Entitlement to service connection for bilateral hearing loss is granted.

Citation Nr: 26001382 Decision Date: 01/30/26 Archive Date: 01/30/26 DOCKET NO. 18-05 899 DATE: January 30, 2026 ORDER Entitlement to service connection for bilateral hearing loss is granted. Entitlement to service connection for a vision disorder is denied. REMANDED Entitlement to service connection for fibromyalgia is remanded. Entitlement to service connection for a lumbar spine disorder is remanded. FINDINGS OF FACT 1. Resolving doubt in the Veteran's favor, the Veteran's hearing loss began during active service and has had continuity of symptomatology since. 2. The evidence is persuasively against finding that the Veteran has a vision disorder related to an in-service injury, event, or disease. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385. 2. The criteria for entitlement to service connection for a vision disorder have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the Air Force from November 1980 to November 1985. The claim for service connection for bilateral hearing loss comes before the Board of Veterans' Appeals (Board) from a June 2017 decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran has not requested a Board hearing. The matter has come before the Board previously, most recently in October 2024, when the Board remanded for additional evidentiary development. The RO has substantially complied with the Board's remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). In February 2025, the RO issued a supplemental statement of the case (SSOC), and the matter now returns to the Board. The other claims come before the Board from a May 2018 decision by the RO. The Veteran has not requested a Board hearing. These matters were previously before the Board in December 2022, when the Board remanded for additional evidentiary development. Except as specifically noted below, the RO has substantially complied with the Board's remand directives. See Stegall, 11 Vet. App. at 271. In August 2024, the RO issued an SSOC, and the matters now return to the Board. The Veteran has waived RO consideration of any evidence associated with the claims file after the August 2024 and February 2025 SSOCs. Service Connection Generally, service connection requires: (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. See Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may also be granted for any disease diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Sensorineural hearing loss, as an organic disease of the nervous system, is a chronic disease under 38 C.F.R. § 3.309(a). See Fountain v. McDonald, 27 Vet. App. 258, 271 (2015). Where a chronic disease is shown as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected unless clearly attributable to intercurrent causes. 38 C.F.R. § 3.303(b). Service connection may also be granted where there is continuity of symptomatology linking a current chronic disease and a chronic disease in service. 38 C.F.R. §§ 3.303(b), 3.309; Walker v. Shinseki, 708 F.3d 1331, 1336 (Fed. Cir. 2013). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154(a). Lay testimony is competent to prove that a claimant exhibited certain lay-observable symptoms and the time that those symptoms appeared. Layno v. Brown, 6 Vet. App. 465, 470 (1994). Lay evidence cannot be determined to be not credible merely because it is unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). In determining the probative value to be assigned to a medical opinion, the Board must consider three factors: whether a medical expert was fully informed of the pertinent factual premises (i.e., medical history) of the case; whether the medical expert provided a fully articulated opinion; and whether the opinion is supported by a reasoned analysis. The most probative value of a medical opinion comes from its reasoning. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-04 (2008). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of the matter, the benefit of the doubt will be given to the appellant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776, 777-79 (Fed. Cir. 2021). 1. Entitlement to service connection for bilateral hearing loss The Veteran asserts entitlement to service connection for bilateral hearing loss, which he contends is related to in-service exposure to noise from jet engines and computer systems. For the following reasons, service connection is granted. The first element of service connection is met. The Veteran has been diagnosed with bilateral sensorineural hearing loss, and audiometric testing confirms that the Veteran's hearing impairment meets the requirements of 38 C.F.R. § 3.385. The second element of service connection is also met. The Veteran's reports of exposure to noise from jet engines and computer systems are competent, credible, and consistent with the circumstances of his service. In any event, VA conceded military noise exposure in a June 2023 RO decision granting service connection for tinnitus. As to the third element, a nexus, there is evidence both for and against the Veteran's claim. In favor of the Veteran's claim are statements from the Veteran. In an April 2012 written statement, the Veteran reported that his hearing "difficulty" began while stationed at Eglin Air Force Base and continued thereafter. The Veteran similarly reported at a May 2012 VA medical examination that his hearing loss began in 1982, during active service. In a November 2018 claim, the Veteran reported that his hearing loss began between 1981 and 1984, again during active service, due to being near jets and computer noise. The Veteran is competent to prove that he exhibited