING LOSS

JIMMY L. BARDIN · 2026 · Case ID: A26041009

MIXED

Summary

The veteran, who served from August 1988 to June 1989, appeals the denial of service connection for left ear hearing loss and the remand of his claim for right ear hearing loss. The veteran contends his bilateral hearing loss is due to military service, specifically citing noise exposure. The Board reviewed the evidence, including two VA hearing examinations from March 2020 and January 2025. These examinations showed normal hearing thresholds in the left ear and significant hearing loss in the right ear, with speech discrimination scores within normal limits. The Board found the veteran's left ear hearing loss did not meet the regulatory criteria for service connection, noting the absence of in-service complaints or findings of acoustic trauma, and that the veteran's lay opinion was not competent to diagnose the condition. The Board denied service connection for left ear hearing loss, finding the evidence weighed against the claim. However, the Board remanded the claim for right ear hearing loss, finding the prior VA examiner's opinion inadequate. The examiner failed to discuss alternative etiologies, delayed-onset hearing loss, or the significance of normal military hearing findings, and based the opinion on an inadequate rationale regarding threshold shifts. The Board directed a new VA examination to address these deficiencies and determine if the right ear hearing loss is at least as likely as not related to service, considering noise exposure and potential delayed onset.

Rationale

No in-service complaints or findings of acoustic trauma for left ear; Veteran's lay opinion not competent to diagnose; Evidence persuasively weighs against the Veteran

Special Benefit

NO SPECIAL BENEFIT

Docket No.

260113-623417

Full Decision Text

Citation Nr: A26041009
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 260113-623417
DATE: April 30, 2026

ORDER

Entitlement to service connection for left ear hearing loss is denied.

REMANDED

Entitlement to service connection for right ear hearing loss is remanded.

FINDING OF FACT

The Veteran does not have left ear hearing loss for VA purposes.

CONCLUSION OF LAW

The criteria for entitlement to service connection for left ear hearing loss have not been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served active duty from August 1988 until June 1989.

In October 2024, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a October 2023 decision. The Higher-Level Reviewer determined that there had been a duty to assist error and transferred the claim to the Supplemental Claim decision review option for additional development.

This matter is now before the Board of Veterans' Appeals (Board) on appeal from the October 2024 higher level review rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO).

In the January 2026 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 October 2023 agency of original jurisdiction (AOJ) decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 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 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.

However, because the Board is remanding the claim of entitlement to service connection for right ear hearing loss, 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).

Entitlement to service connection for left ear hearing loss.

The Veteran contends his bilateral hearing loss is due to his military service. See August 2023 VA 21-526EZ, Fully Developed Claim.

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 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).

For certain chronic diseases, a disability 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. 38 C.F.R. §§ 3.307, 3.309. If the disease's chronicity was not noted in service, the disability can still be presumed related to service if the evidence shows there is a continuity of symptomatology since service. Walker v. Shinseki, 708 F.3d 1331, 1338.

For VA compensation purposes, impaired hearing will be considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 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
the disease's chronicity was not noted in service, the disability can still be presumed related to service if the evidence shows there is a continuity of symptomatology since service. Walker v. Shinseki, 708 F.3d 1331, 1338.

For VA compensation purposes, impaired hearing will be considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 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 threshold for normal hearing is from zero to 20 decibels, and higher threshold levels indicate some degree of hearing loss. Hensley v. Brown, 5 Vet. App. 155, 157 (1993); 38 C.F.R. § 3.385.

The Veteran was provided with a hearing examination in March 2020. The examination showed that pure tone thresholds, in decibels, from audiometric testing, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 55 50 45 55 60

LEFT 15 10 20 20 15

The Veteran's speech recognition scores based on the Maryland CNC Test were 96 percent in the right ear and 100 percent in the left ear. The examiner noted that speech discrimination scores were appropriate.

The Veteran was provided with another hearing examination in January 2025. The examination showed that pure tone thresholds, in decibels, from audiometric testing, were as follows:

HERTZ

500 1000 2000 3000 4000

RIGHT 55 55 50 55 60

LEFT 15 10 15 20 20

The Veteran does not have an auditory threshold in any of the frequencies of 40 decibels or higher or three frequencies at 26 decibels or greater, or speech recognition score of less than 94 percent that resulted from in-service exposure to acoustic trauma for his left ear. The Board acknowledges that the Veteran believes he has bilateral hearing loss. However, he is not competent to provide a diagnosis. The issue is medically complex as it requires specialized medical education. As such, the Board gives more probative weight to the medical evidence.

For the above reasons, the Board finds that the evidence is neither evenly balanced or approximately so with regard to whether service connection for left ear hearing loss is warranted. Rather, the evidence persuasively weighs against the Veteran. As such, the benefit of the doubt doctrine, see 38 U.S.C. § 5107 (b), is for application, and the claim for service connection for left ear hearing loss is denied. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

REASONS FOR REMAND

Entitlement to service connection for right ear hearing loss is remanded.

As stated above, the Veteran contends his bilateral hearing loss is due to his military service. In order to establish service connection, the Veteran needs to show a current disability, an in-service incurrence, and a nexus between the current disability and his military service.

