Sensorineural Hearing Loss
Hazardous military noise exposure (weapons, aircraft, armor, blast) and noise-induced sensorineural hearing loss in service members.
38 CFR diagnostic code 6100
Peer-reviewed evidence (5)
The verified studies behind a Sensorineural Hearing Loss claim — each links to its real PubMed or DOI record. These are sources our nexus drafts can draw from; none are invented.
- Pfannenstiel TJ. Noise-induced hearing loss: a military perspective. Curr Opin Otolaryngol Head Neck Surg. 2014;22(5):384-7. PMID:25188428. doi:10.1097/MOO.0000000000000083.
- Alamgir H, Turner CA, Wong NJ, Cooper SP, Betancourt JA, Henry J, Senchak AJ, Hammill TL. The impact of hearing impairment and noise-induced hearing injury on quality of life in the active-duty military population: challenges to the study of this issue. Mil Med Res. 2016;3:11. PMID:27076916. doi:10.1186/s40779-016-0082-5.
- Reavis KM, McMillan GP, Carlson KF, Joseph AR, Snowden JM, Griest S, Henry JA. Occupational Noise Exposure and Longitudinal Hearing Changes in Post-9/11 US Military Personnel During an Initial Period of Military Service. Ear Hear. 2021;42(5):1163-1172. PMID:33974789. doi:10.1097/AUD.0000000000001008.
- McIntire A, Miller T, Thapa S, Joseph A, Carlson KF, Reavis KM, Hughes CK. Blast Exposure Associations With Hearing Loss and Self-Reported Hearing Difficulty. Otolaryngol Head Neck Surg. 2024;171(5):1370-1378. PMID:38984918. doi:10.1002/ohn.890.
- Orru H, Luha A, Pindus M, Jõgeva R, Vahisalu M, Lekk U, Indermitte E, Merisalu E. Hearing loss among military personnel in relation to occupational and leisure noise exposure and usage of personal protective equipment. Noise Health. 2020;22(107):90-98. PMID:33402609. doi:10.4103/nah.NAH_12_19.
Controlling law
The CFR sections and cases the theories relevant to this condition rest on — the legal standard raters evaluate against, never a prediction about any claim.
Direct (§ 3.303)
Regulation
38 C.F.R. § 3.303
Direct service connection — a current disability linked to service. (Continuity of symptomatology under § 3.303(b) is limited by case law to the § 3.309(a) chronic diseases — Walker.)
Case law
Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004)
The three-element test: current disability, in-service event, and a nexus between them.
Holton v. Shinseki, 557 F.3d 1363 (Fed. Cir. 2009)
Federal Circuit restatement of the same three direct-service-connection elements.
Caluza v. Brown, 7 Vet. App. 498 (1995)
The evidentiary framework a rater weighs each element against.
Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013)
Continuity of symptomatology (§ 3.303(b)) is available ONLY for a chronic disease listed in § 3.309(a); any other condition must use the medical-nexus pathway.
Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009)
A categorical 'a medical opinion is always required for nexus' is legal error — competent lay evidence can suffice.
Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465 (1994)
A veteran is competent to report symptoms they personally observe (Layno), and lay evidence can even establish a simple diagnosis in the right case (Jandreau).
McLendon v. Nicholson, 20 Vet. App. 79 (2006)
A LOW threshold — evidence that merely indicates a nexus MAY exist obligates VA to provide a C&P exam.
38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990)
When the evidence is in relative equipoise, the tie goes to the veteran — the preponderance must be AGAINST the claim to deny it.
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