certain lay-observable symptoms, such as hearing impairment, and the time that those symptoms appeared. Layno, 6 Vet. App. at 470. These statements from the Veteran are facially credible. And these statements tend to show that the Veteran's hearing loss began prior to separation from active service and has continued since that time. There is also evidence against the Veteran's claim. Specifically, a May 2012 VA examiner opined that the Veteran's hearing was within normal limits at separation from service and showed no significant worsening from enlistment. The examiner further opined that hearing loss due to noise exposure occurs at the time of exposure, not subsequently. Similarly, in September 2024 and November 2024, VA examiners opined that the Veteran experienced no significant audiometric shift in service, that hearing loss due to noise exposure was immediate in onset, and that the Veteran's present hearing loss was thus not related to service. However, the absence of documented hearing loss while in service is not fatal to a claim for service connection. Ledford v. Derwinski, 3 Vet. App. 87, 89 (1992). Additionally, a threshold shift in hearing is not necessary for entitlement to service connection for hearing loss. See id. Considering the record as a whole, the evidence is in at least approximate balance as to when the Veteran's hearing loss began. Resolving doubt in the Veteran's favor, the Veteran's hearing loss began in service and has had continuity of symptomatology since that time. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch, 21 F.4th at 777-79. Thus, service connection is granted. 2. Entitlement to service connection for a vision disorder The Veteran asserts entitlement to service connection for a vision disorder. Specifically, the Veteran contends that, due to eye strain in service, his vision has deteriorated, requiring him to use reading glasses and possibly prescription glasses. For the following reasons, service connection is denied. As an initial matter, refractive error of the eye is not a disease or injury subject to service connection. 38 C.F.R. § 3.303(c). Thus, to the extent the Veteran seeks service connection for deteriorating vision requiring eyeglasses, the claim must be denied. However, the Veteran has also been diagnosed with and treated for allergic conjunctivitis, and a VA examiner has clarified that this disability is not an error of refraction or a congenital defect. Thus, the Veteran has a present disability of the eyes. That said, service connection is denied, as the evidence is persuasively against a finding that the Veteran's allergic conjunctivitis is related to service. In May 2023, a VA medical examiner opined that the Veteran's allergic conjunctivitis was less likely than not due to service because allergic conjunctivitis is due to environmental allergens, not injury or trauma such as the Veteran's claimed eye strain. This opinion merits great probative weight. The examiner reviewed the complete medical evidence of record and issued an opinion with a rationale grounded in medical knowledge about the etiology of the Veteran's diagnosed eye disability. Moreover, no competent medical source has offered a contrary opinion. The Board recognizes the Veteran's assertion that his tension headaches are 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. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). The evidence is thus persuasively against finding that the Veteran's tension headaches were incurred in or are otherwise related to service. As 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, 21 F.4th at 777-79. Service connection is denied. REASONS FOR REMAND 1. Entitlement to service connection for fibromyalgia is remanded. The Veteran asserts entitlement to service connection for fibromyalgia, on a direct basis or as secondary to his (not presently service-connected) lumbar spine disorder or his service-connected major depressive disorder. Unfortunately, the Board is unable to grant service connection at this time. No competent medical source has opined that the Veteran has a present disability of fibromyalgia that is related to service or was caused or aggravated by a service-connected disability. And the determination of whether a nexus exists requires medical expertise that the Board may not exercise in the first instance. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). Nor can service connection be granted based on chronicity or continuity of symptomatology, as fibromyalgia is not a chronic disease listed in 38 C.F.R. § 3.309(a). That said, remand is required to obtain an adequate VA medical opinion. When VA undertakes to obtain an examination, it must ensure that the examination is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). In this case, the September 2023 VA examiner opined, on review of the record and examination of the Veteran, that the Veteran had trigger points but that his symptoms did not qualify for a diagnosis of fibromyalgia. However, treatment records repeatedly document a diagnosis of fibromyalgia, with an April 2007 note specifically documenting a deep pain response to all trigger points in the neck, back, arms, and thighs, warranting a fibromyalgia diagnosis. In opining that the Veteran did not meet the criteria for a fibromyalgia diagnosis, the examiner did not acknowledge or address such treatment records. Remand is therefore warranted for an addendum opinion. 