Under the Appeals Modernization Act (AMA), the Board is bound by favorable findings by the AOJ unless rebutted by evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c). With respect to the Veteran's claim of entitlement for right ear hearing loss, the RO made favorable findings that: (1) the Veteran has sensorineural hearing loss in his right ear and a current disability for VA purposes; (2) the evidence shows a qualifying event, injury, or disease that had onset during service as the Veteran served as a DG-9720 and therefore exposure to hazardous noise is conceded; and (3) participation in a toxic exposure risk activity is conceded as well. See January 2025 Rating Decision - Narrative.

As elements one and two of service connection for right ear hearing loss has been met, the remaining question before the Board is whether the Veteran's hearing loss is related to his military service.

Under the Appeals Modernization Act (AMA), once the RO issues a decision on the claim, the Board does not have a duty
) the Veteran has sensorineural hearing loss in his right ear and a current disability for VA purposes; (2) the evidence shows a qualifying event, injury, or disease that had onset during service as the Veteran served as a DG-9720 and therefore exposure to hazardous noise is conceded; and (3) participation in a toxic exposure risk activity is conceded as well. See January 2025 Rating Decision - Narrative.

Under the Appeals Modernization Act (AMA), once the RO issues a decision on the claim, the Board does not have a duty to assist but can remand an issue for a pre-decisional duty to assist error. 38 C.F.R. § 3.151(d).

When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 311.

The Board notes in March 2020 hearing examination, the RO did not request an etiology opinion for hearing loss. As such, the only etiology opinions of record are from January 2025.

The VA examiner opined it is less likely than not that the Veteran's right ear hearing loss is due to his military service. The examiner stated the Veteran's hearing results during service were normal at all frequencies with no decrease in high-frequency thresholds. The examiner noted that a high-frequency threshold shift is an early sign of acoustic trauma and high-level continuous sound can result in severe noise overdose according to medical literature. Finally, the examiner noted the Veteran's ENT treatment records from June 2017 reported sudden hearing loss occurring in 2017 consistent with labyrinthitis, right ear. The Board notes the VA examiner inadvertently provided a final opinion stating left ear but in a May 2025 addendum corrected his opinion to reflect his opinion was about the Veteran's right ear.

The VA examiner also opined that the Veteran's right ear hearing loss was less likely than not caused by the indicated toxic exposure risk activity after considering the total potential exposure through all applicable military deployments of the Veteran and the synergistic, combined effect of all toxic exposure risk activities of the Veteran. The Veteran was exposed to radiation therapy. The examiner stated in reviewing the records there was no risk factors outside of military service and no treatment was received for the condition specifically claimed as related to the TERA including outpatient treatment, hospitalization, or evaluations by a specialist. He noted hearing loss is not presumed by regulation to result from radiation exposure and there is no competent medical evidence that relates hearing loss to radiation.

The Board finds that the direct service connection medical opinion is inadequate and less than probative. The examiner did not discuss why having normal hearing in the military or high frequency changes in 2017 is a significant factor, identify an alternative etiology, or address the possibility of delayed-onset hearing loss. In addition, the examiner based the lack of threshold shifts in service which is an inadequate rationale. Hensley, 5 Vet. App. At 159.

The matters are REMANDED for the following action:

Obtain a medical opinion from a qualified VA examiner regarding the Veteran's claim for service connection for right ear hearing loss. The entire claims file and a copy of this Remand should be made available to and reviewed by the examiner in conjunction with the opinion. If the examiner believes that an in-person audiology examination is warranted, then schedule the Veteran for a full VA audiology examination.

Based on a complete review of the claims file, the examiner is asked to render an opinion as to whether the Veteran's current right ear hearing loss is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) related to active service, including his reported in-service noise exposure. In providing this opinion, the examiner should consider the evidence noted in the narrative portion of this Remand above.

The examiner must discuss the possibility of delayed-onset hearing loss and may not rely solely on normal audiometric findings to support the opinion. The examiner should also consider the Veteran is service connected for tinnitus.

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In rendering the above opinion, the examiner is advised that the mere absence of in-service evidence of hearing loss is not fatal to a service connection claim. See Ledford v. Derwinski, 3 Vet. App. 87, 89. Evidence of a current hearing loss disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting
-onset hearing loss and may not rely solely on normal audiometric findings to support the opinion. The examiner should also consider the Veteran is service connected for tinnitus.

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In rendering the above opinion, the examiner is advised that the mere absence of in-service evidence of hearing loss is not fatal to a service connection claim. See Ledford v. Derwinski, 3 Vet. App. 87, 89. Evidence of a current hearing loss disability and a medically sound basis for attributing that disability to service may serve as a basis for a grant of service connection for hearing loss where there is credible evidence of acoustic trauma due to significant noise exposure in service, post-service audiometric findings meeting the regulatory requirements for hearing loss disability for VA purposes, and a medically sound basis upon which to attribute the post-service findings to the injury in service. See Hensley v. Brown, 5 Vet. App. 155.

JIMMY L. BARDIN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Bond, Tyana N.

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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