Citation Nr: 0309432 Decision Date: 05/21/03 Archive Date: 05/27/03 DOCKET NO. 02 00 004A ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida THE ISSUE Entitlement to service connection for Meniere's disease. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD W. Yates, Counsel INTRODUCTION The veteran served on active duty from April 1952 to April 1956. This case comes to the Board of Veterans' Appeals (Board) from a March 2000 RO decision which denied service connection for Meniere's disease. FINDINGS OF FACT The veteran is currently service connected for ear problems including otitis externa, hearing loss, and tinnitus. He now has diagnosed Meniere's disease which is medically associated with his service-connected ear problems. CONCLUSION OF LAW Meniere's disease is proximately due to or the result of a service-connected disability. 38 C.F.R. § 3.310 (2002). REASONS AND BASES FOR FINDINGS AND CONCLUSION The present claim on appeal is service connection for Meniere's disease. Prior final RO and Board decisions denied service connection for episodes of unsteadiness or dizziness. The Board will treat the claim for service connection for Meniere's disease as a new claim. If the Meniere's claim is viewed as the same as the prior claim concerning episodes of unsteadiness or dizziness, there is nonetheless new and material evidence to reopen the claim, and the Meniere's claim may be reviewed on a de novo basis. See 38 U.S.C.A. §§ 5108, 7104, 7105; 38 C.F.R. § 3.156; Manio v. Derwinski, 1 Vet.App. 140 (1991). Under the circumstances of this case, there has been adequate compliance with the notice and duty to assist provisions of the law. 38 U.S.C.A. §§ 5103, 5103A; 38 C.F.R. § 3.159. The veteran served on active duty from April 1952 to April 1956. During service he was treated for otitis externa of the ears. In March 1956 he was treated for a syncopal attack of questionable etiology. His April 1956 separation examination noted that two weeks earlier he had been seen for a fainting episode and no organic disease was found. A January 1966 RO decision granted service connection for otitis externa. Hearing loss and tinnitus is first medically shown years after service. An April 1994 Board decision granted secondary service connection for hearing loss and tinnitus (as due to otitis externa). Episodes of dizziness and similar symptoms are shown in medical records from years after service. A September 1999 VA audiology examination noted the veteran's ongoing problems with hearing loss and tinnitus. The doctor at an October 1999 VA ear examination commented that with the veteran's history of progressive hearing loss and with his tinnitus, he may have had Meniere's disease; the current diagnosis at this examination was Meniere's syndrome. In support of his claim, the veteran has submitted medical records and opinions from M. Patete, M.D. When the veteran was seen by this doctor in July 2000, the diagnoses were otitis externa, hearing loss, and Meniere's syndrome. These diagnoses are shown in later treatment letters from this doctor. In a July 2000 letter, Dr. Patete opined that the veteran's Meniere's disease developed from his longstanding ear problems over the course of years. In an April 2001 letter, the doctor said the veteran had Meniere's syndrome by history and physical examination, and this may have been present since 1953. In a January 2002 letter, Dr. Patete indicated that the veteran has had hearing loss and Meniere's disease since 1953. These letters noted that this was documented on an examination report dated in 1953. The Board notes it is unclear what particular 1953 document the doctor was referring to. Service connection may be granted for disability due to a disease or injury which was incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303. Secondary service connection may be granted for a disability which is proximately due to or the result of a service- connected disorder. 38 C.F.R. § 3.310(a). Secondary service connection may be found in certain instances in which a service-connected disability aggravates another condition. When aggravation of a veteran's non-service-connected condition is proximately due to or the result of a service- connected condition, the veteran shall be compensated for the degree of disability (but only that degree) over and above the degree of disability existing prior to the aggravation. Allen v. Brown, 7 Vet.App. 439 (1995). The Board notes that the opinions of Dr. Patete could be better in describing supporting evidence. Yet this doctor does appear to be a qualified specialist and provided some reason for his belief that the veteran's Meniere's disease either had been present since service or resulted from his other ear problems. The file contains some historical medical evidence to buttress the private medical opinion, especially along the lines of secondary service connection. After reviewing all the medical evidence from service and since then, there appears to be a reasonable basis for finding that even though Meniere's syndrome was not found until years after service, it developed in connection with the already service-connected ear problems of otitis media, hearing loss, and tinnitus. With application of the benefit- of-the-doubt rule, 38 U.S.C.A. § 5107(b), the Board finds that the veteran's Meniere's disease is due to his service- connected ear problems. Meniere's disease is proximately due to or the result of a service-connected disability, and secondary service connection for Meniere's disease is warranted. ORDER Service connection for Meniere's disease is granted. _________________________________________________ L.W. TOBIN Veterans Law Judge, Board of Veterans' Appeals IMPORTANT NOTICE: We have attached a VA Form 4597 that tells you what steps you can take if you disagree with our decision. We are in the process of updating the form to reflect changes in the law effective on December 27, 2001. See the Veterans Education and Benefits Expansion Act of 2001, Pub. L. No. 107-103, 115 Stat. 976 (2001). In the meanwhile, please note these important corrections to the advice in the form: ? These changes apply to the section entitled "Appeal to the United States Court of Appeals for Veterans Claims." (1) A "Notice of Disagreement filed on or after November 18, 1988" is no longer required to appeal to the Court. (2) You are no longer required to file a copy of your Notice of Appeal with VA's General Counsel. ? In the section entitled "Representation before VA," filing a "Notice of Disagreement with respect to the claim on or after November 18, 1988" is no longer a condition for an attorney-at-law or a VA accredited agent to charge you a fee for representing you.