2. Entitlement to service connection for a lumbar spine disorder is remanded. The Veteran asserts entitlement to service connection for a lumbar spine disorder, contending that he experiences residuals of an in-service back injury sustained in 1982. Unfortunately, the Board is unable to grant service connection at this time. No competent medical source has opined that the Veteran's lumbar spine disorder is related to service. And the determination of whether a nexus exists requires medical expertise that the Board may not exercise in the first instance. See Colvin, 1 Vet. App. at 175. Although the Veteran has been diagnosed with arthritis, a chronic disease listed in 38 C.F.R. § 3.309(a), the present record does not support a finding that this disability was noted as chronic in service or has had continuity of symptomatology since service. That said, remand is warranted to obtain outstanding records. The Veteran has reported making a Workers' Compensation claim in connection with a January 2003 back injury sustained while working in construction. In the December 2022 remand, the Board concluded that records from this claim would be relevant by clarifying the Veteran's diagnoses and ongoing symptomatology. Thus, the Board remanded for the RO to obtain these records. The RO attempted to obtain the Workers' Compensation records. In August 2023, the RO asked the Veteran to sign a release for these records, and in October 2023, November 2023, and December 2023 the RO requested these records from the Ohio Bureau of Workers' Compensation. In January 2024 and February 2024, the RO informed the Veteran that a different release was required by the Ohio Bureau or Workers' Compensation and requested that he complete this release. In March 2024, the Ohio Bureau of Workers' Compensation advised the RO that the Veteran had not completed the form in its entirety, and in June 2024 the RO requested that the Veteran submit a complete form so that the records could be obtained. The Veteran does not appear to have responded to this request. The RO substantially complied with the Board's prior remand directives by making reasonable efforts to obtain the Workers' Compensation records. However, these records are relevant to this claim, and no VA medical examiner has reviewed these records in opining as to the nature, severity, and etiology of the Veteran's lumbar spine condition. To ensure full and fair consideration of the Veteran's claim, remand is warranted for another attempt to obtain these records and, if they are obtained, for an addendum opinion addressing them. That said, the Veteran is reminded that VA's duty to assist is a two-way street. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). The matters are REMANDED for the following action: 1. Obtain any outstanding VA and private treatment records and associate them with the claims file. 2. Obtain an addendum opinion from an appropriate clinician to determine the nature, severity, and etiology of the Veteran's claimed fibromyalgia. An examination should only be scheduled if the clinician deems one is necessary to provide the requested opinions. The examiner should opine as to whether the Veteran has a present disability of fibromyalgia and, if so: (a.) Is the Veteran's fibromyalgia at least as likely as not related to an in-service event, injury, or disease? (b.) Is or was the Veteran's fibromyalgia at least as likely as not caused by the Veteran's service-connected major depressive disorder? (c.) Is or was the Veteran's fibromyalgia at least as likely as not aggravated by the Veteran's service-connected major depressive disorder? If the examiner concludes that the Veteran does not have a present disability of fibromyalgia, the examiner should address and explain the inconsistency between such a conclusion and the records of diagnosis of fibromyalgia, including an April 2007 notation of deep pain response to all trigger points in the neck, back, arms, and thighs. A rationale for all opinions must be provided. If the examiner cannot provide an opinion without resort to speculation, he or she must explain why an opinion cannot be provided (e.g., lack of sufficient information or evidence, the limits of medical knowledge, etc.). 3. Request that the Veteran submit a properly completed Consent to Release Information for the Ohio Bureau of Workers' Compensation in connection with his 2003 claim for a work-related back injury. Upon receipt of a completed consent, make two requests for the authorized records from the Ohio Bureau of Workers' Compensation unless it is clear after the first request that a second request would be futile. All attempts to obtain such records should be documented in the file. 4. After the development in #3, if the Ohio Bureau of Workers' Compensation records have been obtained, associate them with the claims file and forward the claims file to a qualified clinician to offer an addendum opinion regarding the nature, severity, and etiology of the Veteran's lumbar spine condition. An examination should only be scheduled if the clinician deems one is necessary to provide the requested opinions. The examiner should identify each diagnosed disability of the lumbar spine and, for each such disability, opine whether the disability is at least as likely as not related to an in-service event, injury, or disease, to include the Veteran's 1982 in-service back injury. A complete rationale must be provided for any opinion expressed. If any requested opinion cannot be provided without resorting to mere speculation, then the examiner should explain why this is so, specifically addressing whether the inability to provide an opinion stems from not having sufficient information/evidence or the limits of medical knowledge. D. SMART Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Mansfield, Associate 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.