Service connection for bilateral hearing loss is granted.

Citation Nr: A26069916 Decision Date: 07/30/26 Archive Date: 07/30/26 DOCKET NO. 220323-230098 DATE: July 30, 2026 ORDER Service connection for bilateral hearing loss is granted. Service connection for thoracolumbar spine disability is granted. Service connection for a left knee disability is granted. FINDINGS OF FACT 1. The Veteran's bilateral hearing loss for VA purposes is related to his in-service noise exposure. 2. The Veteran's thoracolumbar spine disability is related to active service. 3. The Veteran's left knee disability is related to active service. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss are met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a thoracolumbar spine disability are met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for a left knee disability are met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from May 1983 to August 1983 and addition Reserve service. This matter comes before the Board of Veterans' Appeals (Board) from a December 7, 2021 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran timely appealed this decision to the Board in March 2022 by filing a VA Form 10182 Notice of Disagreement (NOD) in which he selected the Board's hearing docket. As the Veteran selected the Board's Hearing docket, the evidence for consideration by the Board is evidence of record at the time of the December 7, 2021 rating decision and any evidence submitted at the hearing on December 9, 2024 or within 90 days following the hearing which is March 10, 2025. 38 C.F.R. § 20.302(a). If the Veteran submitted evidence that was added to the record after the June 7, 2021 rating decision and before the September 15, 2025 Board hearing, or more than 90 days following the Board hearing, the Board did not consider it. If the Veteran wishes to have VA consider any evidence that was not considered, a supplemental claim should be submitted identifying such evidence. See 38 C.F.R. § 3.2501. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 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). 1. Entitlement to service connection for bilateral hearing loss The Veteran contends that his diagnosed bilateral hearing loss disability is related to active-duty noise exposure. Favorable findings noted on the rating decision on appeal consist of the Veteran having a diagnosis of bilateral hearing loss under the VA criteria per a November 2021 VA examination and hazardous noise exposure during active service being established due to the Veteran's MOS of watercraft operator. A review of the Veteran's service treatment records shows no diagnosis or indications of bilateral hearing loss. A November 2021 VA hearing loss disability benefits questionnaire (DBQ) shows that the Veteran was diagnosed with bilateral hearing loss under the VA hearing loss criteria. The VA examiner noted that the Veteran's in-service audiograms were normal and he was not diagnosed with hearing issues until 2013. The VA examiner opined that it was less likely than not that the Veteran's bilateral hearing loss was related to active-duty noise exposure. The VA examiner's rationale included that there was no evidence found during the Veteran's active-duty time, and therefore an opinion could not be provided and mere speculation would be required. An August 2025 private examination report shows that the private examiner noted the Veteran's service as a watercraft operator that carried a high risk of acoustic trauma. The private examiner noted that Veteran's active and reserve service, corroborated in-service hazardous noise exposure, and self-reports from the Veteran regarding onset of hearing loss, that it was at least as likely as not that the disability was caused by active duty and active duty for training warranting service connection. The private examiner also cited to medical literature to support the provided opinion and rationale. Initially, the Board notes that the VA examination report of record is speculative and of no probative value. Here, the VA examiner based the opinion only on the absence on in-service documented hearing loss. Additionally, the VA examiner specifically reported that speculation was required to provide an opinion. In contrast, the Board finds the August 2025 private opinion to be the most probative evidence of record. In this regard, the Board finds that the August 2025 private examiner considered all pertinent evidence of record, to include the Veteran's statements and his relevant medical history, and provided complete rationales, relying on and citing to the records reviewed. Moreover, the opinions include clear conclusions with supporting data, as well as reasoned medical explanations connecting the two. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). As such, the Board finds that three elements required for service connection has been met. Accordingly, the Board finds that service connection bilateral hearing loss is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 2. Entitlement to service connection for thoracolumbar spine disability The Veteran generally contends that service connection for a thoracolumbar spine disability is warranted due to his general duties during active service. For example, On the Veteran's June 2021 claim he reported that pulling cables resulted in the herniated disc which onset in 1992. The Veteran testified before the undersigned Veterans Law Judge that his duties on boats in choppy water resulted in lots of falls, slips, and lifting. He also reported pulling ropes resulted in the back disability. The Veteran testified that he started to notice his back acting up in the 1990s and received a diagnosis of herniated disc in 1993 or 1994. A June 2024 private treatment record noted that the Veteran sought