Citation Nr: 18146046
Decision Date: 10/30/18	Archive Date: 10/30/18

DOCKET NO. 17-07 320
DATE:	October 30, 2018
REMANDED
Entitlement to service connection for Meniere's Disease, to include as secondary to service-connected hearing loss and tinnitus, is remanded.
Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU), is remanded.
REASONS FOR REMAND
The Veteran served on active duty from August 1965 to August 1969
1. Entitlement to service connection for Meniere's Disease, to include as secondary to service-connected hearing loss and tinnitus, is remanded.
The Veteran was provided with a VA examination for Meniere’s Disease in July 2013.  The examiner opined that the Meniere’s Disease was not likely caused by service-connected hearing loss and tinnitus.  The examiner did not provide an opinion as to whether the Meniere’s disease was aggravated by service-connected hearing loss or tinnitus.  Further, the examiner did not provide an opinion as to whether the Meniere’s Disease was directly related to service.  In statements, the Veteran has asserted he experienced dizziness beginning in service.  Therefore, the Board finds that a new VA examination is necessary to obtain an adequate opinion.  When VA obtains an examination or opinion, the examination or opinion must be adequate.  Barr v. Nicholson, 21 Vet. App. 303 (2007).  Therefore, remand is necessary to obtain an adequate VA examination.
2. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU), is remanded.
The Veteran has testified that he stopped working due to service-connected disabilities.  The Board finds that a remand is necessary to obtain a medical opinion regarding the impact of all service-connected disabilities on the Veteran’s ability to obtain and maintain employment.  
The matters are REMANDED for the following action:
1. Identify and obtain any outstanding VA and private treatment records that are not already associated with the claims file.
2. Schedule the Veteran for a VA examination with a medical doctor examiner who has not previously examined him to ascertain the nature and etiology of diagnosed Meniere’s Disease.  The examiner must review the claims file, including medical articles submitted by the Veteran, and should note that review in the report.  The rationale for all opinions should be provided.  The examiner should explicitly provide the following opinions:
(a.) Is it at least as likely as not (50 percent or greater probability) that Meniere’s Disease was incurred during service, or is due to any event, disease, or injury during service.  The examiner must address the Veteran’s lay testimony regarding the onset and continuity of symptomology.
(b.) Is it at least as likely as not (50 percent or greater probability) that Meniere’s Disease is due to or the result of a service-connected hearing loss or tinnitus disability?  
(c.) Is it at least as likely as not (50 percent or greater probability) that Meniere’s Disease has been aggravated (permanently increased in severity beyond the natural progression of the disability) by a service-connected hearing loss or tinnitus disability?  
(d.) The examiner should describe the symptoms and effects of all of the service-connected disabilities on employment.  The examiner should opine as to whether, without regard to the Veteran’s age or the impact of any nonservice-connected disabilities, it is at least as likely as not (50 percent probability or greater) that the service-connected disabilities, either separately or in combination, make the Veteran unable to secure or follow a substantially gainful occupation consistent with his education and occupational experience.  If the Veteran is felt capable of work, the examiner should state what type of work and what accommodations would be necessary due to the service-connected disabilities.  The examiner should set forth the complete rationale for all opinions expressed and conclusions reached.
 
Harvey P. Roberts
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	H. Ahmad, Associate Counsel