medical care for his back as he had been experiencing lower back pain since being tackled while refereeing a football game eight months prior in October 2023. The Veteran was diagnosed with bulging disc via x-rays. An August 2025 private examination report shows that the private examiner reported that the Veteran did not recall a specific incident but attributed his back disability to cumulative musculoskeletal strains. The private examiner noted that the Veteran was first diagnosed with degenerative disc disease around 2002 to 2004. The private examiner noted that during the Veteran's active-duty training as a watercraft operator, he was subjected to repeated heavy physical training, long-distance jogging, and frequent lifting, all of which imposed cumulative stress on his spine. Although no single traumatic injury was documented, the repetitive musculoskeletal strain inherent in his duties was a well -recognized mechanism for the gradual development of degenerative disc disease. The private examiner noted that the Veteran credibly reported that he first noticed worsening back problems in the early 2000s, when diagnostic imaging confirmed lumbar degeneration. The private examiner reported that the delayed onset was consistent with the natural progression of cumulative spinal trauma, which may remain silent for years before becoming symptomatic. Taken together, the medical evidence, credible lay history, and service duties were determined by the private examiner to demonstrate that the Veteran's back disability is at least as likely as not related to the physical strain of his active duty and reserve service, warranting service connection. The private examiner cited to medical literature to support the positive nexus opinion. The Board finds the August 2025 private opinion to be the most probative evidence of record and persuasively favors that the thoracolumbar spine disability was related to active service. In this regard, the Board finds that the August 2025 private examiner considered all pertinent evidence of record, to include the Veteran's statements and his relevant medical history, and provided complete rationales, relying on and citing to the records reviewed. Moreover, the opinion include a clear conclusions with supporting data, as well as reasoned medical explanations connecting the two. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301-04 (2008) (stating that it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions."). As such, the Board finds that three elements required for service connection has been met. The Veteran has been diagnosed with a thoracolumbar spine disability, he has credibly reported in-service duties that caused back pain, and the private examiner has provided a positive nexus opinion of record. Additionally, there are no other medical examination report of record. Accordingly, the Board finds that service connection for a thoracolumbar spine disability is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. 3. Entitlement to service connection for a left knee disability The Veteran generally contends that service connection for left knee disability is warranted due to his physical duties to include jogging during active service. An August 2025 private examination report shows the Veteran reported injuring his knee during annual training in Virginia in approximately 1985-1986, when he sustained a twisting injury to his left knee while participating in physical training. The Veteran reported immediate pain and swelling, which improved temporarily with rest but never fully resolved. The Veteran reported that over time, his knee pain and functional limitations progressively worsened, with intermittent flares aggravated by jogging, lifting, and prolonged activity. The private examiner reported that the natural history of untreated twisting injuries of the knee often involving meniscal or ligamentous damage commonly progresses to chronic instability and degenerative joint disease. The private examiner reported that the Veteran's duties as a watercraft operator involved frequent lifting, cable pulling, and strenuous PT drills, which imposed additional repetitive stress and aggravated his condition. The private examiner reported that based on the credible lay evidence of an in-service injury, the consistency of his reported progression, and the medical plausibility of trauma-induced degenerative change, it is at least as likely as not that the Veteran's current left knee disability began with his 1986 service injury and was aggravated by years of Reserve training. The Board finds the August 2025 private opinion to be the most probative evidence of record and persuasively favors that the left knee disability was related to active service. In this regard, the Board finds that the August 2025 private examiner considered all pertinent evidence of record, to include the Veteran's statements and his relevant medical history, and provided complete rationales, relying on and citing to the records reviewed. Moreover, the opinions include clear conclusions with supporting data, as well as reasoned medical explanations connecting the two. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). As such, the Board finds that three elements required for service connection has been met. The Veteran has been diagnosed with a left knee disability, he has credibly reported in-service duties that caused knee pain, and the private examiner has provided a positive nexus opinion of record. Additionally, there are no other medical examination report of record. Accordingly, the Board finds that service connection for a left knee disability is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Paul Sorisio Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Dworkin 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.